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1.
Rev Saude Publica ; 54: 41, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32321057

RESUMEN

OBJECTIVE: To describe the sexual behavior of freshmen undergraduate students according to demographic, economic, psychosocial and behavioral characteristics, and evaluate the prevalence of risky sexual behavior and its associated factors. METHODS: A cross-sectional study of the census type with undergraduate students over 18 years old of 80 undergraduate courses of the Universidade Federal de Pelotas (UFPel), in Rio Grande do Sul (RS), who entered in the first semester of 2017 and remained enrolled in the second semester. Undergraduate students who reported having had sex were evaluated. We considered as risky sexual behavior having more than one sexual partner within the last three months and not having used condoms in the last sexual intercourse. RESULTS: The prevalence of risky sexual behavior was 9% (95%CI 7.6-10.5). Men presented more risky behavior than women, with a prevalence of 10.8% and 7.5%, respectively. Of the undergraduate students, 45% did not use condoms in the last sexual intercourse, and 24% had two partners or more within three months before the survey. Smartphone applications for sexual purposes were used by 23% of students within three months before the survey. Risky sexual behavior was associated with gender, age at first sexual intercourse, frequency of alcohol consumption, consumption of psychoactive substances before the last sexual intercourse and use of smartphone applications for sexual purposes. CONCLUSION: Although undergraduate students are expected to be an informed population, the prevalence of risky sexual behavior was important, indicating the need to expand public investment in sexual education and awareness actions.


Asunto(s)
Censos , Conductas de Riesgo para la Salud , Conducta Sexual/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Brasil/epidemiología , Coito/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Factores Sexuales , Conducta Sexual/psicología , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/psicología , Factores Socioeconómicos , Estudiantes/psicología , Adulto Joven
2.
Acta Med Port ; 33(4): 237-245, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32238237

RESUMEN

INTRODUCTION: In Sao Tome and Principe there are no studies on alcohol and drug use among students, who could be potential allies in preventive interventions. The objectives of the present study are 1) to determine the frequency of alcohol and drug consumption in the school population, and 2) to identify the main characteristics associated with this behaviour. MATERIAL AND METHODS: We applied a biographical, demographic and socioeconomic questionnaire on the use of licit and illicit substances to a sample of 2064 students. Demographic and social characteristics are presented based on observed frequencies and comparisons between groups were made using chi-square tests. Significance was assessed at α = 0.05. RESULTS: More than half of the students reported consumed alcohol at least once in their lifetime, and 32% consumed in the last 30 days. Older students were more likely to consume alcohol (p < 0.0001), but even in students under 16 years, 17% consumed in the last 30 days. We also found that 7% consumed one or more times per week in the last 30 days. The reasons presented for frequent consumption were different for boys ("participation in their group of friends") and girls ("decrease anxiety") (p = 0.005). Less than 1% of respondents admitted to having used marijuana, cocaine, crack or ecstasy. DISCUSSION: Despite some limitations, such as self-reporting, we provide a first overview showing high consumption of alcohol by young people and the existence of illegal drugs circulating in the schools. CONCLUSION: It is urgent to implement preventive interventions, namely in the context of public health communication.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Encuestas Epidemiológicas/métodos , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Santo Tomé y Príncipe/epidemiología , Factores Sexuales , Factores Socioeconómicos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Trastornos Relacionados con Sustancias/psicología , Adulto Joven
3.
Accid Anal Prev ; 137: 105428, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32004859

RESUMEN

INTRODUCTION: The threat of application of legal sanctions remains the prominent approach to reduce the prevalence of drink driving in a vast array of motoring jurisdictions. However, ongoing questions remain regarding: (a) the extent that such mechanisms impact upon offending behaviours, (b) the deleterious effect alcohol consumption has on decisions to drink and drive and (c) how best to operationalise (and measure) the concept of drink driving to enhance the accurate measurement of the dependent variable. METHOD: This paper reports on an examination of 773 Queensland motorists' (across nine local government areas) perceptions of both legal and non-legal drink driving sanctions (as well as alcohol consumption) in order to gauge the deterrent impact upon a range of measures of drink driving: the driver thinking they are over the limit, the driver knowing they are over the limit, attempts to evade random breath testing, and intentions to re-offend. The sample completed an online or paper version of the questionnaire. RESULTS: The majority of participants reported "never" engaging in "possible" (74.5 %) or "acknowledged" (83.4 %) drink driving events, although a considerable proportion of the sample reported engaging in "possible" (25.5 %) or "acknowledged" (16.6 %) drink driving and attempting to evade RBT (18 %) events, as well as possible intentions to drink and drive in the future (22 %). Males were more likely to report such events. Perceptions of both legal sanctions (certainty, severity and swiftness) as well as non-legal sanctions (fear of social, internal or physical harm) were relatively high and consistent with previous research. Interestingly, non-legal sanctions were reported as stronger deterrents than legal sanctions. However, multivariate analysis revealed that legal deterrents had limited utility predicting offending behaviours, but rather, demographic characteristics (e.g., younger motorists, males) as well as risky drinking behaviour were better predictors. In regards to intentions to offend, a past conviction for drink driving was also a predictor of re-offending. PRACTICAL APPLICATIONS: These results highlight the ongoing challenges of addressing the problem of drink driving and that some motorists: (a) have entrenched behaviour and/or (b) make the decision to drink and drive before they are under the influence of alcohol.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Conducir bajo la Influencia/psicología , Conducir bajo la Influencia/estadística & datos numéricos , Adulto , Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Toma de Decisiones , Conducir bajo la Influencia/legislación & jurisprudencia , Femenino , Humanos , Intención , Masculino , Persona de Mediana Edad , Prevalencia , Queensland , Asunción de Riesgos , Control Social Formal , Encuestas y Cuestionarios , Adulto Joven
4.
PLoS One ; 15(2): e0229093, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32059050

RESUMEN

AIM: To examine patterns of hazardous, harmful and dependent drinking across different socio-economic groups, and how this relationship may be explained by common mental disorder. METHODS AND FINDINGS: Between 2011-2013, 1,052 participants (age range 17-91, 53% female) were interviewed for Phase 2 of the South East London Community Health study. Latent class analysis was used to define six groups based on multiple indicators of socio-economic status in three domains. Alcohol use (low risk, hazardous, harmful/dependent) was measured using the Alcohol Use Disorders Identification Test and the presence of common mental disorder was measured using the revised Clinical Interview Schedule. Multinomial regression was used to explore associations with hazardous, harmful and dependent alcohol use, including after adjustment for common mental disorder. Harmful and dependent drinking was more common among people in Class 2 'economically inactive renters' (relative risk ratio (RRR) 3.05, 95% confidence interval (CI) 1.07-8.71), Class 3 'economically inactive homeowners' (RRR 4.11, 95% CI 1.19-14.20) and Class 6 'professional renters' (RRR 3.51, 95% CI 1.14-10.78) than in Class 1 'professional homeowners'. Prevalent common mental disorder explained some of the increased risk of harmful or dependent drinking in Class 2, but not Class 3 or 6. CONCLUSIONS: Across distinct socio-economic groups in a large inner-city sample, we found important differences in harmful and dependent drinking, only some of which were explained by common mental disorder. The increased risk of harmful or dependent drinking across classes which are very distinct from each other suggests differing underlying drivers of drinking across these groups. A nuanced understanding of alcohol use and problems is necessary to understand the inequalities in alcohol harms.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Disparidades en el Estado de Salud , Trastornos Mentales/epidemiología , Salud Mental/estadística & datos numéricos , Clase Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/psicología , Estudios Transversales , Femenino , Humanos , Londres/epidemiología , Masculino , Trastornos Mentales/psicología , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
6.
BMC Public Health ; 20(1): 37, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31924194

RESUMEN

BACKGROUND: Alcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12 years and older drink alcohol but don't exceed these recommended limits, yet adult low-risk drinkers have been largely overlooked in Australian alcohol survey research, where they are usually grouped with abstainers. This paper examines the socio-demographic profile of low-risk drinking adults (18+ years old), compared to those who abstain. METHODS: Data from the 2013 National Drug Strategy Household Survey were used. In the past 12 months, 4796 Australians had not consumed alcohol and 8734 had consumed alcohol at low-risk levels, accounting for both average volume and episodic drinking (hereafter low-risk). RESULTS: Multivariate logistic regression results indicated that low-risk drinkers were more likely to be older, married, Australian-born, and reside in a less disadvantaged neighbourhood compared with abstainers. There was no significant difference by sex between low-risk drinkers and abstainers. CONCLUSIONS: The socio-demographic profile of low-risk drinkers differed from that of abstainers. Combining low-risk drinkers and abstainers into a single group, which is often the practice in survey research, may mask important differences. The study may support improved targeting of health promotion initiatives that encourage low-risk drinkers not to increase consumption or, in view of increasing evidence that low-risk drinking is not risk free, to move towards abstinence.


Asunto(s)
Abstinencia de Alcohol/estadística & datos numéricos , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Adolescente , Adulto , Anciano , Australia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
7.
PLoS One ; 15(1): e0227331, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31899781

RESUMEN

The aim of this study was to determine whether there are meaningful subgroups with different types of sexual risk behaviors among youth experiencing homelessness and examine the associations between potential classes and other risk variables. A latent class analysis was used to identify classes of youth according to sexual risk behaviors and sexual assault. A two-class solution was found to be the best fit for the data-Lower and Higher Risk groups. The Higher Risk class had significantly higher levels of synthetic marijuana and alcohol use, mental health diagnoses, and were more likely to have been tested for HIV than the Lower Risk group. Youth were more likely to be in the Higher Risk group if they were cisgender female or lesbian, gay, bisexual, or questioning (LGBQ). Nearly all youth (10/11) who reported having HIV infection were in the Higher Risk group. The Lower Risk group were sexually active but had lower rates of risk behaviors and sexual assault. Youth who were not sexually active had the lowest rates of marijuana and alcohol use as well as HIV testing. Health and social service providers should be aware of the added risks for stress, mental distress, mental health diagnoses, and substance use among youth who also report higher risk sexual behaviors and treat as needed.


Asunto(s)
Infecciones por VIH/epidemiología , Jóvenes sin Hogar , Conducta Sexual/psicología , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/psicología , Sistema de Vigilancia de Factor de Riesgo Conductual , Bisexualidad/psicología , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/virología , Homosexualidad Femenina/psicología , Humanos , Masculino , Tamizaje Masivo , Asunción de Riesgos , Trastornos Relacionados con Sustancias/psicología , Adulto Joven
8.
Public Health ; 178: 49-61, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31614326

RESUMEN

OBJECTIVES: To investigate how various alcohol-drinking behaviours are associated with sociodemographics, lifestyle factors and health status indicators in Brazil. STUDY DESIGN: This study is based on a household survey of 53,034 adults aged 18 + years from all 26 Brazilian capitals and the Federal District conducted in 2017. METHODS: Sex-stratified relationships were modelled using logistic regressions and controlled for capital-specific effects. Main outcome measures included regular alcohol use, weekly alcohol use, heavy episodic drinking (HED), frequent HED and drinking and driving. RESULTS: Overall (unadjusted) prevalence of regular alcohol consumption is 41%. Among drinkers, approximately 70% drink on a weekly basis, and 46% are heavy episodic drinkers. Among this latter group, close to 44% are frequent heavy episodic drinkers (i.e. at least four times in a month). Among regular drinkers who also are drivers, the prevalence of drinking and driving is 28%. These prevalences are considerably higher in men. The relationships investigated vary by drinking behaviour and sex, with some factors consistently associated with various behaviours, when present. Population (men or women) at greatest risk include (largely) younger individuals (up to 700% increase in odds) who are single or divorced, those who are less health conscious and watch television or use mobile devices during leisure time 4 + hours per day and do not have diabetes. For drinking and driving, the additional risk factors include speeding behaviour, the use of mobile devices while driving and HED. Education, race/ethnicity and other health status indicators are differently associated with various drinking behaviours. For women, in particular, the results also show differences in odds of up to 360% and 1430% across cities for frequent HED and drinking and driving, respectively. Similarly, indigenous women are at greatest risk of weekly alcohol use and HED. CONCLUSIONS: HED and drinking and driving are problematic, as the association with other factors suggests a clustering of risky behaviours that may exacerbate the consequences of drinking behaviours.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Femenino , Indicadores de Salud , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
10.
PLoS One ; 14(12): e0226241, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31877166

RESUMEN

A link between adversity, including low socio-economic status, and behaviours which carry health risks, such as alcohol consumption, has often been observed. The causes of this link are, however, poorly understood, making it difficult to explain why the association is often not linear and why there is so much variability between groups and individuals facing similar adversity. We investigate the use of the concept of emergent properties in explaining the link and its non-linear nature. `Emergent properties' arise from the interaction of factors or items in a high-level system which, as a result, has qualities possessed by none of the individual factors. We apply a mixed methods approach to examine the association of an example emergent property, hope, and alcohol consumption among adolescents in a rural South African site. We found that among adolescents living in similar contexts, there was enough variance in reported levels of hope, that an association with alcohol use could be identified. This result is cause for optimism regarding the potential use of emergent properties in explaining variations in risk behaviour. Improving our measurement of emergent properties is perhaps the biggest challenge facing this approach. More work is needed to take further the task of identifying emergent properties capable of distilling the influence of lower level variables into single measures useful for analysis and policy purposes.


Asunto(s)
Conducta del Adolescente/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Asunción de Riesgos , Adolescente , Consumo de Bebidas Alcohólicas/psicología , Femenino , Humanos , Masculino , Investigación Cualitativa , Población Rural , Determinantes Sociales de la Salud , Factores Socioeconómicos , Sudáfrica
11.
J Environ Public Health ; 2019: 3673479, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31885636

RESUMEN

Introduction: Risky alcohol consumption (RAC) and heavy episodic drinking (HED) by parents can have negative effects on their children. At present, little is known about these forms of alcohol consumption among parents in Germany. The aim of this analysis is to estimate the percentage of parents living in Germany who practise RAC and HED and to study associations between these consumption patterns and sociodemographic factors. Material and Methods: The data basis comprises the data of the nationwide studies "Gesundheit in Deutschland aktuell" (GEDA) of 2009, 2010, and 2012. The data were collected by means of computer-assisted telephone interviews (CATI). Our analysis included all participants living in a household with at least one child of their own under 18 years of age (n = 16,224). Information on RAC and HED was collected using the AUDIT-C screening instrument. Logistic regression models were used to study the relationship between parental alcohol consumption and sociodemographic variables. Results: 18.4% of the mothers and 29.6% of the fathers exhibited RAC; 8.4% of the mothers and 21.0% of the fathers practised HED. After mutual adjustment, RAC showed a significant association with the level of education, income (only mothers), employment status (only mothers), migration background, relationship status (only mothers), and the age of the youngest child. HED showed a significant association with income (only mothers), the age of the youngest child (only mothers), and the level of education (only fathers). Conclusions: The presented analysis emphasizes the relevance of preventive measures to reduce parental alcohol consumption. In addition to universal interventions, risk group-specific measures (e.g., for parents with high income) are needed to reduce parental alcohol consumption and thus support a healthy development of children.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Padres/psicología , Asunción de Riesgos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/psicología , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
12.
PLoS One ; 14(12): e0226144, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31887159

RESUMEN

OBJECTIVE: To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMIC). STUDY DESIGN: Pregnant women (n = 1137) enrolled in a South African birth cohort study, the Drakenstein Child Health Study (DCHS) were longitudinally assessed for psychosocial risk factors including depression, psychological distress, alcohol abuse and/or intimate partner violence (IPV). Infants were followed from birth until one year of age for the development of LRTI by active surveillance. Two outcomes were evaluated: any LRTI, and severe and/or hospitalised LRTI. Logistic regression was used to identify associations between individual maternal psychosocial risk factors and LRTI outcomes. Analyses stratified by age were also performed to determine which age groups related to infant LRTI were linked with maternal psychosocial risk factors. RESULTS: There were 606 LRTI episodes in 369 infants in the first year (crude incidence rate = 0.53 episodes per person-year, 95%CI: 0.50; 0.56); 31% (n = 186) of episodes were severe or hospitalised events. Maternal psychosocial risk factors were associated with LRTI and severe LRTI, particularly postnatal and long-term maternal psychological distress, antenatal maternal alcohol consumption, and postnatal maternal IPV. Age stratified analyses found that antenatal maternal alcohol consumption was associated with early infant LRTI, while antenatal maternal depression was linked with infant severe LRTI between 3 and 6 months of age, and postnatal maternal IPV was associated with early LRTI and severe forms of LRTI. CONCLUSION: The associations between maternal psychosocial risk factors and infant LRTI highlight the potential value of screening for maternal psychosocial risk factors in clinical settings and developing targeted interventions. Such interventions may not only improve maternal well-being, but also help reduce the burden of infant LRTI in LMIC settings.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Depresión Posparto/epidemiología , Complicaciones del Embarazo/psicología , Infecciones del Sistema Respiratorio/epidemiología , Adulto , Consumo de Bebidas Alcohólicas/psicología , Estudios de Cohortes , Depresión Posparto/psicología , Países en Desarrollo , Femenino , Humanos , Lactante , Modelos Logísticos , Estudios Longitudinales , Masculino , Edad Materna , Embarazo , Complicaciones del Embarazo/epidemiología , Sudáfrica , Adulto Joven
13.
BMC Public Health ; 19(1): 1684, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31842834

RESUMEN

BACKGROUND: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. METHODS: Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. RESULTS: Almost half of the participants reported ever smoking (44.0%; CI: 40.1-47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2-29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9-30.9) and 19.1% (CI: 16.2-22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8-45.3) were moderately/highly dependent on nicotine. Current 'any tobacco product users' (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5-49.3) while 1.0% (CI: 0.4-2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27-0.41), current smokers (RRR = 0.18; CI: 0.12-0.25), and ATPU (RRR = 0.75; CI: 0.63-0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31-8.25), or current snuff use (RRR = 26.19; CI: 8.32-82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03-1.70), current snuff users (RRR = 1.40; CI: 1.03-1.89) and ATPU (RRR = 1.27; CI: 1.07-1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. CONCLUSION: There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Infecciones por VIH/epidemiología , Tabaquismo/epidemiología , Adolescente , Adulto , Anciano , Antirretrovirales/uso terapéutico , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sudáfrica/epidemiología , Productos de Tabaco/estadística & datos numéricos , Tabaco sin Humo/estadística & datos numéricos , Adulto Joven
15.
Psychiatr Prax ; 46(8): 445-450, 2019 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-31683335

RESUMEN

OBJECTIVE: Substance use patterns and sociodemographic variables of Berlin's party scene were investigated to derive preventive measures and harm reduction services, which meet the needs of the consumers. METHODS: A questionnaire was used online and in the field among Berlin partygoers (N = 877) and structured interviews (N = 20) were conducted with professionals working in this area, including social workers, emergency medical service, police and club owners and users. RESULTS: A risky consumption pattern was found in 67 % of participants, who also stated need for counseling and a wish for reduction of their substance use. Of all preventive measures, drug checking was requested most often. Substances with the highest prevalence were alcohol, cannabis, amphetamine, MDMA, cocaine and ketamine, whereas methamphetamine and new psychoactive substances were barely stated. CONCLUSION: There is an urgent need to expand current preventive measures. There is a willingness of the scene to use according services, especially by those who need it the most.


Asunto(s)
Consumo de Bebidas Alcohólicas , Reducción del Daño , Trastornos Relacionados con Sustancias , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Berlin , Alemania , Humanos , Prevalencia , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología
16.
Behav Ther ; 50(6): 1030-1041, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31735239

RESUMEN

Abstinence self-efficacy, coping skills, and therapeutic alliance are hypothesized mechanisms of behavioral change (MOBCs) in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). However, little is known about when these hypothesized MOBCs change during treatment or in relation to the initiation of abstinence from alcohol, which the current study investigated. Patient-reported abstinence self-efficacy, drinking-related coping skills, and therapeutic alliance were measured at every session throughout a 12-session clinical trial that previously showed equivalent drinking reductions in female-specific individual- and group-based CBT for AUD. Participants (N = 121 women) were classified into subgroups based on whether and when they first initiated 14 days of continuous abstinence from alcohol during treatment. Interrupted time-series analyses evaluated the magnitude and timing of change in MOBC variables in relation to the initiation of abstinence. All three MOBC measures showed gradual improvements throughout treatment (within-subjects d = 0.03 to 0.09 change per week). Participants who initiated abstinence during treatment experienced additional sudden improvements in abstinence self-efficacy (d = 0.47) and coping skills (d = 0.27), but not therapeutic alliance (d = -0.02), the same week they initiated abstinence. Participants who were already abstinent when treatment started maintained higher abstinence self-efficacy and coping skills, but not therapeutic alliance, throughout treatment compared to participants who never initiated abstinence. Initiating abstinence may help facilitate improvements in abstinence self-efficacy and drinking-related coping skills. Clinicians may help patients anticipate when and how much these variables are expected to improve during treatment and encourage initiation of abstinence to potentially help facilitate improvements in abstinence self-efficacy and coping skills.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Alcoholismo/terapia , Terapia Cognitivo-Conductual , Adaptación Psicológica , Adulto , Cognición , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicoterapia de Grupo , Autoeficacia , Resultado del Tratamiento
17.
Psychol Addict Behav ; 33(8): 697-709, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31697091

RESUMEN

Cannabis use has been rising despite recognition of the negative consequences associated with heavy use. The severity of these consequences has been shown to differ across racial/ethnic groups, even when controlling for consumption levels. The present study conducted an item response theory (IRT) analysis of the Cannabis Use Disorders Identification Test (CUDIT) to better understand the patterns of problematic cannabis use and their relation with other substance use across ethnic groups in the Healthy Life in an Urban Setting (HELIUS) study. CUDIT responses from 1,960 cannabis-using African Surinamese, South-Asian Surinamese, Dutch, Moroccan, and Turkish ethnic origin participants were used to test for differential item functioning (DIF) within an IRT framework. After restricting the sample to men because of low frequency of use among women, several instances of uniform DIF were identified. Multiple-group IRT analysis yielded a harmonized cannabis use phenotype that was used to estimate ethnic group differences in problematic cannabis use and its relation to alcohol and tobacco co-use. These analyses suggested that cannabis users from certain ethnic minority groups experienced higher rates of problematic use than the majority group despite lower rates of cannabis use. Further, cannabis and tobacco use were positively related across groups, whereas only ethnic minority groups showed a positive relation between cannabis and alcohol use. These results demonstrate the importance of accounting for DIF when examining group differences in problematic cannabis use, and support prior evidence suggesting that certain ethnic minority groups may be more likely to experience problematic cannabis use and alcohol co-use relative to the majority group. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Fumar Marihuana/psicología , Uso de Tabaco/psicología , Adulto , Consumo de Bebidas Alcohólicas/etnología , Grupos Étnicos , Humanos , Masculino , Fumar Marihuana/etnología , Persona de Mediana Edad , Grupos Minoritarios , Países Bajos , Uso de Tabaco/etnología , Adulto Joven
18.
Pediatrics ; 144(6)2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31744890

RESUMEN

BACKGROUND AND OBJECTIVES: Fetal alcohol spectrum disorders (FASD) comprise the continuum of disabilities associated with prenatal alcohol exposure. Although infancy remains the most effective time for initiation of intervention services, current diagnostic schemes demonstrate the greatest confidence, accuracy, and reliability in school-aged children. Our aims for the current study were to identify growth, dysmorphology, and neurodevelopmental features in infants that were most predictive of FASD at age 5, thereby improving the timeliness of diagnoses. METHODS: A cohort of pregnant South African women attending primary health care clinics or giving birth in provincial hospitals was enrolled in the project. Children were followed longitudinally from birth to 60 months to determine their physical and developmental trajectories (N = 155). Standardized protocols were used to assess growth, dysmorphology, and development at 6 weeks and at 9, 18, 42, and 60 months. A structured maternal interview, including estimation of prenatal alcohol intake, was administered at 42 or 60 months. RESULTS: Growth restriction and total dysmorphology scores differentiated among children with and without FASD as early as 9 months (area under the receiver operating characteristic curve = 0.777; P < .001; 95% confidence interval: 0.705-0.849), although children who were severely affected could be identified earlier. Assessment of developmental milestones revealed significant developmental differences emerging among children with and without FASD between 18 and 42 months. Mothers of children with FASD were significantly smaller, with lower BMIs and higher alcohol intake during pregnancy, than mothers of children without FASD. CONCLUSIONS: Assessment of a combination of growth, dysmorphology, and neurobehavioral characteristics allows for accurate identification of most children with FASD as early as 9 to 18 months.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/psicología , Trastornos del Espectro Alcohólico Fetal/diagnóstico , Trastornos del Espectro Alcohólico Fetal/psicología , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Efectos Tardíos de la Exposición Prenatal/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Preescolar , Estudios de Cohortes , Femenino , Trastornos del Espectro Alcohólico Fetal/epidemiología , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Valor Predictivo de las Pruebas , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Factores de Riesgo , Sudáfrica/epidemiología
19.
Epidemiol Health ; 41: e2019036, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31606979

RESUMEN

OBJECTIVES: The study was to conduct a comparative assessment of drinking behaviors and overall health among pregnant and breastfeeding women. METHODS: This study used data collected from the Korean Community Health Survey in 2015. Data obtained from 2,156 pregnant or breastfeeding women were analyzed using descriptive statistics, the t-test, the chi-square test, and the Pearson correlation coefficient. RESULTS: Current drinking and alcohol consumption were higher among pregnant women than among breastfeeding women. Depression was twice as common among breastfeeding women than among pregnant women, and stress was much higher among breastfeeding women as well. Breastfeeding women also had lower subjective dental health and more unmet medical needs than pregnant women. CONCLUSIONS: Although pregnant women were in better overall health than breastfeeding women, many of them were unable to stop drinking, which is a risky and adverse health behavior that negatively affects maternal and fetal health. In order to reduce drinking among pregnant and breastfeeding women, it is necessary to develop a tailored, standardized educational program and national guidelines.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Lactancia Materna/estadística & datos numéricos , Estado de Salud , Mujeres Embarazadas/psicología , Adulto , Femenino , Encuestas Epidemiológicas , Humanos , Embarazo , República de Corea
20.
Psychol Addict Behav ; 33(8): 677-684, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31599605

RESUMEN

Attentional bias to alcohol is a well-documented effect whereby drinkers allocate greater visual attention toward alcohol-related stimuli rather than nonappetitive, neutral stimuli. Some recent research has shown that acute administration of alcohol temporarily reduces attentional bias to alcohol cues, possibly because alcohol consumption satiates the motivation to drink. However, the specificity of this effect has not been tested, and so it is unclear whether reduced attentional bias following alcohol is specific to alcohol-related stimuli or whether attention to other appetitive stimuli is also reduced (e.g., food). This study tested the degree to which acute alcohol administration selectively reduced attentional bias to alcohol-related but not to food-related cues in a group of 23 healthy young adults who reported consuming alcohol roughly twice per week. Attentional bias to alcohol-related and food-related cues was tested using visual dot probe tasks following 2 active doses of alcohol, .30 g/kg and .65 g/kg, and a placebo. Results showed that attentional bias, measured as fixation time to stimuli on the visual probe tasks, to alcohol cues declined in a dose-dependent manner, whereas attentional bias to food cues was unaffected by the doses. The evidence suggests that alcohol consumption specifically reduces attentional bias to alcohol-related stimuli whereas bias to other appetitive stimuli remains intact. Evidence that alcohol consumption reduces attentional bias specifically to alcohol cues lends further credibility to the satiation theory and to the utility of attentional bias as an indicator of acute and transient changes in an individual's motivation to use alcohol. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Sesgo Atencional/efectos de los fármacos , Señales (Psicología) , Etanol/farmacología , Alimentos , Adulto , Consumo de Bebidas Alcohólicas/psicología , Femenino , Humanos , Masculino , Saciedad/efectos de los fármacos , Adulto Joven
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