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Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011

November 21, 2014 Comments off

Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011
Source: Preventing Chronic Disease (CDC)

Introduction
Excessive alcohol consumption is responsible for 88,000 deaths annually and cost the United States $223.5 billion in 2006. It is often assumed that most excessive drinkers are alcohol dependent. However, few studies have examined the prevalence of alcohol dependence among excessive drinkers. The objective of this study was to update prior estimates of the prevalence of alcohol dependence among US adult drinkers.

Methods
Data were analyzed from the 138,100 adults who responded to the National Survey on Drug Use and Health in 2009, 2010, or 2011. Drinking patterns (ie, past-year drinking, excessive drinking, and binge drinking) were assessed by sociodemographic characteristics and alcohol dependence (assessed through self-reported survey responses and defined as meeting ≥3 of 7 criteria for dependence in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).

Results
Excessive drinking, binge drinking, and alcohol dependence were most common among men and those aged 18 to 24. Binge drinking was most common among those with annual family incomes of $75,000 or more, whereas alcohol dependence was most common among those with annual family incomes of less than $25,000. The prevalence of alcohol dependence was 10.2% among excessive drinkers, 10.5% among binge drinkers, and 1.3% among non-binge drinkers. A positive relationship was found between alcohol dependence and binge drinking frequency.

Conclusion
Most excessive drinkers (90%) did not meet the criteria for alcohol dependence. A comprehensive approach to reducing excessive drinking that emphasizes evidence-based policy strategies and clinical preventive services could have an impact on reducing excessive drinking in addition to focusing on the implementation of addiction treatment services.

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Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study

October 16, 2014 Comments off

Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
Source: BMC Medicine

Background
Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors – healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Methods
In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated.

Results
After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively (P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index.

Conclusions
Combined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.

Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine

October 14, 2014 Comments off

Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine
Source: PLoS ONE

Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms.

AU — Effective drink driving prevention and enforcement strategies: Approaches to improving practice

September 22, 2014 Comments off

Effective drink driving prevention and enforcement strategies: Approaches to improving practice
Source: Australian Institute of Criminology

Although Australia has achieved significant reductions in drink driving since the 1980s, it continues to be a leading cause of road fatalities and injuries. A range of countermeasures have been used to address drink driving, although their effectiveness can be affected by a range of implementation issues.

Through a review of Australian and international literature, this paper outlines principles of effective drink driving countermeasures. It presents guidelines for the effective enforcement and prevention of drink driving through random breath testing, publicity campaigns, penalties and targeted interventions.

The evidence outlined in this paper highlights the importance of implementing effective countermeasures for different populations. Among the general population, personal contact with random breath testing has the strongest deterrent impact on drink driving. Also, targeted interventions that identify the underlying causes of offending are crucial in addressing recidivist drink drivers; a group that contributes disproportionately to road trauma. Strategies that effectively decrease drink driving are vital in the ongoing effort to improve road safety in Australia.

Military Service and Alcohol Use in the United States

August 19, 2014 Comments off

Military Service and Alcohol Use in the United States
Source: Armed Forces & Society

It is well known that enlistees and veterans in the United States are more likely to use alcohol than civilians. However, most of this research is potentially biased in that it often does not employ control variables (other than age) and is based on cross-sectional data. Much of this research also fails to consider the relationship between military service and alcohol use among women. Using longitudinal data taken from the 1997 National Longitudinal Study of Youth, we investigate the relationship between military service and alcohol consumption employing a fixed-effects approach. We find that military service appears to encourage young men to consume alcohol. It is also the case that the effect of military service is not limited to the time that men spend in the military given that male veterans are also more likely to consume alcohol than are comparable nonveterans. We find, however, that women who serve, both enlistees and veterans, are less likely to drink than their civilian counterparts.

Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States

June 30, 2014 Comments off

Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States
Source: Preventing Chronic Disease (CDC)

Introduction
Excessive alcohol consumption is a leading cause of premature mortality in the United States. The objectives of this study were to update national estimates of alcohol-attributable deaths (AAD) and years of potential life lost (YPLL) in the United States, calculate age-adjusted rates of AAD and YPLL in states, assess the contribution of AAD and YPLL to total deaths and YPLL among working-age adults, and estimate the number of deaths and YPLL among those younger than 21 years.

Methods
We used the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application for 2006–2010 to estimate total AAD and YPLL across 54 conditions for the United States, by sex and age. AAD and YPLL rates and the proportion of total deaths that were attributable to excessive alcohol consumption among working-age adults (20-64 y) were calculated for the United States and for individual states.

Results
From 2006 through 2010, an annual average of 87,798 (27.9/100,000 population) AAD and 2.5 million (831.6/100,000) YPLL occurred in the United States. Age-adjusted state AAD rates ranged from 51.2/100,000 in New Mexico to 19.1/100,000 in New Jersey. Among working-age adults, 9.8% of all deaths in the United States during this period were attributable to excessive drinking, and 69% of all AAD involved working-age adults.

Conclusions
Excessive drinking accounted for 1 in 10 deaths among working-age adults in the United States. AAD rates vary across states, but excessive drinking remains a leading cause of premature mortality nationwide. Strategies recommended by the Community Preventive Services Task Force can help reduce excessive drinking and harms related to it.

New From the GAO

June 25, 2014 Comments off

New From the GAO
Source: Government Accountability Office

Reports

1. Information Security: Additional Oversight Needed to Improve Programs at Small Agencies. GAO-14-344, June 25.
http://www.gao.gov/products/GAO-14-344
Highlights - http://www.gao.gov/assets/670/664420.pdf

2. Aviation Safety: Additional Oversight Planning by FAA Could Enhance Safety Risk Management. GAO-14-516, June 25.
http://www.gao.gov/products/GAO-14-516
Highlights - http://www.gao.gov/assets/670/664401.pdf

3. Traffic Safety: Alcohol Ignition Interlocks Are Effective While Installed; Less Is Known about How to Increase Installation Rates. GAO-14-559, June 20.
http://www.gao.gov/products/GAO-14-559
Highlights - http://www.gao.gov/assets/670/664282.pdf

4. Diplomatic Security: Overseas Facilities May Face Greater Risks Due to Gaps in Security-Related Activities, Standards, and Policies. GAO-14-655, June 25.
http://www.gao.gov/products/GAO-14-655
Highlights - http://www.gao.gov/assets/670/664423.pdf
Podcast - http://www.gao.gov/multimedia/podcasts/664325

Testimonies

1. Export-Import Bank: Status of GAO Recommendations on Risk Management, Exposure Forecasting, and Workload Issues, by Mathew J. Scirè, director, financial markets and community investment, before the House Committee on Financial Services. GAO-14-708T, June 25.
http://www.gao.gov/products/GAO-14-708T
Highlights - http://www.gao.gov/assets/670/664379.pdf

2. Medicare Fraud: Further Actions Needed to Address Fraud, Waste, and Abuse, by Kathleen M. King, director, health care, before the Subcommittee on Oversight and Investigations, House Committee on Energy and Commerce. GAO-14-712T, June 25.
http://www.gao.gov/products/GAO-14-712T
Highlights - http://www.gao.gov/assets/670/664382.pdf

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