Ramadan fasting following laparoscopic sleeve gastrectomy: a prospective online survey cohort study in Egypt

Purpose

This study aims to explore the feasibility and implications of Ramadan fasting for patients who have undergone laparoscopic sleeve gastrectomy (LSG), assessing impacts on hydration, nutrient intake, weight management, and gastrointestinal symptoms.

Methods

A prospective online survey was conducted among 218 LSG patients and 83 control individuals with obesity who had not undergone surgery. Participants were surveyed before and after Ramadan, providing data on fasting practices, hunger and satiety levels, fluid and nutrient intake, and the occurrence of gastrointestinal symptoms. Statistical analysis was used to compare outcomes between fasting and non-fasting periods and between LSG patients and control participants.

Results

A total of 70.2% of LSG patients completed the entire month of Ramadan fasting, with a significant correlation found between the duration post-surgery and the ability to fast. Fasting LSG patients reported decreased hunger, increased satiety, and significant reductions in fluid and nutrient intake during Ramadan. Weight loss was reported in 90.8% of fasting patients, with an average total weight loss of 7.2%. Gastrointestinal symptoms were mild and manageable.

Conclusion

The majority of LSG patients can successfully fast during Ramadan with appropriate precautions, including adequate fluid and protein intake. The study highlights the need for patient education and tailored nutritional guidance to ensure safe and effective fasting post-LSG. In order to fast for the entire month, patients may be advised to consider postponing surgery for a few months after Ramadan, avoid overeating during non-fasting hours, and ensure sufficient fluid consumption and protein intake during fasting.

Ad libitum ice slurry ingestion and half-marathon performance in a hot environment: A study comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C

Ice slurry ingestion during prolonged exercises may improve performance in hot environments; however, the ideal amount and timing of ingestion are still uncertain. We determined whether ad libitum ice slurry ingestion influences physiological and perceptual variables and half-marathon performance while comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C. Ten trained participants (28 ± 2 years; mean and SD) were required to run two half marathons while consuming either ice slurry (-1 °C; Ad-1) or water (37 °C; 37 CE) ad libitum. They then performed two other half marathons where, during one, they were required to ingest an amount of water equivalent to the amount consumed during the Ad-1 trial (Pro37), and in the other, to ingest ice slurry in the amount consumed during the 37 CE trial (Pro-1). During the half marathons, dry-bulb temperature and relative humidity were controlled at 33.1 ± 0.3 °C and 60 ± 3%, respectively. Ad-1 ingestion (349.6 ± 58.5 g) was 45% less than 37 CE ingestion (635.5 ± 135.8 g). Physical performance, heart rate, perceived exertion, body temperatures, and thermal perception were not influenced by the temperature or amount of beverage ingestion. However, a secondary analysis suggested that lower beverage ingestion was associated with improved performance (Ad-1 + Pro37 vs. 37 CE + Pro-1: -4.0 min, Cohen's d = 0.39), with a significant relationship between lower beverage ingestion and faster running time (b = 0.02, t = 4.01, p < 0.001). In conclusion, ice slurry ingestion does not affect performance or physiological or perceptual variables during a half marathon in a hot environment. Preliminary evidence suggests that lower beverage ingestion (ice slurry or warm water) is associated with improved performance compared to higher ingestion.

Effects of journey duration and temperature during pre-slaughter transport on behaviour of cull sows in lairage

This observational field study investigated the effects of journey duration, temperature, and waiting duration before unloading on the behaviour of 562 cull sows during lairage from 23 commercial loads. Each load consisted of sows originating from more than one herd, thus experiencing variable pre-slaughter transport and management. In lairage, sows were mixed in groups of 25, involving animals from all journey durations (min-max: 0.8-8.4 h) and video monitored for 60 min. At first most sows were in upright position (approximately 80-90%), decreasing to 30-40% after 30 min. After 60 min, 42% of the sows had initiated aggression (min-max: 0-43 events/sow), 28% had been subjected to aggressive behaviour (min-max: 0-14 events/sow), and 36% s were observed drinking (min-max: 0-16 events/sow). Several significant interactions were found between journey duration, the average temperature in the vehicle and lairage pen (averages: 4.3-26.2 °C) and waiting duration before unloading (min-max: 3-25 min). For example, after short journeys, sows exposed to higher temperature carried out more aggressive behaviour, while a higher temperature after long journeys was associated with more lying and less drinking. This suggests that the sows prioritised lying behaviour over drinking and establishing a dominance hierarchy. We discuss how the results may be interpreted as behavioural signs of fatigue, but further studies, for example involving quantification of physiological and motivational indicators, are needed to clarify this. Irrespectively, the present findings suggest that a stay in a lairage pen, as part of the pre-slaughter logistic chain, involves challenges for the welfare of the cull sows.

Eating and Drinking Ability Classification System to detect aspiration risk in children with cerebral palsy: a validation study

This prospective study has two aims. The first aim is to assess the concurrent validity of the Eating and Drinking Ability Classification System (EDACS) as a means of identifying aspiration risk in children with cerebral palsy by using the Pediatric version of the Eating Assessment Tool (PEDI-EAT-10) as the reference test. The second aim is to investigate the relationship between the aspiration and non-aspiration groups using both the EDACS and the PEDI-EAT-10. Data were collected and analyzed from the EDACS and PEDI-EAT-10 using a convenience sample of 131 children with cerebral palsy and feeding problems (77 males, 54 females; median age 4.4 years [IQR 2.5 years]). Risk of aspiration was identified in 118 individuals using the PEDI-EAT-10 scores of ≥ 5 points. The EDACS proved to be a valid tool in identifying aspiration risk in children who are classified in EDACS levels III-V. There was a significant correlation between the EDACS and PEDI-EAT-10 (r_s = 0.597, p < 0.001). The EDACS had 78% (95% CI = 71-86%) sensitivity and 92% (95% CI = 88-97%) specificity in identifying aspiration risk a positive predictive value of 0.99, a negative predictive value of 0.32, a positive likelihood ratio of 9.75, and a negative likelihood ratio of 0.24.   Conclusion: The EDACS is a useful clinical tool to identify aspiration risk in children with cerebral palsy. Children in EDACS levels III to V are at risk of aspiration. As time permits, we recommend the use of both tools, the EDACS and the PEDI-EAT-10, when making decisions regarding referral for an instrumented swallowing study. What is Known: • Approximately 50% of children with cerebral palsy have dysphagia. • The Eating and Drinking Ability Classification System (EDACS) can be used to classify eating and drinking efficiency and safety in children with cerebral palsy. What is New: • Based on ROC analysis, EDACS demonstrates sensitivity of 78% and specificity of 92% in clinical identification of aspiration risk. • The combined use of the EDACS and the Pediatric version of the Eating Assessment Tool is recommended to make decisions about referral for an instrumented swallow study.

Development of a 20-item questionnaire for drinking behavior pattern (DBP-20) toward personalized behavioral approaches for alcohol use disorder

Although screening tools are available for alcohol use disorders (AUD), such as the Alcohol Use Disorders Identification Test (AUDIT), these tools do not directly characterize individual drinking behavior for patients with AUD. Therefore, the aim of this study was to develop a new self-report questionnaire to identify the characteristics of drinking behavior patterns in patients with AUD.The study team developed a self-administered 20-item questionnaire for drinking behavior pattern (DBP-20) based on semi-structured interviews of patients with AUD. The DBP-20 and AUDIT were administered to 232 patients with AUD and 222 normal drinkers (1 ≤ AUDIT <20) as controls. Exploratory factor analysis of the DBP-20 was conducted for patients with AUD, followed by comparisons of its item and subscale scores between patients with AUD and controls. Correlations of AUDIT with total and subscale scores of the DBP-20 were also analyzed. Receiver operating characteristic (ROC) analyses for the DBP-20 and its subscales were performed to distinguish patients with AUD from controls.Exploratory factor analysis revealed a multidimensional 4-factor model of the DBP-20: coping with negative affect, automaticity, enhancement, and social use. Significant differences in DBP-20 total and subscale scores were observed for patients with AUD versus controls for all factors, except the social use subscale. Both the coping with negative affect and automaticity subscale scores as well as total DBP-20 scores were highly correlated with AUDIT scores. Total DBP-20 scores showed the greatest sensitivity, negative predictive value, and area under the ROC curve to distinguish patients with AUD from normal drinkers.Drinking as a means of coping with negative affect and automaticity may be specific for patients with AUD. DBP-20 may help patients with AUD to be aware of their own targeted problematic drinking behaviors and to seek their personalized behavioral approaches in a collaborative relationship with therapists.

[Drinking behavior at the beginning and during the SARS-CoV-2 pandemic: results of a literature review]

Background and objective

It is well known that alcohol consumption and abuse, as well as alcohol-induced problems, increase during difficult economic times. Previous studies showed increased alcohol consumption in the 2003 SARS outbreak in China. The review examines global changes in alcohol consumption under current SARS-CoV‑2 (severe acute respiratory syndrome coronavirus 2) pandemic.

Materials and methods

The databases PubMed, Ovid, Cochrane Library, Scopus, PsycINFO, and Web of Science with a cut-off date of 11 January 2022 were used. An initial hit count of 791 publications was found. After reading the title and abstract, 62 texts were still eligible. After reviewing the full text, 40 studies were included in this review.

Results

Study results were available from North and South America, Europe, Asia and Oceania. Increases as well as reductions in alcohol consumption were shown. Studies examining multiple waves of the pandemic found that alcohol consumption increased with duration of the pandemic. Binge drinking played a large role in this. There were very large regional differences in the increase in alcohol consumption: from about 10% of respondents to > 45%. In most studies, alcohol consumption was about the same for 40-50% of respondents and decreased for 30-40%.

Conclusions

Further study follow-ups under the continuing pandemic are relevant. Since the populations studied were predominantly of working age, occupational prevention measures of elevated stress levels for some of the respondents with increased alcohol consumption seem reasonable.

[Tasteless thickening agents? A competitive comparison]

Hintergrund

Das Andicken von Flüssigkeiten gehört zu den Standardverfahren der Dysphagietherapie. Diese adaptive Methode soll u. a. einem posterioren Leaking entgegenwirken und die Anforderung an verlangsamte Schutzreflexe durch eine reduzierte Fließgeschwindigkeit des Bolus senken. Bisherige Erhebungen zeigen jedoch aufgrund der Geschmacksperzeption eine ablehnende Haltung von Patienten gegenüber angedickten Flüssigkeiten. Diese Studie untersucht, ob zwischen verschiedenen Andickungsmitteln Geschmacksunterschiede bestehen.

Methoden

An der Studie haben 37 gesunde Probanden Teil genommen und 8 auf dem deutschen Markt erhältliche Andickungsmittel untereinander verglichen. Zur Testung wurden jeweils 2 mit Wasser angerührte Andickungsmittel einander gegenübergestellt. Die Probanden sollten dann entscheiden, welches sie geschmacklich präferierten. Bis zu 7 dieser Paarvergleiche wurden von jedem Probanden vorgenommen. Insgesamt wurden 224 Paarvergleiche durchgeführt. Aus diesen wurde mittels eines probabilistischen Modells eine relative Geschmacksgüte bestimmt und eine Signifikanztestung der Unterschiede durchgeführt.

Ergebnisse und Schlussfolgerung

Zwischen den verschiedenen Andickungsmitteln zeigten sich signifikante Geschmacksunterschiede. Es kann vermutet werden, dass sich die Geschmacksunterschiede auf die Inhaltsstoffe der jeweiligen Andickungsmittel zurückführen lassen. Im therapeutischen Setting sollte für eine höhere Akzeptanz von Kostanpassungen nach Möglichkeit die Ausprobe unterschiedlicher Andickungsmittel erfolgen. Unklar bleibt, ob die hier gezeigten Geschmacksunterschiede sich auch zeigen, wenn anstelle von Wasser andere Flüssigkeiten wie Kaffee, Tee oder Säfte angedickt werden.

Central interaction between nitric oxide, lactate and glial cells to modulate water and sodium intake in rats

The "astrocyte-to-neuron lactate shuttle" (ANLS) mechanism is part of the central inhibitory pathway to modulate sodium intake. An interaction between the GABAergic neurons and nitric oxide (NO) in the subfornical organ (SFO) in salt-appetite inhibition has been suggested. In addition, NO is a key molecule involved in astrocytic energy metabolism and lactate production. In the present study, we hypothesized there is an interaction between astrocytic lactate and central NO to negatively modulate water and sodium intake through the ANLS mechanism. The results showed that central Nω-nitro-L-arginine methyl ester (L-NAME, NO-synthase inhibition) induced an increase in water and sodium intake. These responses were attenuated by previous central microinjection of fluorocitrate (FCt, a reversible glial inhibitor). Interestingly, L-NAME-induced water and sodium intake were also decreased by previous microinjection of lactate but did not change after inhibition of the ANLS mechanism by α-cyano 4-hydroxycinnamic acid (α-CHCA), an inhibitor of the MCT lactate transporter. Our results suggest a central interaction between NO, glial cells, and lactate to modulate water and sodium intake.

The copita question: Exploring alcohol consumption among Latina women

We explored whether Dominican women underreport alcohol consumption according to questionnaire wording and examined factors associated with their alcohol use through structured interviews in Spanish. We measured consumption with the word "alcohol" and with the common colloquialisms "copita/trago/vinito." We used logistic regressions to examine associations between alcohol consumption, demographics, and alcohol-related norms. Of 419 female participants, 411 completed alcohol-related questions. Most (n=343, 83.5%) were current drinkers and 88 (21%) reported having never consumed alcohol but also that they occasionally drink a "copita/trago/vinito." This indicates alcohol use is potentially underreported among Dominican women. Alcohol-related research should incorporate culturally sensitive language to improve accuracy.

Changing Patterns of Alcohol Use and Probability of Unsuppressed Viral Load Among Treated Patients with HIV Engaged in Routine Care in the United States

We examined HIV viral load non-suppression ([Formula: see text] 200 copies/mL) subsequent to person-periods (3-18 months) bookended by two self-reports of alcohol use on a standardized patient reported outcome assessment among adults in routine HIV care. We examined the relative risk (RR) of non-suppression associated with increases and decreases in alcohol use (relative to stable use), stratified by use at the start of the person-period. Increases in drinking from abstinence were associated with higher risk of viral non-suppression (low-risk without binge: RR 1.16, 95% CI 1.03, 1.32; low-risk with binge: RR 1.35, 95% CI 1.11, 1.63; high-risk: RR 1.89, 95% CI 1.16, 3.08). Decreases in drinking from high-risk drinking were weakly, and not statistically significantly associated with lower risk of viral non-suppression. Other changes in alcohol use were not associated with viral load non-suppression. Most changes in alcohol consumption among people using alcohol at baseline were not strongly associated with viral non-suppression.

Factors influencing water intake in dairy cows: a review

Water is a very critical nutrient in the diet of lactating animals as it performs several functions, viz., transfer of nutrients and excretions of waste products produced during metabolism, digestion, and body temperature regulation of all living organisms. Besides growth, other parameters like milk production, reproduction, adaptive potential, and feed consumption are also influenced by water status in feed and body reserves. Water intake in dairy cows is influenced directly or indirectly by several factors; direct factors include animal-related factors such as breed, body size, physiological stage, age, health, stress, and ecological adaptations and environmental factors, viz., season of the year, environmental temperature, humidity, wind speed, and precipitation. These factors significantly influence the drinking water intake of dairy cows. Nonetheless, different managemental practices such as rearing type, feeding practices, housing, water availability, and its quality can also affect water intake indirectly. However, overall understanding of these factors affecting water intake in dairy cows could help to improve the dairy husbandry practices and subsequently health, production, and welfare of dairy cows.

A Context-Specific Instrument to Record Drinking Behaviour: A Pilot Study on Implications of Identifying the Context of Risky Drinking

A context-specific quantity-frequency (CSQF) questionnaire has been developed to accurately measure alcohol consumption using probing questions on drinking context. The study aimed to describe the drinking context associated with different drinking intensities in a community of southern Thailand using the CSQF. A cross-sectional survey was conducted among adults aged > 15 years in Songkhla Province, Thailand. Among 804 participants, there were 183 current drinkers with 412 drinking events (215 low-, 79 medium-, and 118 high-intensity). More than half of these events occurred in special situations (i.e., holiday, party, and cultural drinking). About half of the drinking events occurred outside the drinker's house and most drinking events occurred among friends. Higher drinking intensity was associated with higher level of education [adjusted odds ratio (aOR) 4.74 for medium- and aOR 5.23 for high-intensity] and with a special drinking situation (aOR 2.46 for medium- and aOR 2.78 for high-intensity).

Not by associations alone: The role of contextual factors, individual differences, and propositional learning in the malleability of implicit alcohol attitudes

Alcohol attitudes predict unique variance in drinking behavior and have been the target of manipulations and interventions to reduce high-risk alcohol use among youth and adults. However, whether these manipulations create long-lasting changes in alcohol-related attitudes and drinking behavior is unclear. The current mini-review focuses on evaluative conditioning (EC), a manipulation which pairs alcohol-related stimuli repeatedly with affectively valanced stimuli to create new semantic associations in memory; such associations underlie reflexive or impulsive behaviors like high-risk alcohol use. Across experimental studies, EC has been shown to promote negative alcohol attitudes and reduce alcohol consumption. However, recent evidence suggests the effectiveness of EC may depend on the depth of learning facilitated during the task, which may strengthen the semantic associations through propositional learning. While researchers have experimentally promoted greater depth of learning through the manipulation of contextual factors, we review evidence that alcohol-related individual differences also impact the effectiveness of alcohol EC, particularly when these factors are explicitly linked to the stimuli used during the manipulation. This review provides future directions for researchers and practitioners aiming to shape alcohol-related attitudes and behaviors. Specifically, the malleability of alcohol-related attitudes may depend on propositional learning facilitated by contextual and individual factors. Researchers and practitioners should incorporate these factors into interventions like EC aiming to reduce high-risk alcohol consumption.

Alcohol consumption and consequences in adolescents in 68 low and middle-income countries - a multi-country comparison of risks by sex

AIMS

Alcohol use is a leading risk factor for disease burden among youth. This study estimated sex differences in the prevalence of alcohol use and consequences among adolescents living in low and middle-income countries (LMIC).

DESIGN

Multi-staged cross-sectional international standardized self-report questionnaires administered in the classroom.

SETTING

The Global school-based student health survey (GSHS) comprised adolescents from 68 LMIC between 2003-2014.

PARTICIPANTS

271,156 students aged 13-17 years old.

MEASUREMENTS

Alcohol measures included: past month alcohol consumption, history of intoxication and alcohol-related problems. Regions were based on the World Health Organization definitions: Africa, America, Eastern Mediterranean, Europe, South-east Asia, and Western Pacific.

FINDINGS

Overall, males had higher odds of alcohol use (OR = 2.38 [1.91-2.96]), a history of intoxication (OR = 2.64 [2.11-3.31]), and alcohol-related problems (OR = 1.72 [1.41-2.10]) than females. All regions recorded overall greater odds of alcohol use by males versus females; five regions (excluding Europe) recorded greater odds of intoxication in males; and three regions (America, South-east Asia, and Western Pacific) recorded greater odds of alcohol-related problems amongst males. However, there were country-level differences - in some countries, adolescent drinking rates and consequences were comparable by sex. Countries with the highest odds of alcohol use among males compared to females were Indonesia, Myanmar, Cambodia, Tuvalu, Morocco, Senegal, Kiribati, and Thailand.

CONCLUSIONS

Among adolescents living in LMIC, males had on average two-fold higher odds of drinking alcohol and experiencing adverse consequences. Growing affluence and improvements in sex equality in societies may increase the future prevalence of hazardous drinking in females in LMICs.

In the eye of the drinker: Drinking motives influence the effectiveness of conditioning implicit alcohol attitudes

Risky alcohol use is prevalent among college students. Pre-intervention research has established methods of influencing alcohol cognition and reducing short-term alcohol consumption among students using evaluative conditioning (EC), repeatedly pairing alcohol with emotionally valenced images. Specifically, negative EC promotes negative attitudes toward alcohol, but additional research is needed to understand the range of EC effects and conditions under which it is or is not effective. For example, whether pairing alcohol with positive images promotes positive alcohol attitudes has not been tested. Further, drinking motives may influence the effectiveness of conditioning alcohol attitudes, since these motives are strongly associated with emotional stimuli like those presented in EC. The current experiment tested the interaction of drinking motives (coping and enhancement) and EC valence (negative or positive) on implicit alcohol avoidance. Participants (N = 95) were undergraduate students reporting active alcohol use. Results indicated no main effect of EC condition on implicit alcohol avoidance. However, drinking motives interacted with EC procedures assigned to participants. Those reporting greater coping motives exhibited less implicit alcohol avoidance following negative EC, whereas those reporting greater enhancement motives exhibited less alcohol avoidance following positive EC. Findings indicate drinking motives may influence the effectiveness of EC for altering alcohol attitudes. Negative EC did not promote alcohol avoidance among college students reporting higher coping motives, and positive EC only reduced avoidance among students reporting higher enhancement motives. These results indicate drinking motives interact with situational cues to impact both positive and negative responses to alcohol.

Analysis of the alcohol drinking behavior and influencing factors among emerging adults and young adults: a cross-sectional study in Wuhan, China

BACKGROUND

The relationship between alcohol use in adolescents and young adults and outcomes has not been widely researched in China. The aim of the current study was to understand the current status of drinking behavior of Chinese youth transitioning into adulthood.

METHODS

The cross-sectional study included 1634 participants between 18 and 34 years of age. The participants were randomly chosen from 13 administrative districts in Wuhan, and invited to complete a questionnaire. Univariate analysis was performed to describe the demographic distribution of alcohol consumption and the association with drinking status. Stepwise Logistic regression analysis was undertaken analyzing the factors influencing the drinking behaviors. The data were weighted to the population in Wuhan and analyzed using SAS version 9.3.

RESULTS

For our sample of emerging and young Chinese adults the prevalence of drinking alcohol was 45.84%. The non-drinkers predominated, accounting for 54.16% and light drinkers accounted for 42.94%, while moderate and heavy drinkers were in the minority (2.90%). The earlier the age of first alcohol drinking or the age of first being intoxicated, the greater the likelihood of being a moderate or heavy drinker. People with high emerging adulthood were more likely to have moderate or heavy drinking behaviors. The logistic regression analysis indicated that heavy drinkers were more likely to not be married and to be classified as high emerging adulthood.

CONCLUSIONS

Our findings suggested that the drinking pattern should be further evaluated over time to explore the ways in which social and cultural factors shape the drinking route of this age group. Effective drinking behavior prevention and interventions and appropriate guidance should be formulated to establish an appropriate attitude towards drinking alcohol and develop a drinking behavior which is conducive to physical and mental health between this particular demographic.

Effectiveness of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder

The purpose of this study was to examine the effects of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder. This study used a quasi-experimental nonequivalent control design. This study was performed from March 2015 to July 2015. The drinking-reduction program was conducted once per week for 11 weeks. This program improved drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in the experimental group compared to the control group (p < .05, n = 34). The drinking-reduction program can be used as a nursing intervention for people with moderate alcohol use disorder.

Changing multiple health risk behaviors in CHOICES

Multiple health behavior change (MHBC) intervention trials to date have only considered behaviors that were directly targeted. Research has yet to consider how untargeted behaviors can affect change in behaviors directly targeted by an intervention or how changes in targeted behaviors might lead to changes in other, untargeted behaviors. This study addresses these gaps with a secondary analysis of change in risk drinking (targeted behavior) and smoking (behavior that was not addressed) in the efficacy trial of CHOICES, an intervention for the prevention of alcohol-exposed pregnancies. Measures included the Timeline Followback for daily alcohol consumption and questions about smoking behavior. Participants were women of childbearing age who were at risk of alcohol-exposed pregnancy at baseline. Baseline smokers were less likely to change their drinking behavior than baseline non-smokers at nine months (n = 579) with Odds Ratio (OR) of 0.681 (95% CI = 0.471–0.985); 41.1% of smokers vs 50.6% of non-smokers reduced drinking to below risk levels (<5 drinks/day and < 8 drinks per week). Meanwhile, smokers who had changed their drinking behavior were more likely than smokers who had not changed their drinking behavior to have also quit smoking at nine months (OR = 2.769; 95% CI = 1.533–5.000); 19.5% vs. 8.1%, respectively. Together, these findings suggest a natural tendency towards change of multiple related behaviors and indicate that while the presence of unaddressed risk behaviors may make a targeted behavior change more difficult, change in one behavior may facilitate change in related behaviors, even when they are not addressed.

Behaviors and Culture of Drinking among Korean People

BACKGROUND

The objective of this study was to identify behaviors and culture of drinking alcohol in Korean people.

METHODS

Among a panel of subjected enrolled in existing domestic survey companies, adults aged 19 to 59 yr old who replied that their drinking frequency was more than once a month for the past one year were selected in 2017. Sample size and methods used for analysis were determined by considering demographically proportioned stratified sampling and monthly alcohol drinking rate. A total of 1,185 subjects (731 males and 454 females) responded to questionnaires.

RESULTS

Most drinking behaviors were in the domain of leisure time. Drinking for two or more times a month and binge drinking were mainly concentrated in five occasions types: going out with friends (44.2%), going out with colleague (34.2%), drinking at home or friend's home with friends (32.9%), drinking at home alone (29.3%), and drinking with meals at home (27.5%). Regarding the ratio of experiences in drinking for subjects according to occupations, 'Directors/Managers' who participated in receptions of guests, either hosted by or invited thereto, had the highest percentage (64.2%), followed by 'Individual Proprietors' (56.4%). Differences between each type of occupation were found to be statistically significant (P< 0.001).

CONCLUSION

The drinking culture in Korea was characterized by more social drinking than by drinking alone at home. The drinking behavior was often one-shot at a time rather than drinking a little sip. The practices of collective drinking should be improved to avoid secondary harmful effects.

Maternal hair testing to disclose self-misreporting in drinking and smoking behavior during pregnancy

This study aimed to objectively verify smoking and drinking behavior during pregnancy and to disclose self-misreporting through maternal hair analysis. A total of 153 women attending a university hospital in Barcelona (Spain) were selected and interviewed after delivery, on their smoking and drinking habits during pregnancy. A 9-cm hair strand was collected and analyzed by liquid chromatography tandem mass spectrometry for the presence of nicotine (NIC) and ethyl glucuronide (EtG) as biomarkers of tobacco and alcohol consumption, respectively. Concentrations of EtG <7 pg/mg hair and ≥30 pg/mg hair in the 0-3-cm hair segment have been used to assess, respectively, total abstinence and chronic excessive consumption in the previous 3 months, with repetitive moderate drinking lying in the interval 7-30 pg EtG per mg hair. Hair NIC less than 1 ng/mg hair indicates non-exposure to tobacco smoke while hair NIC indicates daily active smoking. In the interview, 28.1% of women declared to have smoked occasionally during gestation, while only 2.6% stated to have consumed alcohol on more than one occasion during pregnancy. Hair testing of smoking biomarkers disclosed that 7.2% of women remained active smokers during the whole pregnancy (hair NIC: 3.21-56.98 ng/mg hair), 16.3% were passive non-smokers or occasional smokers (hair NIC: 1.04-2.99 ng/mg hair), while 76.5% were not exposed to any cigarette smoke (hair NIC < limit of quantification - 0.91 ng/mg hair). Conversely, alcohol hair biomarkers showed that only 35.3% of women were totally abstinent during gestation (hair EtG: 3.89-6.73 pg/mg hair), while 62.7% drank a non-negligible amount of alcohol during pregnancy (hair EtG: 7.06-26.57 pg/mg hair), and 2% were chronic excessive drinkers (hair EtG: 35.33-47.52 pg/mg hair). Maternal hair analysis has shown to be significantly more sensitive than interviews in revealing an alarming misreported prevalence of alcohol use during pregnancy. These findings stress the need to use objective measures to assess alcohol exposure and to consider the inclusion of targeted actions to reduce alcohol consumption in maternal-child health policies.

Consumption of Caffeinated Energy Drinks Among Youth and Young Adults in Canada

The growing market for caffeinated energy drinks (CEDs) has caused concern about excessive caffeine intake and potential adverse effects, particularly among young people. The current study examined patterns of CED consumption among youth and young adults in Canada, using data from a national online survey conducted in October 2014. Data from a non-probability sample of 2040 respondents aged 12-24 from a consumer panel was weighted to national proportions; measures of CED consumption were estimated, including prevalence, excessive daily consumption, and context for use (locations and reasons). Separate logistic regression models for two outcomes, past-week consumption and "ever" exceeding two energy drinks in a day (as per common guidance), were conducted to examine associations with demographic variables (sex, age, geographic region, race/ethnicity, and language). Overall, 73.6% of respondents reported "ever" consuming energy drinks; 15.6% had done so in the past week. Any consumption of energy drinks in the past week was more prevalent among males, Aboriginal respondents (vs. white only or mixed/other), and residents of British Columbia. Among "ever-consumers," 16.0% reported ever consuming more than two energy drinks in a day. Exceeding two in a day was more prevalent among older respondents (young adults aged 18-24), aboriginal respondents (vs. white only), and British Columbia residents. While the majority of youth and young adults had consumed energy drinks, about half were "experimental" consumers (i.e., consumed ≤ 5 drinks in their lifetime). Approximately one in six consumers had exceeded the usual guidance for maximum daily consumption, potentially increasing their risk of experiencing adverse effects.

Beliefs underlying Women's intentions to consume alcohol

BACKGROUND

Changing trends demonstrate that women, in a number of economically-developed countries, are drinking at higher levels than ever before. Exploring key targets for intervention, this study examined the extent to which underlying beliefs in relation to alcohol consumption predicted intentions to drink in three different ways (i.e. low risk drinking, frequent drinking and binge drinking).

METHODS

Utilizing a prospective design survey, women (N = 1069), aged 18-87 years, completed a questionnaire measuring their beliefs and intentions regarding alcohol consumption. Then, two weeks later, 845 of the original sample, completed a follow-up questionnaire reporting their engagement in the drinking behaviors. A mixed design ANOVA was conducted to examine potential differences between women of different age groups (18-24, 25-34, 35-44, 45-54, 55 years and above) and their intentions to engage in the three different drinking behaviors. Based upon The Theory of Planned Behavior, critical beliefs analyses were carried out to identify key determinants underlying intentions to engage in the three different drinking behaviors.

RESULTS

Significant effects of age were found in relation to frequent and binge drinking. The critical beliefs analyses revealed that a number of behavioral, control and normative beliefs were significant predictors of intentions. These beliefs varied according to age group and drinking behavior.

CONCLUSIONS

Previously unidentified key factors that influence women's decisions to drink in certain ways have been established. Overall, future interventions and public policy may be better tailored so as to address specific age groups and drinking behaviors.

Students' drinking behavior and perceptions towards introducing alcohol policies on university campus in Denmark: a focus group study

BACKGROUND

High alcohol consumption among university students is a well-researched health concern in many countries. At universities in Denmark, policies of alcohol consumption are a new phenomenon if existing at all. However, little is known of how students perceive campus alcohol policies. The aim of this study is to explore students' perceptions of alcohol policies on campus in relation to attitudes and practices of alcohol consumption.

METHODS

We conducted six focus group interviews with students from the University of Southern Denmark at two different campuses. The interviews discussed topics such as experiences and attitudes towards alcohol consumption among students, regulations, and norms of alcohol use on campus. The analysis followed a pre-determined codebook.

RESULTS

Alcohol consumption is an integrated practice on campus. Most of the participants found it unnecessary to make major restrictions. Instead, regulations were socially controlled by students themselves and related to what was considered to be appropriate behavior. However students were open minded towards smaller limitations of alcohol availability. These included banning the sale of alcohol in vending machines and limiting consumption during the introduction week primarily due to avoiding social exclusion of students who do not drink. Some international students perceived the level of consumption as too high and distinguished between situations where they perceived drinking as unusual.

CONCLUSION

The study showed that alcohol is a central part of students' lives. When developing and implementing alcohol policies on campus, seeking student input in the process and addressing alcohol policies in the larger community will likely improve the success of the policies.

Periconceptional Risk Factors for Birth Defects among Younger and Older Teen Mothers

STUDY OBJECTIVES

We sought to determine whether selected periconceptional health behaviors that influence risk for birth defects differ between older and younger adolescents and whether pregnancy intention predicts more positive preconception health behaviors among teens.

DESIGN AND PARTICIPANTS

We analyzed interview responses from 954 adolescent control group participants from the National Birth Defects Prevention Study who delivered live infants during 1997-2007.

MAIN OUTCOME MEASURES

Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated for factors of interest by age categories (13-15, 16-17, and 18 years, relative to 19 years). To construct a composite periconceptional behavior index, we summed the following healthy behaviors: nonsmoker, nondrinker, folic acid supplementation, and eating 5 or more servings of fruits and vegetables per day.

RESULTS

Analyses indicated that women in the youngest group (13-15 years of age) were more likely to be Hispanic (aOR 2.83, 95% CI 1.40-5.70) and less likely to engage in some unhealthy pregnancy-related behaviors compared with 19-year-olds, such as smoking (aOR 0.45, 95% CI 0.20-0.99) and being overweight or obese (aOR 0.32, 95% CI 0.16-0.61). However, they were also less likely to have taken periconceptional folic acid (aOR 0.44, 95% CI 0.21-0.90). About one-third of teen mothers indicated that their pregnancies had been intended. Among 18- and 19-year-olds, this predicted a higher mean value for the composite periconceptional behavior index (2.30 versus 1.94, P ≤ .01).

CONCLUSIONS

Teen mothers are not a homogeneous group. Each age subgroup presents varied demographic and behavioral factors that put them at varying levels of risk for birth defects. Furthermore, caregivers should not assume that teens do not plan pregnancies or that they need not be informed of the importance of periconceptional health.

Underage college students' alcohol displays on Facebook and real-time alcohol behaviors

PURPOSE

College is often a time of alcohol use initiation and displayed Facebook alcohol references. The purpose of this longitudinal study was to determine associations between initial references to alcohol on social media and college students' self-reported recent drinking, binge drinking, and excessive drinking.

METHODS

First-year students from two U.S. public universities were randomly selected from registrar lists for recruitment. Data collection included 2 years of monthly Facebook evaluation. When an initial displayed Facebook alcohol reference was identified, these "New Alcohol Displayers" were contacted for phone interviews. Phone interviews used the validated timeline followback method to evaluate recent alcohol use, binge episodes, and excessive drinking. Analyses included calculation of positive predictive value and Poisson regression.

RESULTS

A total of 338 participants were enrolled; 56.1% participants were female, 74.8% were Caucasian, and 58.8% were from the Midwestern University. A total of 167 (49.4%) participants became new alcohol displayers during the first 2 years of college. Among new alcohol displayers, 78.5% reported past 28-day alcohol use. Among new alcohol displayers who reported recent alcohol use, 84.9% reported at least one binge episode. Posting an initial Facebook alcohol reference as a profile picture or cover photo was positively associated with excessive drinking (risk ratio = 2.34; 95% confidence interval, 1.54-3.58).

CONCLUSIONS

Findings suggest positive associations between references to alcohol on social media and self-reported recent alcohol use. Location of initial reference as a profile picture or cover photo was associated with problematic drinking and may suggest that a student would benefit from clinical investigation or resources.

Effects of alcohol intoxication and autonomic arousal on delay discounting and risky sex in young adult heterosexual men

OBJECTIVES

The relationship between alcohol use and risky sexual behavior is complex and depends on psychological and environmental factors. The alcohol myopia model predicts that, due to alcohol's impact on attention, the behavior of intoxicated individuals will become increasingly directed by salient cues. Autonomic arousal (AA) may have a similar effect on attention. Experiential delay discounting (DD) may be increased by both alcohol consumption and AA due to their common effects and may mediate the relationship between these conditions and risky sex.

METHODS

This study employed a 3 (alcohol, placebo, control)×2 (high, low arousal) experimental design to examine the effects of acute alcohol intoxication and AA on experiential delay discounting, subjective sexual arousal, and risky sex.

RESULTS

Path models revealed complex results that only partially supported study hypotheses. Ratings of subjective sexual arousal did not differ across either beverage or arousal conditions. DD was also unrelated to any study variable. However, subjective sexual arousal was positively related to risky sexual intentions. Alcohol intoxication was also positively associated with increased unprotected sex intentions, consistent with past studies.

CONCLUSIONS

These results affirm the role of subjective sexual arousal and alcohol intoxication in risky sexual decision-making, yielding effect sizes similar to comparable past studies. The lack of differences across autonomic arousal groups also suggests that effects of attentional myopia may be behavior-specific. Failure to replicate effects of alcohol intoxication on DD also suggests reservation regarding its involvement in alcohol-involved risky sex.

Modeling the effects of low toxin levels in food on feeding: dose-dependent reduction of fluid intake by low levels of lithium chloride

The present study examined the dose related effects of low levels of the toxin, LiCl, on the ingestion of a palatable sucrose plus salt solution. Over five days (acquisition phase) rats were presented with a 0.3M sucrose solution containing one of the following salt combinations: 0.12 M NaCl (n=10 negative control group); 0.005 M LiCl+0.115 NaCl (n=10); 0.01 M LiCl+0.11 NaCl (n=10); 0.015 M LiCl+0.105 M NaCl (n=10); 0.02 M LiCl+0.10 M NaCl (n=10); and 0.12 M LiCl (n=8 positive control group). During an extinction phase (5 days), all rats were presented with 0.3M Sucrose+0.12 M NaCl solution. Fluid intake levels and number of licks were quantified on each day. At low LiCl concentration levels rats exhibited a dose related reduction in amount consumed and number of licks of the sucrose plus salt solutions. This toxin related suppression of fluid intake and licking rapidly dissipated during the extinction phase. The present findings support the hypothesis that rats use a behavioral tolerance mechanism to regulate their intake of foods containing low levels of toxins.

Drinking behaviors by stress level in Korean university students

The purposes of this study are to estimate the stress level of university students, and to verify the relationships between stress level and drinking behavior. A questionnaire survey was administered to 430 university students in the Gangwon area in Korea from November 5 to November 28, 2008, and data from 391 students were used for the final statistical analysis. The most stressful factor was "Worry about academic achievements" (2.86 by Likert-type 4 point scale). The subjects were divided into two groups, a low stress group (≤ 65.0) and a high stress group (≥ 66.0), by the mean value (65.1) and median value (66.0) of the stress levels. The drinking frequency was not different between the two stress groups, but the amount of alcohol consumption was significantly different (P < 0.05). The portion of students reporting drinking "7 glasses or over" was higher in the lower stress group than in the higher stress group. In addition, factor 6, "Lack of learning ability", was negatively correlated with drinking frequency and the amount of alcohol consumption (P < 0.05), and factor 3, "Worry about academic achievements", was negatively correlated with the amount of drinking (P < 0.05). The major motive for drinking was "When overjoyed or there is something to celebrate" (2.62), and the main expected effect of drinking was "Drinking enables me to get together with people and shape my sociability" (2.73). The higher stress group showed significantly higher scores on several items in the categories of motives (P < 0.01), negative experience (P < 0.05), and expected effects (P < 0.05) of drinking than the lower stress group. Our results imply that university students at the lower stress level may drink more from social motives in positive drinking environments, while those at the higher stress level may have more problematic-drinking despite their smaller amount of alcohol consumption.

The genetic factors affecting drinking behaviors of korean young adults with variant aldehyde dehydrogenase 2 genotype

OBJECTIVE

We determined whether aldehyde dehydrogenase 2 (ALDH2) activity alters the way in which drinking behaviors are affected by gene polymorphisms of other alcohol-metabolizing enzymes and serotonin-related proteins.

METHODS

Through a follow-up survey with a cohort comprising 551 university freshmen over a period of 6 years, we examined the genetic factors affecting drinking behaviors. In 2000, drinking behaviors were assessed and tryptophan hydroxylase (TPH) and ALDH2 gene polymorphisms were determined. Drinking behaviors were repeated in 2006 (n=150), and the gene polymorphisms of ADH1B, ADH1C, CYP2E1, 5-HTR2A 1438A/G, and 5-HTR2A IVS2 were also determined.

RESULTS

In 2000, the variant and wild-type ALDH2 groups exhibited little difference in terms of drinking frequency and problem drinking. Furthermore, some genotypes influenced only the variant group: ADH1B*2/*2 was associated with a lower drinking frequency, and CYP2E1 c2 allele was associated with an increased risk of problem drinking. In 2006, drinking frequency and risk of problem drinking were significantly lower in the variant group than in the wild-type group. However, the TPH AA genotype disturbed that difference, meaning that the subjects in the variant group had developed a similar level of risk of problem drinking to that in the wild-type group.

CONCLUSION

Korean university freshmen who were identified as a variant group drank as frequently as those in the wild-type group. For the subsequent 6 years they drank less frequently, thus decreasing the risk of problem drinking. However, that frequency drop was interrupted in those with gene polymorphisms such as ADH1B*1, CYP2E1 c2, and TPH A.