Search

Aims: To investigate whether 'binge-drinking' is new by comparing the behaviour and attitudes of two generations at the same age and of one generation at different ages. Methods: Fifty-six student/parent pairs completed questionnaires partially based on the Adolescent version of the Alcohol Expectancy Questionnaire (Brown, S.A., Christiansen, B.A., & Goldman, M.S. (1987). The alcohol expectancy questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol, 48, 483-491). Students' reports of their behaviour and attitudes were compared to their parents' memories of their behaviour and attitudes at 18. Parents' memories were compared to their current behaviour and attitudes to explore possible lifespan effects. Data regarding the groups' attachment to aspects of society were drawn on as a possible explanation of differences between generations. Findings: Parents recalled consuming more alcohol more frequently, having more favourable attitudes towards alcohol and having fewer ties with their communities when they were 18 than their children. They drank less and had a less favourable attitude towards alcohol at the time of the research than in their youth. Conclusions: Despite contrary 'evidence', it may be that today's young people are less prone to 'binge-drinking' than previous generations. Whilst it is recognized that data may be contaminated by parents' 'forgetting', the study highlights the possibility that the 'binge-drinking' crisis is merely media hype, spurious, or both. [ABSTRACT FROM AUTHOR]

Recent randomised controlled trials suggest non-invasive ventilation may offer benefit in the long-term management of ventilatory failure in stable COPD. The best mode of ventilation is unknown and newer volume assured modes may offer advantages by optimising ventilation overnight when treatment is delivered. This study compares volume assured with pressure preset non-invasive ventilation. Randomised crossover trial including twenty five subjects previously established on long-term non-invasive ventilation to manage COPD with chronic ventilatory failure. Two 8-week treatment periods of volume assured and pressure preset non-invasive ventilation. The primary outcomes were daytime arterial blood gas tensions and mean nocturnal oxygen saturation. Secondary outcomes included lung function, exercise capacity, mean nocturnal transcutaneous carbon dioxide, health status and compliance. No significant differences were seen in primary or secondary outcomes following 8 weeks of treatment when comparing volume assured and pressure preset ventilation. Primary outcomes assessed: mean (standard deviation) PaO2 7.8 (1.2) vs 8.1(1) kPa, PaCO2 6.7 (1.1) vs 6.3 (1.2) kPa and mean nocturnal oxygenation 90 (4) vs 91 (3)% volume assured versus pressure preset, respectively. Volume assured and pressure preset non-invasive ventilation appear equally effective in the long-term management of ventilatory failure associated with stable COPD. [ABSTRACT FROM AUTHOR]

Patients with ventilatory failure due to chronic obstructive pulmonary disease (COPD) are increasingly managed with long-term non-invasive positive pressure ventilation (NIPPV) and this may improve survival. NIPPV can frequently be interrupted but there are few data detailing the short-term effects and none on the longer-term consequences of treatment withdrawal. Ten patients withdrew from NIPPV for 1 week and were randomised to restart NIPPV or to continued withdrawal for up to 6 months. Outcomes assessed included daytime blood gases, nocturnal ventilation, lung function, exercise capacity and health status. After 1 week of withdrawal PaO2, PaCO2, nocturnal oximetry, lung function and exercise capacity did not change, but mean nocturnal transcutaneous CO2 (6.3 (1) vs. 7.6 (1.1) kPa p = 0.04) and daytime blood gas bicarbonate (30.3 (4.5) vs. 31.2 (3.9) mmol/L p = 0.04) rose. During a 6-month period of withdrawal of nocturnal NIPPV, daytime PaCO2 (6 (1.1) vs. 7.5 (1.3) kPa p = 0.002) increased and health status (total St George's Respiratory Questionnaire score 55.5 (6.3) vs. 65.6 (10) p = 0.006) worsened. Three out of five patients met a priori criteria to restart NIPPV in the continued withdrawal group. Short interruptions to domiciliary NIPPV used to manage chronic ventilatory failure as a consequence of COPD do not cause a rapid clinical deterioration but nocturnal ventilation worsens and daytime bicarbonate levels increase following 1 week's cessation. Thereafter, daytime PaCO2 rises and health status worsens, supporting the role of long-term NIPPV in the management of such patients. [ABSTRACT FROM AUTHOR]

Health disparities that affect whole communities may involve factors like housing quality that lie at least partly within planners' realm of policy influence. This article demonstrates a link between housing and childhood asthma. The magnitude of the childhood asthma epidemic in Harlem in New York City and the commitment of engaged community partners led to an interdisciplinary, participatory, and multifaceted approach to the planning, implementation, and evaluation of the Harlem Children's Zone Asthma Initiative. Here we present the first year's data on environmental triggers in the homes of program participants, showing that intensive, community-based programs can reduce both home environmental triggers and adverse childhood asthma outcomes. This provides an example of a community-wide public health intervention that informs public policy and planning, and may provide a sustainable model for reducing childhood asthma in impoverished communities. [ABSTRACT FROM AUTHOR]