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Background: The relationship between alcohol consumption and ischaemic heart disease (IHD) risk is complex and several issues remain unresolved because many studies used rather crude exposure measures often based on one or two questions. The objective of this study was to investigate the association between heavy drinking occasions and IHD mortality while controlling for average daily alcohol intake and separating former drinkers from lifetime abstainers.Methods: Cox regression analyses were used with IHD mortality as the outcome in a sample of 9934 participants of the US National Alcohol Surveys conducted in 1984 and 1995.Results: To the end of 2006, 326 deaths from IHD were recorded in the 11- to 22-year follow-up period. Any past heavy drinking occasions in former drinkers [hazard ratio (HR) = 2.06; 95% confidence interval (95% CI): 1.10-3.85] compared with former drinkers without such drinking occasions, and any heavy drinking occasion in current drinkers at baseline (HR = 2.05; 95% CI: 1.03-3.98) compared with current drinkers with average daily intake of one to two drinks, were associated with higher IHD mortality in men and any heavy drinking occasions among drinkers of up to 1 drink average consumption in women with similar effect size. Confounding effects from age, race, education, employment, income, marital status, geographical region, depression score, survey period or other drug use were small.Conclusions: Among former and current drinkers, heavy drinking occasions should be taken into account when examining the complex association of alcohol consumption on IHD mortality risk. [ABSTRACT FROM AUTHOR]

Aims. To examine the consistency and/or variability of gender differences in drinking behavior cross-culturally. Design, setting, participants. Women's and men's responses in 16 general population surveys from 10 countries, analyzed by members of the International Research Group on Gender and Alcohol. Measurements. Comparable measures of drinking, versus abstention, typical drinking frequencies and quantities, heavy episodic drinking, intoxication, morning drinking, and alcohol-related family and occupational problems. Findings. Women and men differed little in the probability of currently drinking versus abstaining, but men consistently exceeded women in typical drinking frequencies and quantities and in rates of heavy drinking episodes and adverse drinking consequences, while women were consistently more likely than men to be life-time abstainers. In older age groups, both men and women drank smaller quantities of alcohol and were more likely to stop drinking altogether, but drinking frequencies did not change consistently with age. Conclusions. A theoretical synthesis proposes that gender roles may amplify biological differences in reactions to alcohol, and that gender differences in drinking behavior may be modified by macrosocial factors that modify gender role contrasts. [ABSTRACT FROM AUTHOR]

Objective: Previous studies conducted on hepatitis C virus (HCV) transmission have focused primarily on its transmission among people who inject drugs. However, there is evidence that transmission may also occur through the sharing of contaminated non-injection implements used to consume drugs nasally, orally, or by inhalation. Studies to date have not conclusively established a relationship between these routes of cocaine use and HCV. We quantified the association between cocaine use and HCV, specifically among individuals who have never injected an illicit substance., Method: Data from the 2011-2018 National Health and Nutrition Examination Survey were analyzed. Multivariable logistic regression was used to test for an association between cocaine use and HCV among 10,106 individuals (5,201 females). Covariates included age, race, sex, education, income, and immigrant status., Results: In the unadjusted model, individuals who reported cocaine use had 4.79 (95% CI [2.70, 8.47]) times the odds of ever having HCV compared with those who did not use cocaine. In the adjusted model, individuals who reported cocaine use had 4.48 (95% CI [2.36, 8.50]) times the odds of ever having HCV compared with those who did not use cocaine., Conclusions: This study highlights that individuals who report non-injection cocaine use have an inflated risk of HCV compared with individuals who report no cocaine use. Harm reduction interventions to reduce the transmission of HCV should therefore be targeted to all people who use drugs, including those who use cocaine orally, intra-nasally, and by inhalation.

Background: Hong Kong and Canada have very different primary health care systems. We thus hypothesized family physicians between the two places would be different in how they protected themselves, their staff and families during the epidemic., Objective: The purpose of this study was to explore and contrast the impact of SARS on family physicians in Hong Kong and Toronto., Methods: A postal questionnaire was designed and sent to 183 tutors affiliated with the Chinese University of Hong Kong with 137 replies (74.8%). In Toronto, 150 questionnaires were sent to academic family physicians affiliated with the University of Toronto with 51 replies (34%)., Results: All agreed SARS had changed their clinical behaviour. For public health measures in the control of SARS, Hong Kong physicians were less likely to quarantined themselves (77.1% versus 19.4%, P < 0.01) or gave quarantine leave to staff (95% versus 59.7%, P < 0.01) after exposure to probable or suspected SARS. However, they were more likely to wear a mask (52.7% versus 97.7%, P = 0) during consultation, having support staff to wear masks (68.6% versus 97.8%, P = 0) and test patient's temperature (47.1% versus 68.1%, P < 0.01)., Conclusion: There were noticeable differences in how family physicians deal with SARS between the two cities. As SARS emerged as a global disease, better understanding of practice differences among physicians from different countries would facilitate globalization of public health.