Search

BACKGROUND: Studies on cardiovascular risk factors among diabetic persons in Ethiopia are lacking. The objective of this study was to determine the prevalence of the cardiovascular risk factors (hypertension, obesity, physical inactivity, dyslipidemia and smoking) among diabetic patients at the diabetic clinic of Jimma University Specialized Hospital. METHODS: A cross-sectional study was conducted from October to December 2007. Three hundred one individuals were randomly selected from 950 patients on follow-up. Data were collected using a structured format and appropriate equipments and reagents. Laboratory data were recorded in a separate checklist. The data were entered into SPSS for Windows version 12. Multivariate regression analysis was carried out to identify predictors of hypertension, obesity and dyslipidemia. RESULTS: Two hundred and fifty six (85.1%) of the sample participated in the study. The prevalence of hypertension, obesity, dyslipidemia, physical inactivity and current smoking was 46.5%, 23.4%, 63.5%, 55.1% and 5.5% respectively. Age . 45 years, type 2 diabetes and obesity were predictors of hypertension. Females were less likely to be hypertensive (OR =2.26, 3.37, 3.79 and 0.48 respectively). Type 2 diabetics and females were more while rural diabetics were less likely to be obese. (OR =6.08, 4.17 and 0.37 respectively). Female gender, hypertension and fasting blood glucose . 180mg/dl were predictors of dyslipidemia. Alcohol users were less likely to be dyslipidemic. (OR =4.25, 3.5, 3.56 and 0.39, respectively) CONCLUSION: Hypertension, obesity, dyslipidemia and physical inactivity were common while smoking was uncommon among diabetic patients in Jimma University Specialized Hospital. Type 2 DM was a predictor of hypertension and obesity. Diabetic women were more likely to be obese and dyslipidemic. We recommend screening and management of these risk factors.

No Abstract.

This study examined the prevalence of alcohol use, alcohol-related problems, psychological distress, anxiety and depression mood and the relationship between these variables in a sample of 534 college students in the USA. In college men, 91% were current alcohol users (those who use alcohol at least once a month) and in college women 80% were current alcohol users (p

Purpose Each textbook on ophthalmology in the 19th and the 20th centuries included a description of “tobacco-alcohol amblyopia”. In the last 200 years several thousand cases of “tobacco-alcohol amblyopia” were described, but the occurrence of the disorder has considerably decreased in modern times. Methods Review of the literature and described cases of the entity. Results By the end of the 20th century, a paradox had become apparent: the population of tobacco and alcohol users in some areas of the world continued to be very high, but there was a marked decrease in the incidence of the disease. Some believe that the disease never existed, some argue that it was a mismatch – or / and overdiagnosed. Conclusion The presentation is going to cover the present status of knowledge about “tobacco-alcohol amblyopia” and to finally give the answer whether such entity exists.

Conclusions Differences in the pattern of alcohol use and related problems exist among various ethnicities Slavs and Arabs in Belarus. The Slavs had higher percentages of alcohol users, but relatively lower proportion of problem drinkers, compared to the results of the Arabs. Higher AUDIT scores were recorded for the Arabs. No significant differences were noted in the preference for alcoholic beverages among all ethnicities. Published: 22 April 2010

The spread of HIV among drug and alcohol users, as a high-risk group, is a significant problem in Africa, as in other parts of the world. Few programs have been implemented in Africa to deal specifically with this issue. Since November 2006, the AED Capable Partners Program in Kenya project has provided technical direction to eight Kenyan NGOs to design and implement programs to reduce the spread of HIV among this population. Programs were developed utilizing conventional outreach models modified for application in Kenya and various other community-based interventions geared to reduce HIV among substance abusers. In addition to outreach, programs also provide components of recovery services, VCT and general HIV education in varying degrees. The effectiveness of these programs is reviewed in this paper along with the need to develop advanced technical skills of NGOs to deliver more effective services. KEY WORDS: Alcohol, drug, community outreach, HIV and AIDS, Kenya

An estimated 38.6 million persons globally are living with HIV, of whom over 1.1 million reside in Zambia. Of the 2 million cases in the US, 64% of new cases among women are among African Americans. Alcohol and drug use represents a significant risk factor for HIV transmission among both Zambians and African Americans. In addition, gender dynamics in both the US and Zambia promote transmission. This study examines two interventions targeting HIV risk behavior among HIV positive substance users, women in Miami, USA (the New Opportunities for Women (NOW) Project) and men in Lusaka, Zambia (the Partner Project). The study compares the efficacy of these two culturally tailored sexual behavior interventions provided in group and individual session formats. US and Zambian participants increased sexual barrier use and reduced substance-related sexual risk. Comparatively greater gains were made by higher risk Zambian males than US females in both group and individual conditions. Among lower risk participants, women in the group condition achieved and sustained the greatest comparative risk reductions. Results suggest that cost effective group HIV transmission risk reduction interventions for multiethnic individuals can be successfully implemented among both female and male drug and alcohol users in multinational settings.

This study estimates the individual and joint prevalence of cigarette smoking and alcohol misuse, and examines the association between these risks and socioeconomic factors in Thailand. The self-reported data on cigarette and alcohol use are from a 2004 nationally representative cross-sectional survey of 39290 individuals aged 15 and over. Substantially more men than women were current smokers (45.8% vs. 2.3%; p

O objetivo deste trabalho é fazer uma revisão de literatura a respeito do ensaio dos micronúcleos, explicando o seu significado e sua aplicação em células esfoliadas da mucosa bucal. Micronúcleo (MN) é um núcleo acessório, originado a partir de fragmentos de cromossomo ou de cromossomos inteiros que não são incluídos no núcleo principal durante a mitose. MNs surgem por alterações genéticas espontâneas ou são induzidos por agentes genotóxicos. A análise dos micronúcleos tem sido utilizada como uma ferramenta importante de biomonitoramento de populações. Estudos demonstram que consumidores de fumo e álcool, assim como grupos expostos a determinados agentes em função de sua ocupação ou estilo de vida apresentam um elevado número de MNs nas células bucais esfoliadas., The aim of this study is to summarise the literature on micronucleus assay, explaining its meaning and its application in exfoliated oral mucosal cells. Micronuclei (MN) is an extra nuclei, originated from chromosome fragments or whole chromosomes that are not included in the main nuclei during mitosis. MNs arise from spontaneous genetic damage or are induced by genotoxic agents. MN analysis has been used as an important tool to biomonitore populations exposed to life-style agents. Studies demonstrate that tobacco and alcohol users, as well as occupationally exposed groups present increased number of MNs in exfoliated oral mucosa cells. Despite the fact that the role of MN frequency has not yet been fully understood, the MNs assay is considered to be an effective biomarker of oral squamous cell carcinoma risk factors effects

O álcool é a droga mais consumida no mundo, que pode gerar problemas sociais e de saúde, afetando usuários, pessoas que com estes convivem e a sociedade em geral. O objetivo foi identificar melhores evidências em intervenções para redução do abuso de álcool. Revisão integrativa de literatura, realizada na LILACS, CINAHL, PUBMED e SCOPUS, por meio dos descritores intervention studies e alcoholism. Os 19 artigos selecionados, em sua maioria, foram classificados como nível dois de evidência, envolviam intervenções com usuários de álcool, destacando-se como as mais eficientes as intervenções breves, intervenções baseadas na internet e aconselhamento. Embora não se comprovou a cessação do uso do álcool a partir das intervenções, os resultados apontam redução significativa do consumo, aumento na disponibilidade para mudança do ato de beber e impacto efetivo das intervenções breves quando comparadas aos tratamentos usuais. As intervenções breves constituem as melhores intervenções para redução do abuso de álcool.

Purpose This study will present the prevalence of self-reported marijuana and alcohol impaired driving, compare perceived risks of driving under the influence of alcohol versus marijuana, and examine risk factors associated with impaired driving. Methods Data are from a telephone survey conducted by the Colorado Department of Transportation in 2014. The survey included questions assessing substance use, perceptions of risks and consequences related to impaired driving, and frequency of impaired driving among a representative sample of Colorado adults. The sample (n = 770) was weighted to reflect the 2010 Census estimates for Colorado. Results Few respondents perceived it safe to drive under the influence of alcohol (6%). However, those who reported past month marijuana use were more likely to report that they could safely drive after using marijuana (49%) compared to those that did not use in the past month or those that used alcohol in the past month. Of those that used marijuana in the past month, 73% endorsed marijuana impaired driving is safer than alcohol impaired driving. Marijuana users reported driving under the influence of marijuana on an average of 5.1 days in the past month compared to alcohol users who reported driving alcohol impaired on 1.2 days. Marijuana impaired drivers were more likely to be male, younger (18–34) and have some college education as compared to a bachelor degree or more education. Conclusions Perceptions of risk associated with marijuana impaired driving is lower than that associated with alcohol, particularly for current marijuana users. Current marijuana users drive impaired more frequently than alcohol users. Significance Understanding who drives impaired and their perceptions of risk can inform prevention messaging and public awareness campaigns.

Introduction: HIV/AIDS is one of the most destructive epidemics the world has ever witnessed. Non-adherence to the proposed antiretroviral regimen is considered to be one of the greatest dangers to the response to treatment on an individual level and the dissemination of resistant viruses on the community level. An adherent patient is defined as one who takes > 95% of the prescribed doses. Objective: To assess the level of adherence and associated factors among adult HIV/AIDS patients receiving Highly Active Antiretroviral Therapy in Mekelle Hospital, Northern Ethiopia. Methods: A cross sectional study was carried out from January 1, 2013 to July 30, 2013 among 382 adult PLWHA (>=18 years) attending HAART clinic at Mekelle Hospital. Data was collected by a combination of structured questionnaire and document review. The data was entered and cleaned using Epi-Info; transported to SPSS 16.0 version for final analysis. Bivariate and multivariate analyses were performed to identify factors associated with adherence. Results: The rate of self reported adherence in the study based on the Schedule and indicator of the dose, time measurement in the last 7 days was (78.3%). Females were more adhered than males (185(87.7%)). Alcohol users have poor adherence than non alcohol users with 70.5% and 82.2% level of adherence respectively. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18, 6.69) and 2.60(1.43, 4.71) respectively. Conclusion: The level adherence we found, 78.2%, is still very low considering the WHO recommendation of 95%. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18,6.69) and 2.60(1.43,4.71) respectively. More focus should be given to males and individuals with low educational status to improve level of adherence and to assure the efficacy of HAART in prolonging the life of PLWHA. Adherence is a process, not a single event, and adherence support must, therefore, be integrated into regular clinical follow up. Investigation of factors related with long-term adherence would require longer follow-up than the present study.

The role of platelets in the neurological diseases that underlie cognitive impairment has attracted increasing attention in recent years. Multiple pathways in platelets contribute to host defenses, as well as to CNS function. In the current study, we hypothesize that the Blood Brain Barrier (BBB) is disrupted when exposed to platelets from patients with triple Co-morbidity (hazardous alcohol users+ HIV+ thrombocytopenia), compared to those with dual, single or no morbidity (HIV only, alcohol only or healthy controls).

Two direct ethanol metabolites, namely ethyl glucuronide (EtG) and cocaethylene (CE), in the hair of cocaine (COC) users were compared in this study. Hair samples (n = 68) were submitted to the determination of EtG (by liquid chromatography-electrospray-tandem mass spectrometry) and of COC and metabolites, including CE (by gas chromatography-mass spectrometry). Quantitative and qualitative results were compared. No quantitative correlation was found between EtG and CE, as well as between EtG and the cocaethylene concentration divided by the concentration of COC and its metabolites (benzoylecgonine and ecgonine methylester, as COC equivalents). Nevertheless, many factors are supposed to affect the amount of the two substances incorporated in the hair matrix, such as the subject's habits in ethanol and COC use, genetic variability in the metabolism of both substances, and the different chemical and physical properties of EtG and CE. When establishing a cut-off of 4 pg/mg for EtG and of 200 pg/mg for CE, 47 samples tested positive for EtG and 41 samples tested positive for CE; 12 samples out of the 47 EtG-positives tested negative for CE (25%), whereas 6 samples out of the 41 CE-positives tested negative for EtG (15%). According to these data, EtG appears to be a more sensitive and specific marker of non-moderate alcohol users than CE.

Background: Reduction of tobacco use in the general population is preceded by a reduction in tobacco use among health professionals. There are very few data on tobacco use among health professionals in Nepal and no data on their role in cessation.Methods: We conducted a cross-sectional study among 377 health professionals (men 59%) in two of the 75 districts of Nepal to understand their tobacco use, factors associated with tobacco use and their role in tobacco cessation. Information on tobacco use, alcohol use, friends’ use of tobacco, knowledge on harmful effects of tobacco use and health professionals’ self-reported tobacco intervention was collected using a pre-tested and structured questionnaire. Multiple logistic regression analysis was conducted to identify the important predictor variables of tobacco use.Results: Overall prevalence of current tobacco use was 20.4% (95% CI 16.5–24.9); men 32.4%, women 3.2%. Multiple logistic regression analysis showed that men (OR 6.87; 95% CI 2.41–19.53), alcohol users (OR 3.91; CI 2.08–7.36) and those whose friends used tobacco (OR 3.40; CI 1.79–6.45) were more likely to be current tobacco users compared to their counterparts. Current users were less likely to always ask (p < 0.001) and advise (p < 0.001) on tobacco use compared to nonusers.Conclusion: More than 20% of health professionals in our study currently used tobacco. Efforts should be made to control tobacco use among health professionals focusing on men and alcohol users. Strategies to resist peer pressure and making health institutions tobacco free are likely to reduce tobacco use among health professionals.

The Personal Responsibility and Work Opportunity Reconciliation Act imposed work requirements on welfare recipients. Using 1999-2001 data from Boston, Chicago, and San Antonio, we compared the labor market and welfare experience of women with four employment barriers: poor mental health, moderate to heavy drug and alcohol use, a child with a behavior problem, and a child under the age of 3. Women with poor mental health and drug and alcohol users were much less likely to move into work than other groups, and more likely to be sanctioned for noncompliance with welfare requirements in 2000-2001 as federal work participation requirements increased

The aim of this study was to predict retention in residential rehabilitation (RR) services for drug users, focusing on service provider factors. A national postal survey of RR services in England and Wales was carried out and information was obtained from 57 of 87 services identified (65.5%). Service managers were asked to complete a questionnaire asking about treatment philosophy, treatments provided, staff characteristics and staffing levels, as well as overall service size and funding. Services also provided information on the number of clients admitted and the number who had completed, dropped out and been asked to leave in the past year. Completion rates varied widely, from 3% to 92%, with an average of 48%. Higher completion rates were associated with lower counsellor caseloads, fewer beds, single rooms, shorter scheduled treatment durations, higher fees per client and provision of what could be termed a balanced treatment programme containing adequate amounts of individual counselling and programme-free time, and with only moderate demands for domestic duties. Programmes with more drug than alcohol users had lower completion rates, but the proportion of dual diagnosis or criminal justice referred clients did not appear to affect retention. Completion rates varied as a function of a number of service factors that are amenable to manipulation. To retain clients successfully, programmes should not be too large and should have adequate levels of therapeutic staff, a well-developed treatment schedule which is not too demanding for the client in terms of duties or overall time spent in structured activities, and which incorporates sufficient levels of individual counselling. [Meier PS, Best D. Programme factors that influence completion of residential treatment. Drug Alcohol Rev2006;25:349 - 355].

A community-based cross-sectional survey with cluster sampling method (probability proportionate to size) was carried out to estimate the prevalence of alcohol consumption among Nepalese women in Dharan town to assess the pattern of use and to identify the factors associated with this habit. A representative sample of 2340 women, aged 15 years and above was interviewed in 2002. The estimated prevalence of alcohol consumption was nearly 17%. Alcohol use is prevalent among females of hill ethnic groups. Nearly half of the divorced (formal or informal) women consumed alcohol. The women, aged 50 years and above, were at risk to become addicted to its use. Most popular drink in this area is a homemade product (Local Raksi). The alcohol users are more likely to smoke as well. More than 9% of pregnant women are found to consume alcohol during their pregnancy. Effective awareness programs are required to discourage the excessive use of alcohol among women and encourage those seeking regular health care services.Key Words: Prevalence, pattern, factors, women, alcohol, Dharan, Nepal.

Despite the widespread use of tobacco and alcohol by illicit drug users, the medical effects of smoking and alcohol use remain understudied among such individuals. We investigated the relationship between smoking and alcohol use, and medical symptoms among 125 cocaine dependent patients. Subjects were assessed for smoking, alcohol use, and medical problems using a standardized self–report instrument (MILCOM). Medical symptoms were compared among nonsmokers, moderate smokers (less than 10 cigarettes per day), and heavy smokers (10 or more cigarettes per day) using partial chi–square statistics. Similar comparisons of medical symptoms were made between alcohol users (more than 2 drinks per day) and nonusers. Contrary to our expectations, there were no significant differences between nonsmokers, moderate smokers, and heavy smokers across most of the 14 major medical systems. However, regardless of the level of cocaine use, nonsmokers reported the fewest symptoms on the general subscale (p < 0.05) while moderate smokers reported the most nose/throat and respiratory symptoms (p < 0.01) among the three groups. As expected, significant relationships were observed between medical symptoms and alcohol use. Alcohol users reported more respiratory (p < 0.05), cardiovascular (p < 0.01), digestive (p < 0.05), head/neck (p < 0.001), eye (p < 0.01), and general (p < 0.05) symptoms than nonusers. While the findings generally support the link between alcohol and medical problems, it seems that the relationship between medical symptoms and smoking among cocaine patients may be more complex than that observed in the general population.

This paper presents a report of an observational study on the impact of alcohol and presence of women on verbal behaviour of Nigerian alcohol users. Specifically, the study investigated how speech is influenced by alcohol use in relation to; the frequency of speech, the type of issues discussed and if the presence of women is related to these aspects of verbal behaviour. Three hundred and thirty-one Nigerians were unobtrusively observed in alcohol and/or non- alcohol scenes. In 78% of the 77 locations covered, the people observed used alcoholic drinks. An observational schedule in which a list of issues (themes) was made was used to collect the data. Two trained observers visited each location during which a group of drinkers and / or diners were observed and the content of their speech recorded using the themes on the schedule as a guide. The analysis of data showed that the total frequency of issues discussed was significantly more in the alcohol scenes than the non- alcohol scenes. But in terms of specific issues discussed, there were significant differences between the locations only in the case of seven (7) issues out of twenty-four (24) issues in favour of alcohol serving locations. Furthermore, the result showed that the presence of women significantly influenced the frequency of speech and not the type of issues discussed. In other words, speech was more in the women-present locations than the women —absent locations. However, there were no significant differences in specific issues discussed between the locations. In general, alcohol-serving locations were inclined to the discussion of less serious issues such as women (19.6%) whereas the non- alcohol serving locations were more inclined to discussion of serious issues such as the economic condition of the country. The findings were discussed in terms of the effect of alcohol on people’s mental activities relevant to speech production, particularly the removal of inhibition following alcohol use. Suggestions for future directions of research in the area were made. (IFE Psychologia (2002) 10(2), 185-198)

Schizotypy research has revealed associations between positive schizotypal symptomatology and substance use but has not related substance use to important schizotypal traits such as anhedonia. Users and nonusers of cannabis and alcohol completed the Oxford-Liverpool Inventory of Feelings and Experiences, the Peters Delusion Inventory, and the Hospital Anxiety and Depression Scale. Cannabis users scored significantly higher on Unusual Experiences, a scale measuring positive schizotypal symptomatology. Both cannabis and alcohol usage were associated with significantly lower scores on Introvertive Anhedonia, which represents negative symptomatology. Delusional ideation and delusional conviction were significantly higher in cannabis users, but for delusional conviction this was only true for users who also drank alcohol. Neither anxiety or depression scores were higher in cannabis users, but delusional ideation correlated with both anxiety and depression, thus providing mixed support for the idea of the "happy schizotype." Overall, these results suggest that cannabis and alcohol usage is related to different dimensions of psychosis-proneness that broadly parallel the relationship between substance use and positive and negative schizophrenic symptoms, thus supporting the continuity view of psychosis and the multidimensionality of psychosis-proneness.

Background: Sexual behaviour is an important determinant of HIV transmission. Aims & Objective: To study sexual behaviour among migrant construction workers in Indore. Materials and Methods: A population based cross sectional survey of sexual behaviour among migrant construction workers. Results: Median age at first sexual exposure was 20 years. Only 34.68 % of the respondents could tell at least two correct ways of protection from HIV. 16.30 % had sex with non-regular partner. 86.49% of individuals reporting casual sex reported use of alcohol. Condom use during casual sex was very low 29.72%. Conclusion: The study has brought out that migrant labor is a high risk group for HIV transmission in view of poor knowledge, high proportion of alcohol users among those reporting casual sex, and low proportion of condom use during casual sex.

Surnmna~ -Th~s study examined che rehability of an inventory measuring AIDSrelated knowledge among 553 black drug users. Data were collected from a socially high-risk cornmunlry in Birmingham, Alabama. The KR-20 reliability scores were computed from the inventory for each drug-use group. The KR-20 rehabilities ranged from .39 to .57. These findings may suggest chat the inconsistent reports of the predictive power of AIDS knowledge among drug users reported in previous studies might be related to the low internal consistencies of the inventory. There is considerable evidence that the use of alcohol or i however, research has shown that knowledge of AIDS has not successfully prehcted behavior of drug users (1, 2). This poor prediction may be attributable to two reasons: (a) the inventory measuring AIDS-related knowledge of drug users may not be reliable and (b) the sample of drug users selected for study may consist of different types of drug users and the cognitive traits of these drug users may ddfer. For example, some samples may consist of mostly alcohol users, while another study sample may include individuals who use &it drugs such as marijuana and crack or those who swap needles. The present study attempted to examine these issues in communities where drug use is common.

In this article Michelle Duffin reports on the difficulties of finding adequate housing for vulnerable groups including drug users and ex drug users.

OBJECTIVE This study used laboratory tests to identify current drug and alcohol users among psychotic patients seeking treatment in an urban psychiatric emergency room. Rates of clinician-suspected use and self-reported use were compared, as were treatment and disposition of users and nonusers. METHODS Logistic regression modeling was used to identify factors that differentiated current substance users from nonusers in a sample of 112 psychotic patients. RESULTS Laboratory analyses revealed that 24 of the 112 psychotic patients (21 percent) had used alcohol or an illegal substance before visiting the emergency room. Younger age, male gender, African-American ethnicity, clinician-suspected substance use, and presentation in the emergency room between 7 p.m. and 7 a.m. were associated with a higher likelihood of positive results on the urine test. Only five of the patients who had positive results (21 percent) self-reported substance use. Clinicians suspected that 59 patients (53 percent) were under the influence; however, only 17 of those suspected (29 percent) had positive laboratory results. Patients with positive laboratory results required more intense care in the psychiatric emergency room and were more often hospitalized. CONCLUSIONS Some demographic and clinical factors were associated with concurrent substance use among psychotic patients in the emergency room. Clinicians' suspicions of use in this sample of psychotic patients lacked specificity due to the fact that potential use was suspected in a large number of cases for which laboratory results were negative. In contrast, self-reported use was uncommon among patients with positive results. Because neither clinician judgment nor patient self-report meaningfully predicts current substance use, routine urine drug screens may be appropriate.

Working with Drug and Alcohol Users—A Guide to Providing Understanding, Assessment and Support . By Tony White, Jessica Kingsley, 2012. £19.99. 224 pp. ISBN: 978-1-84905-115-6. The author is a registered psychologist in private practice in Western Australia. He is also a teacher and a supervisor of transactional analysis psychotherapists. The book comes from his experience of 30 years of work with clients suffering from various forms of drug misuse-including alcohol. The book is clearly written and would be of interest to those setting out on a career as a counsellor or cognitive behaviour therapist. The clinical illustrations in the book bring alive some of the constructs of transactional analysis. The first chapter contains a cursory …

One of the most important concerns about alcohol harm is on the psychophysiological sphere, especially in conditions of longterm alcohol use. In fact this remains a very important concern to alcohol users too. Hence, indices of psychophysiological functions could well serve the most important indicators for defining “moderate” and “problematic” level of use. While up-todate definition of moderate alcohol use varies across scientific studies, there is a growing need for unification and guidelines for unit specification. The different concentrations of endogenous synthesized ethanol in different categories of people also compound the problem of guideline unification, besides differences in the definition of endogenous synthesis. In this study we analyze the range of values for moderate and problematic alcohol use, based on solid and flexible psychophysiological parameters. We also analyze the frequency and number of peer-reviewed literature (in scientific databases) defining moderate, and problematic use, and non-alcohol use, and their corresponding dose classification. The results of this study show that cells are very sensitive to slight increase in endogenous alcohol (caused by increased endogenous and exogenous intake or variations in internal and external milieu). The resultant effect is the remodeling of physiological functions of the cells; both intracellular and extracellular signaling mechanisms are affected. Physiological cellular changes resulting from increase in both intracellular and extracellular ethanol concentration will serve a useful criterion for formulating moderate threshold of exogenous ethanol.

Cocaine abusers (N = 42) from an inpatient drug rehabilitation program were interviewed regarding combined use of cocaine with alcohol or cigarettes. Concurrent use of alcohol and cocaine was reported by 37 patients and concurrent use of cigarettes and cocaine by 41 patients. All but two concurrent users reported simultaneous use of alcohol or cigarettes with cocaine. Increased cocaine effect was perceived by 43% of simultaneous alcohol users compared with 15% of simultaneous cigarette users. Patients experienced decreased craving for cocaine and alcohol during treatment, but craving for cigarettes remained essentially unchanged.

Introduction The study was carried out to describe the characteristics of three wheeler drivers and to determine the associated driver factors for the road traffic accidents involving three wheelers registered in the Urban Council, Panadura. Methodology A descriptive cross sectional study was carried out in the Urban Council (UC) area of Panadura. A total of 338 eligible three wheeler (TW) drivers were studied using a pretested interviewer administered questionnaire. Results The mean age of the three wheeler drivers was 33.3 (SD ±8) years. Fifty two percent (n=175) had studied up to grades 6 to 10 and 42.3% (n=143) have sat for the G.C.E. (O/L) Examination. Their median monthly income was Rs.18000 (IQR 13000, 20000). 66% (n=223) were alcohol users, 53.6% (n=181) were smokers and 5.6 %( n=19) were illicit drug users. There were 49 (14.5%) road traffic accidents (RTAs) involving TW drivers during the period of 6 months prior to the research. The occurrence of RTAs was significantly higher among the drivers who drive rented TWs (OR=2.48; 95% CI: 1.32 - 4.66), who have the habit of driving after having alcohol (OR= 2.06; 95% CI: 1.11 - 3.79) and smoke while driving (OR= 2.27; 95% CI: 1.23 - 4.19) compared to drivers who drive their own TWs, who never drink and drive and who never smoke while driving respectively. Conclusions Alcohol use and smoking were common among TW drivers. RTAs are more common among drivers who drive rented TWs, who have the habit of drinking and driving and smoking while driving. DOI: http://dx.doi.org/10.4038/jccpsl.v15i1.4937 Journal of the College of Community Physicians of Sri Lanka Vol.15(1) May 2010 33-44

Background: Youth alcohol use is serious health problem. Consequences of youth alcohol use include suicide, homicide, sexual assault, risky sexual behaviors, unintentional injuries, other drug use, and failing grades. Methods: This study examined whether recent alcohol use among 7th - 12th grade students (N = 54,361) differed based on frequency of pro-social behaviors, risky behaviors; friends’ involvement in alcohol/drug use; and specific parent, teacher and school factors. Results: Results indicated that 20.3% reported using alcohol in the past month. Male students were more likely than female students to report recent use. Hispanic students were also at increased risk for using. Compared to nonusers, recent alcohol users were more involved in risky behaviors, less involved in pro-social behaviors, and less likely to have parents and teachers talk about and set/enforce rules regarding alcohol use. Conclusions: Recent alcohol use is a significant issue among youth with one in four youth reporting this behavior. Positive connections to parents, teachers/school protected students from recent alcohol use.

How the psychophysiological functions (cognition, attention, memory, neuropsychic functions) change after alcohol use at different doses remains poorly understood. This study examines the extent to which the psychophysiological functions are restored after moderate dose of alcoholic beverages. University students (non-alcohol users; alcohol users after 1–2 weeks and 3–6 weeks of drinking) approved their participation on a consent form after the aims and objectives of the study had been explained. Continuous Tests using psychphysiological methods were applied to produce maximum stressed condition for the participants. The statistical value for significance was set at p < 0.05. No significant changes in the psychophysiological functions were noted among the non-alcohol users. There was a significant decrease in psychophysiological functions of alcohol users in course of the study. Restoration of the psychophysiological functions was recorded only among drinkers of 3–6 weeks after alcohol use. Restoration of psychophysiological functions after alcohol use may take 3–6 weeks interval (abstinence time frame i.e. psychophysiological abstinence).

Present researches on students drinking behavior have laid down the mechanism of low academic performance among alcohol users (Welcome et al 2010). Although we had earlier shown that alcohol significantly reduces academic performance of students, how various parameters of academic performance (e.g. frequency of resit examinations) vary among alcohol users, compared to non-alcohol users remains unknown. In this study, we examined the relative risk of resit examinations among alcohol users, compared to non-alcohol users. Students of the Belarusian State Medical University, Minsk, Belarus participated after the study aims and objectives had been explained. The AUDIT screening instrument, Academic performance questionnaire according to (Welcome et al 2010) was employed with modifications. The number of times a given student had taken the same examination was stated and numbered from 0 (zero i.e. no resit) through 3 (maximum number of times to sit for a given examination). The statistical value for significance was set at p < 0.05. The risk of resit examinations was statistically higher among alcohol users, compared to the non-alcohol users by about half-times (p< 0.05). Also, the average grade point of alcohol users was lower than that of the non-alcohol users. According to the results of this study, the risk of resit examination associated with alcohol use significantly increases among alcohol users. This is not the case for non-alcohol users.

Alcohol causes significant sleep disturbance but the causes are not well understood. We investigated the relationship between alcohol use and periodic limb movements in a large population of patients at a sleep disorders center. The likelihood of having a clinically significant number of periodic leg movements (more than 20 per hour of sleep) was increased 3-fold in women who consumed two or more alcoholic drinks per day compared with those who did not (25% versus 8%). A similar relation was found among men (22% versus 13%). In addition, women who consumed two or more drinks per day were more likely to report symptoms of restless legs and to be diagnosed with restless legs syndrome. These findings suggest that periodic leg movements contribute to sleep disturbance in a significant proportion of alcohol users. Alcohol use may increase the frequency of periodic leg movements in susceptible individuals. On the other hand, subjects with symptoms related to periodic leg movements may be using alcohol to relieve symptoms, or the movements may be secondary to alcohol-induced sleep disturbance.

BackgroundAlcohol use is a major public health problem and contributes to the burden of disease world-wide. The problem of alcohol use might defer among the natives and foreigners in a given cultural milieu.AimTo screen for the prevalence of alcohol use among the native Belarusians and foreigners.Materials and methods1517 respondents (172 foreigners and the rest native Belarusians) from different cities in Belarus enrolled for the study. Standardized questionnaire containing the AUDIT, CAGE, MAST and other alcohol-related questions were administered to all respondents. The Student's t and Pearson, χ2 tests were employed for analysis of results.ResultsAlcohol users were 90% native Belarusians and 62% foreigners. Problem drinkers were 16% native Belarusians and 30% foreigners. A significant increase (in approximately 2 times) in the rate of alcohol use after a 2-4 years stay in Belarus was noted among the foreigners (p< 0.05).ConclusionThere is a significant difference in the pattern of alcohol use among the foreigners and native Belarusians. The rate of alcohol use and related problems is higher among foreigners, compared to the native Belarusians.

ObjectivesAlcohol use is a major public health problem in the general students’ population in Belarus. We therefore screen for the prevalence and trace the order of increase in alcohol use and related problems among students in Belarusian universities.MethodsA total of 565 (1st-2nd courses, mean age - 19yrs); 537 (3rd - 4th courses, mean age - 21yrs); and 397 (5th - 6th courses, mean age - 23yrs) university students in Minsk, Belarus were administered questionnaire, containing the AUDIT, CAGE. The cut-off point on the AUDIT was set at 8. All statistical analyses were performed using SPSS 16.0 version for Windows; the criteria of Pearson, χ2 and Student's t testsñ. The probability value for significance was set at p< 0.05.ResultsAlcohol use and related problems increased with increase in the average age and year of study. In the 1st - 2nd, 3rd - 4th, 5th - 6th, alcohol users were 83.6%, 85.6%, 94.2% respectively and problem drinkers were 14.5%, 17.9%, 20.9% respectively. The use of strong strength alcoholic beverages was linked to a high risk of alcohol problems.ConclusionThe level of alcohol use and related problems in the general students’ population in Belarus are high and show increase in order of increase both in the average age and the year of study.

ObjectivesThe influence of religion on the rate of alcohol use can not be overemphasized. In recent times, some studies have suggested that the inter-religion differences in alcohol use might be fading away. And that closer relationship might exist between the Christian and Muslim societies, especially in a population where alcohol use has become part of the life of people. We analyzed the prevalence of alcohol use and related problems among Muslims and Christians in Minsk, Belarus.MethodsAfter the aims and objectives had been explained, 65 Christians and 70 Muslims agreed to participate in the anonymous and randomized study which was conducted among students at major four universities in Minsk, Belarus. All respondents were administered the AUDIT, CAGE and MAST questionnaire. Statistical analysis was performed using SPSS 16.0 version for Windows and the Pearson χ2.ResultsThe present study revealed that no differences in both the number of alcohol users and problem drinkers exist (according to the results of all three screening instruments) among the Christians and Muslims. Alcohol users were 67.7% Christians and 57.1% Muslims. Problem drinkers were 27.7 Christians and 34.3% Muslims.ConclusionThis study is an exceptional one where for both Christians and Muslims, the percentages (as well as the average scores) of alcohol users and problem drinkers were the same on the AUDIT, CAGE and MAST.

ObjectivesThe problem of alcohol use is a major public health problem in the general students’ population in Belarus. We therefore screen for the prevalence and trace the order of increase in alcohol use and related problems among freshmen and seniors in Belarusian universities.Materials and methodsA total of 565 (1st - 2nd courses, mean age - 18.9yrs), 537 (3rd - 4th courses, mean age - 20.9yrs) and 397 (5th - 6th courses, mean age - 22.8 yrs) university students in Minsk (Belarus) were administered the AUDIT questionnaire, including other alcohol related questions. The cut-off point on the AUDIT was set at 8. All statistical analyses were performed using SPSS 16.0 version for Windows; the criteria of Pearson, X2 and Student's t testsñ. The probability value for significance was set at p< 0.05.ResultsAlcohol use and related problems increased with increase in the average age and year of study. In the 1st - 2nd, 3rd - 4th, 5th - 6th courses, alcohol users were 83.56%, 85.64%, 94.22% respectively and problem drinkers were 14.51%, 17.88%, 20.91% respectively. The use of strong strength alcoholic beverages was linked with a high risk of alcohol related problems, than the use of weak alcoholic beverages in the general students’ population.ConclusionThe level of alcohol use and related problems in the general students’ population in Belarus are high and show increase in order of increase both in the average age and in the year of study.

IntroductionA variety of inconsistencies in the pattern of alcohol use exists between male and female genders.AimTo examine the differences in the rate alcohol use and related problems in the general students’ population in Minsk, Belarus.Materials and methodsA total of 465 males (mean age of 21yrs) and 1030 females (mean age of 20.5yrs) were administered standardized anonymous AUDIT questionnaire. The cut-off point on the AUDIT was set at 8. Statistical analysis: All data analyses were performed using SPSS 16.0 version for Windows; the Pearson criteria and t-test. The probability value for significance was set at p< 0.05. All volumes of alcohol are in values of pure ethanol.ResultsAll in all, 85.7% males and 88.5% females were alcohol users. On the average, the total monthly quantities of alcohol use by the males and females were 131.3ml and 100.9ml respectively. Problem drinkers were 33.7% males and 10.1% females.Discussion and conclusionEven though the rate of alcohol use for the males and females was approximately the same, the percentage of related problems was significantly higher among the male population. Also, the quantity of alcohol use was higher among the males. The present study confirms that alcohol related problems are higher among males, compared to females.

ObjectivesAlcohol use by students is a major public health problem, leading to the Secondhand Effects - decrease in academic performance, injuries, blackouts etc.AimTo determine the extent of alcohol use on academic performance of university students.MethodsParticipants (n=46, mean age - 21 yrs) received the AUDIT questionnaire and other alcohol related questions. Grade Point Average and the effectiveness to sit for examinations of all participants from the 1st to 6th semesters of university education were used as objective criteria for problems related with alcohol use. The Pearson χ2 and Student's t-tests were employed for analysis of results. The probability value for significance was set at p< 0.05.ResultsAlcohol and non-alcohol users were 41.3% and 58.7% respectively. Among alcohol users, the average quantity of alcohol used by one person per month was 37ml of absolute ethanol. A 10.9 - 11.4% higher rate of academic performance was noted among the non-alcohol users only in the 3rd, 4th and 5th, 6th semesters. The cases of injuries and blackouts were higher among the alcohol users by approximately 35 times. About 75% of all drinkers reported alcohol use only during their university education. The dose-time response effect of alcohol use on cademic performance was also proven.

ObjectivesModerate alcohol use might be detrimental under certain conditions. We examined the efficiency of maintenance of blood glucose level (BGL) at normal range among non-alcohol and moderate alcohol users under intensive mental activities.MethodsFourth year medical students - male volunteers (5 non-alcohol and 8 moderate alcohol users who had abstained from alcohol for the last 7-10 days before the study) were involved in the study, which took 6 hrs on fasting. AUDIT, texts and questions, tests on visual, auditory short-term memory and attention were used as a measure. BGL was measured at 2hrs interval. Hypoglycemia was defined according to Galan ED et al (Neth J Med 2006; 64 (8): 269-279) as BGL ≤4.5mMole/L. The t-test was employed for statistical analysis.ResultsAlcohol users on the average drank 23ml of pure ethanol/session and 1-2 times/month. Non-alcohol users had increased BGL (4.02 as initial to 5.76mMole/L after 6hrs) in all phases of the experiment (ð< 0.001). Alcohol users had increase in BGL (0.45mMole/L increase, initial - 4.20) within the first two hours and a significant fall in the 4-6 hrs (p< 0.05) up to 3.80mmole/L, and was accompanied by a significant decrease in mental work productivity coefficient.ConclusionAlcohol use even in moderate doses results in hypoglycemia, subsequently leading to low mental work productivity, especially under 4-6 hr intensive mental activities.

BackgroundThe pattern of alcohol use might differ among people of different ethnic groups. Differences in alcohol use and related problems among undergraduates of various ethnic groups - Belarusians, Arabians and Nigerians in Belarus were examined.MethodsAltogether, 1345 Belarusian, 120 Arabian and 84 Nigerian undergraduates participated in a randomized anonymous study using the AUDIT questionnaire, including other alcohol related questions.ResultsOverall, 91.1% Belarusian, 63.3% Arabian and 56.9% Nigerian alcohol users were identified. A total of 16.3% Belarusians, 32.5% Arabians and 22.7% Nigerians were problem drinkers. Beer was the most preferred alcoholic beverage among the general undergraduates’ population of all ethnicities.ConclusionDifferences in the pattern of alcohol use and related problems exist among the undergraduate population of various ethnicities in Minsk, Belarus. The Belarusians had higher percentages of alcohol users, but relatively lower proportion of problem drinkers, compared to the Arabs and Nigerians. No significant differences were noted in the preference for alcoholic beverages among all ethnicities.

Carbohydrate-deficient transferrin (CDT) in serum was studied as a possible marker of heavy drinking in a sample of 187 female and 102 male 1st year university students from Finland. CDT was measured by a new radioimmunoassay (Pharmacia CDT RIA). Alcohol consumption was measured on a quantity-frequency scale. For female students CDT was 18.2 +/- 0.45 units/liter (mean +/- SEM) and for male students 13.3 +/- 0.48 units/liter. 9.6% of female students and 7.8% of male students had elevated CDT with a cut-off level of 26 units/liter for females and 20 units/liter for males. The correlation between CDT and reported alcohol consumption was 0.30 (p less than 0.001) for females and 0.25 (p = 0.014) for males. Those reporting a consumption of at least 10 kg of pure ethanol per year were considered as heavy drinkers (3.7% of females and 22.5% of males). In female students the average CDT of heavy drinkers did not differ significantly from that of social drinkers but in teetotalers CDT was significantly (p less than 0.03) lower than in female alcohol users. In male students the average CDT of heavy drinkers was higher than the average of social drinkers (p less than 0.1) and significantly higher than the average of teetotalers (p less than 0.001). In the detection of heavy drinking among male students elevated CDT had a specificity of 96.2% and a sensitivity of 21.7%.(ABSTRACT TRUNCATED AT 250 WORDS)

Treating Drinkers and Drug Users in the Community . By Tom Waller and Daphne Rumball, Blackwell Science, Malden, MA, 2004, £38.50. Paperback: 480 pp. ISBN-10: 0632035757 This book is grounded in the principle of a unified approach to understanding and helping alcohol and drug takers with problems or dependence. So for instance, combined services for drug and alcohol users are espoused. Tobacco smoking is omitted ‘reluctantly’ except in relation to pregnancy, prevention in young people and physical health because of size constraints to the book, but the authors acknowledge that for a truly combined substance approach it would be more fully covered. With the statement in the foreword ‘The old battles of abstinence-orientated treatments versus maintenance and harm reduction are battles based on ignorance and grounded …

PURPOSE: Geographic variation in hepatocellular carcinoma (HCC) has not been previously studied in the US. The purpose of this study was to determine whether geographic variation exists in the incidence of HCC and to assess the effects of individual and population-level risk factors. METHODS: Using NCI SEER program data, we identified cases of HCC from 5 states and 4 metropolitan areas. The 1990 BRFSS survey provided regional prevalence data for several HCC risk factors. Age-adjusted incidence rates were calculated for each geographic region. Hierarchical linear modeling was used to assess the association between HCC incidence and geographic region, adjusting for age, gender, race, year of diagnosis, and the population prevalence of current smoking (smoke everyday/some days and ≥100 cigarettes in lifetime), chronic alcohol use (⩾2 drinks/day or ⩾60 drinks/month), heavier body weight (BMI:25.0–29.9), and diabetes. RESULTS: Between 1975–98, 11,547 cases were identified. Hawaii had the highest age-adjusted incidence rate (4.6), followed by San Francisco-Oakland (3.2), New Mexico (2.0), Detroit (1.9), Seattle-Puget Sound (1.8), Atlanta-Metropolitan (1.7), Connecticut (1.6), Iowa (1.1), and Utah (1.0); all rates per 100,000. Overall, men had a 2–3 times higher age-adjusted incidence rate than women. Whites had an age-adjusted incidence rate of 1.5, blacks 3.2, and other races 7.0. However, variation in HCC incidence rates persisted among geographic areas irrespective of age, gender, or race. These geographic differences were confirmed by hierarchical linear modeling, adjusting for demographic factors; these analyses also showed that the risk of HCC was greater in regions with a higher proportion of alcohol users (p = 0.02) and heavier body weights (p = 0.06). CONCLUSION: Significant geographic variation in HCC incidence exists in the US. These variations are only partly explained by differences in age, gender, race, year of diagnosis, and prevalence of chronic alcohol use and heavier body weight in the underlying population.