21 July 2021 In General Health
BACKGROUND: College student drinking in on-premises establishments has been associated with heavy alcohol consumption and a range of problems including assault, fighting, risky sex, and drinking and driving. Although more strictly enforcing overservice laws might reduce heavy drinking in on-premises establishments, law enforcement agencies have few resource-efficient tools for doing so, resulting in these laws seldom being enforced. OBJECTIVES: In this paper, we report the results of an evaluation of the Stop Service to Obviously-impaired Patrons (S-STOP) program that was implemented in 303 bars and restaurants in 18 university communities in California using a randomized cross-over design (early vs. delayed implementation). The S-STOP program: (a) deployed pseudo-intoxicated patrons who attempted to purchase a drink when showing obvious signs of intoxication; (b) provided feedback to owners and managers on staff performance; and (c) offered free online refresher training for staff. RESULTS: Overall, alcohol servers in bars and restaurants in these college communities were willing to serve a pseudo-intoxicated mystery shopper 90% of the time. The study found no evidence that S-STOP reduced the prevalence of alcohol sales to apparently impaired patrons during the two intervention stages of the study. CONCLUSIONS: The findings highlight the need for developing effective interventions to prevent overservice and should prompt college and university leaders to take the lead in addressing the problem of alcohol overservice at on-premises establishments by working with community leaders, law enforcement, and retailers.
26 May 2021 In Pregnant Women
BACKGROUND: Alcohol consumption during pregnancy is associated with major birth defects and developmental disabilities. Questionnaires concerning alcohol consumption during pregnancy underestimate alcohol use while the use of a reliable and objective biomarker for alcohol consumption enables more accurate screening. Phosphatidylethanol can detect low levels of alcohol consumption in the previous two weeks. In this study we aimed to biochemically assess the prevalence of alcohol consumption during early pregnancy using phosphatidylethanol in blood and compare this with self-reported alcohol consumption. METHODS: To evaluate biochemically assessed prevalence of alcohol consumption during early pregnancy using phosphatidylethanol levels, we conducted a prospective, cross-sectional, single center study in the largest tertiary hospital of the Netherlands. All adult pregnant women who were under the care of the obstetric department of the Erasmus MC and who underwent routine blood testing at a gestational age of less than 15 weeks were eligible. No specified informed consent was needed. RESULTS: The study was conducted between September 2016 and October 2017. In total, we received 1,002 residual samples of 992 women. After applying in- and exclusion criteria we analyzed 684 samples. Mean gestational age of all included women was 10.3 weeks (SD 1.9). Of these women, 36 (5.3 %) tested positive for phosphatidylethanol, indicating alcohol consumption in the previous two weeks. Of women with a positive phosphatidylethanol test, 89 % (n = 32) did not express alcohol consumption to their obstetric care provider. CONCLUSIONS: One in nineteen women consumed alcohol during early pregnancy with a high percentage not reporting this use to their obstetric care provider. Questioning alcohol consumption by an obstetric care provider did not successfully identify (hazardous) alcohol consumption. Routine screening with phosphatidylethanol in maternal blood can be of added value to identify women who consume alcohol during pregnancy.
23 February 2021 In Liver Disease

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Whether moderate alcohol consumption plays a role for progression of NAFLD is disputed. Moreover, it is not known which tool is ideal for assessment of alcohol consumption in NAFLD. This study aimed to evaluate if moderate alcohol consumption assessed with different methods, including the biological marker phosphatidylethanol (PEth), is associated with advanced fibrosis in NAFLD.

METHODS: We conducted a cross-sectional study of patients with biopsy-proven NAFLD. All participants were clinically evaluated with medical history, blood tests, and anthropometric measurements. Alcohol consumption was assessed using PEth in blood, the questionnaire AUDIT-C, and clinical interview.

FINDINGS: 86 patients were included of which 17% had advanced fibrosis. All participants reported alcohol consumption < 140g/week. Average weekly alcohol consumption was higher in the group with advanced fibrosis. Moderate alcohol consumption, independently of the method of assessment, was associated with increased probability of advanced fibrosis (adjusted OR 5.5-9.7, 95% CI 1.05-69.6). Patients with type 2 diabetes mellitus (T2DM) consuming moderate amounts of alcohol had a significantly higher rate of advanced fibrosis compared with those consuming low amounts (50.0-60.0% vs. 3.3-21.6%, p<0.05).

CONCLUSIONS: Moderate alcohol consumption, irrespective of assessment method (clinical interview, AUDIT-C, and PEth), was associated with advanced fibrosis. PEth in blood >/= 50ng/mL may be a biological marker indicating increased risk for advanced fibrosis in NAFLD. Patients with T2DM consuming moderate amounts of alcohol had the highest risk of advanced fibrosis, indicating a synergistic effect of insulin resistance and alcohol on the histopathological progression of NAFLD.

23 November 2020 In Drinking Patterns

The purpose of this study was to investigate the association between drinking patterns and health-related quality of life (HRQoL) in the Korean general population and to validate the estimation of the association of alcohol use on HRQoL when former drinkers are separated from never drinkers and low-risk drinkers depending on gender. Data were collected from 23,055 adults (over 19 years old) who completed the Korean National Health and Nutritional Examination Survey (2010-2013).

Multivariate logistic and linear regression analyses were performed to investigate the association between drinking patterns and HRQoL. When former drinkers were separated from never drinkers and low-risk drinkers to control for misclassification bias, there were gender differences in the associations between alcohol use and HRQoL. Although the estimation of the association of alcohol use was not valid in men, the estimation of association was valid in women, as low-risk women drinkers showed better HRQoL than nondrinkers.

Therefore, when conducting research related to alcohol and health, analyses should correct for the various confounding variables and minimize the misclassification bias of drinking patterns. It is also necessary to consider gender characteristics when intervening to improve HRQoL related to drinking.

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