Introdução: A hipertensão arterial é de causa multifatorial, envolvendo hábitos de vida e estilos de vida inadequados como o consumo excessivo de bebida alcoólica que propiciam a elevação dos níveis pressóricos. Além disso, os sintomas relacionados ao transtorno mental comum também podem se associar ao estado de saúde, provocando mais danos ao sujeito com hipertensão arterial. Diante disso, o presente estudo teve como objetivo principal identificar associação entre a ocorrência de hipertensão arterial com o consumo de bebidas alcoólicas e a presença de transtorno mental comum em indígenas das aldeias Muras, residentes em região rural e urbana. Casuística e Métodos: Estudo transversal, de base populacional, com 455 indígenas Mura residentes no município de Autazes, Amazonas, Brasil. Foi aplicada a entrevista semi-estruturada com questões referentes aos dados socioeconômicos e educacionais, hábitos de vida, história clínica, histórico familiar, além dos questionários Alcohol Use Disorders Identification Test (AUDIT) e Self-Reporting Questonnaire (SRQ-20), para avaliar o consumo de álcool e presença de transtorno mental, respectivamente. A pressão arterial foi medida com aparelho automático de braço validado. Foram realizadas três medidas e usada a média das duas últimas medidas. Realizaram-se ainda, medida do peso, altura, circunferência do pescoço, circunferência da cintura, avaliação de bioimpedância; glicemia, triglicérides e colesterol com medida capilar. Na análise bivariada, foi testada a associação entre hipertensos, separadamente, com os dois desfechos: consumo de bebidas alcoólicas e a presença de transtorno mental comum explorando especialmente, os aspectos relacionados à hipertensão arterial. Foi ajustada a regressão de Poisson com variância robusta, para ambos os desfechos, com modelagem em stepwise backward automatizado, tendo como critério de entrada, p<0,20 e de significância no modelo final, p0,05. Utilizou-se como estimativa, as razões de prevalência e respectivos intervalos de confiança de 95%. Resultados: A maioria dos participantes era do sexo feminino (57,8%), com 42,10 (16,74) anos, vivendo com companheiro (74,7%) e cerca de quatro filhos por família, baixo nível de escolaridade Analfabeto/Fundamental incompleto (41,1%) e renda até dois salários mínimos (85,0%). A prevalência de hipertensão arterial foi de 26,6%, tabagismo (20,4%) e ser sedentário/irregularmente ativo (52,8%). O consumo de bebida alcoólica foi de 40,2%, sendo 13,4% classificados como alto risco para dependência alcoólica, e maior na área rural em comparação à urbana (57,3% vs 22,2%) p<0,001. Destacam-se os seguintes aspectos do uso abusivo de álcool: sentimento de culpa/remorso (45,9%); amnésia repentina por não lembrar o ocorrido na noite em que bebeu (31,7%); além de machucar-se ou sentir-se prejudicado por causa da bebida (29,6%); preocupação por parte de parentes, amigos ou profissionais de saúde, que aconselharam o entrevistado a interromper o consumo (51,5%). Não houve associação entre a presença e consumo de bebida alcoólica (23% e 26%). Os indígenas com diagnóstico de hipertensão referida, faziam menos uso de bebida alcoólica (14,2%vs 85,8%, p=0,009), porém nas ocasiões em que bebiam, ingeriam maior quantidade, comparado com os que não referiram hipertensão [55,3(72,2) vs 33,3(62,2) gramas de Etanol p=0,008]. A prevalência de transtorno mental comum foi de 45,7%, com destaque para os seguintes itens: referência de dores de cabeça frequentes (69,5%), sentir-se nervoso, tenso ou preocupado (66,2%), ter se sentido triste ultimamente (56,0%), dormir mal (55,2%) e ter sensações desagradáveis no estômago (42,9%). Além disso, destaca-se que 7,3% referiram ideia de acabar com a própria vida e 4,2% sentiram-se incapazes de desempenhar papel útil. Após análise ajustada a razão de prevalência após análise ajustada (Razão de prevalência, IC-95%), verificou-se associação positiva entre ingestão de bebida alcoólica e sexo masculino (2,72, IC-2,12-3,48), tabagismo (1,29, IC-1,06-1,56) e morar na zona rural (2,09, IC-1,61-2,72). Porém, a ação foi protetora para idade (0,98, IC-0,98-0,99), consumo de alimentos in natura (0,97, IC-0,95-0,99), e ausência de dislipidemias (0,75, IC-0,62-0,9). Entre os que apresentaram transtorno mental comum, a hipertensão arterial identificada esteve presente em 30,3% e o consumo de álcool uma vez ao mês em 22,1%. Após a análise ajustada (Razão de prevalência, IC-95%) verificou-se associação positiva entre o transtorno mental comum e a zona de moradia urbana (1.25, IC-1,02-1,54), não sabia que tinham antecedentes para diabetes (1.56, IC-1,24-1,96) e a ingestão de bebida alcoólica (1.01, IC-1,00-1,02). Porém, foi ação protetora não ter antecedentes pessoais de cardiopatia (0.59, IC-0,48-0,73). Conclusão: Observou-se que a presença de hipertensão arterial, consumo de bebida alcoólica e de transtorno mental comum foram elevados nos indígenas da etnia Mura. Esses achados podem ser decorrentes da aproximação e convivência entre indígenas e não indígenas favorecendo mudanças culturais, especialmente de hábitos e estilos de vida, com aumento do risco de doenças crônicas não transmissíveis. / Background: The arterial hypertension has a multifactorial disorder, including unappropriated habits and lifestyle as the excessive consumption of alcoholic beverages that may increase the blood pressure. Additionally, the symptoms related to the common mental disorder may be also associated with the health status, producing even more damages to the hypertensive subjects. Thus, this study aimed to identify the association of arterial hypertension occurrence with alcoholic beverages consumption and presence of common mental disorder in Indigenous from Mura villages, who live in rural and urban zones. Casuistic and Methods: Its a cross-sectional investigation, with demographic base, conducted with 455 Mura Indigenous from Autazes, Amazon, Brazil. Through a semi-structured interview, we gathered data about sociodemographic and educational profile, lifestyle, clinical records, family antecedents. In this occasion, the Alcohol Use Disorders Identification Test (AUDIT) and the Self-Reporting Questionnaire (SRQ-20) were applied to assess respectively the alcohol consumption and the presence of common mental disorder. The blood pressure was measured with an arm automatic device, validated for this goal, being three measures taken and, from the two last of them, a mean was obtained. Furthermore, we gathered weight, height, neck circumference, waist circumference, bioimpedance, glycemia, triglycerides and cholesterol, capillary measure for the last ones. In the bivariate analysis, we analyzed the association between hypertensive persons and the both outcomes- the alcohol consumption and the presence of common mental disorder, emphasizing the issues hypertension-related issues. The Poison regression, with robust variance, was adjusted for both outcomes, with a modelling in automatized stepwise backward, being p<0,20 the entrance criteria and p<0,05 the significance level for the final model. As estimative, we used the odds ratios and their respective confidence intervals of 95%. Results: Most were females (57,8%), with mean age of 42,2(16,74) years, living with a partner (74,7%), with about four children per family, poor educational level- Illiterate/Incomplete Basic (41,1%) and income of up two minimum wages (85,0%). 26,6% of the sample had hypertension, 20,4% were smokers and 52,8% were sedentary/irregularly active. Alcohol consumption was of 40,2%, with 13,4% showed high risk for alcohol addiction, and the consumption was higher in rural area in comparison with the urban one (57,3% vs 22,2%) p<0,001. We emphasize the following aspects of alcohol abuse: feeling of guilty and remorse (45,9%); abrupt amnesia for not remembering what happened in the night that they had drunk (31,7%); feeling hurt or impaired due to the drink consumption (29,6%); concerns from relatives, friends or healthcare professionals who advised the interviewed to interrupt the consumption (51,5%). There was not association between presence and alcoholic beverages consumption (23% and 26%). Indigenous diagnosed with referred arterial hypertension drank less alcoholic beverages (14,2%vs 85,8% p=0,009), but, when they drank, they had a larger amount than those with referred hypertension [55,3(72,2) vs 33,3(62,2) grams of Ethanol p=0,008]. The common mental disorder was identified in 45,7% of the individuals, being highlighted the following items: reporting of frequent headaches (69,5%), feeling nervous, anxious or worried (66,2%), feeling sad in the last days (56,0%), sleeping badly (55,2%) and having upset stomach (42,9%). Additionally, 7.3% reported the idea of committing suicide, and 4,2% felt themselves unable to play a useful role. We verified positive association between alcoholic beverage consumption and male gender (2.72, CI-2,12-3,48); smoking (1.29, CI-1.06-1.56); and living in rural area (2.09, CI-1.61-2.72). However, the action was protective for the age (0.98, CI-0,98-0,99), intake of natural foods (0.97, CI-0,95-0,99), and absence of dyslipidemias (0.75, CI-0,62-0,9). Among those diagnosed with common mental disorder, the arterial hypertension was found in 30,3% and the alcohol consumption once a month in 22,1%. We observed a positive association of common mental disorder and: living in the urban area (1.25, CI-1,02-1,54); unknowing the antecedents for diabetes (1.56, CI-1,24-1,96); and the alcohol consumption (1.01,CI-1,00-1,02). However, the absence of personal background of heart diseases was not protective (0.59, CI-0,48-0,73). Conclusion: We observed that the presence of arterial hypertension, alcoholic beverages consumption and common mental disorder were high in the Mura ethnicity. This finding may be explained for the approach and interaction among Indigenous and non-Indigenous, which favors cultural changes, especially in habits and lifestyle, increasing the risk of non-transferable chronic diseases.

Syftet med vårt arbete är att undersöka hur hemtjänstpersonal ser på problematisk alkoholkonsumtion i förhållande till självbestämmande bland äldre samt om det kan ha betydelse för deras omsorg av den äldre. Kvalitativa halvstrukturerade intervjuer genomfördes med hemtjänstpersonal (n=4) som analyserades hermeneutiskt utifrån teorier om makt och handlingsutrymme. Av resultaten framgår att självbestämmanderätten som Socialstyrelsen beskrivit den, är villkorad i hemtjänstpersonalens tolkning och att det saknas tydliga riktlinjer och rutiner i hemtjänstens arbete med äldre som har en problematisk alkoholkonsumtion. Resultaten visar att hemtjänstpersonalen gör individuella bedömningar i arbetet med äldre som har en problematisk alkoholkonsumtion. Det framgår att hemtjänstpersonalens arbete är förenat med svåra etiska ställningstaganden, där även maktförhållanden synliggörs och där hemtjänstpersonalen har tolkningsföreträde i förhållande till den äldre och förmynderi är en potentiell riskfaktor. En slutsats är att tydligare riktlinjer angående inköp av alkohol till äldre med en problematisk alkoholkonsumtion kan tänkas bidra till att hemtjänstpersonalen arbetar på ett mer likformigt sätt vilket i sin tur ökar rättssäkerheten för den äldre. / The aim of our study was to examine how integrity and self-determination is conceived by care assistants regarding older care takers with a problematic alcohol consumption, and if it affects their care provided. Qualitative semi-structured interviews, carried out with home care assistants (n=4) and analyzed hermeneutically with theories of power and discretion, showed that self-determination, as described by The Swedish National Board of Health and Welfare, is fulfilled only under certain conditions in the home care assistant’s interpretation. We also found a lack of guidelines and routines concerning problematic alcohol consumption among older care takers. Our results showed that home care assistants made individual assessments in their work with older care takers with problematic alcohol consumption actualizing a difficult ethical dilemma between neglect and paternalism. These ethical issues visualize power relationships where home care assistants have the prerogative to decide in relation to the care takers, where paternalism is a potential risk factor. Clear guidelines regarding the purchase of alcohol to older care takers with problematic alcohol consumption may contribute to home care assistants working more uniformly which leads to a higher state of legal security for the care takers.

Ce travail est principalement axé sur la modélisation par approche de groupe de trajectoires développementales de la consommation d'alcool des adolescents au Quebec. / Contexte: L’impulsion à cette étude est le fait que la consommation d'alcool chez les adolescents a augmenté au cours des dernières années et que la consommation excessive d'alcool épisodique est de plus en plus fréquente chez les jeunes adultes. La prévention des problèmes de la consommation d’alcool chez les jeunes doit commencer par l'identification appropriée des sous-groupes d'adolescents à risque élevé. Objectifs: Cette étude avait trois objectifs: (i) identifier les trajectoires de développement de la consommation d'alcool chez les adolescents; (ii) d'examiner l'influence du sexe sur les trajectoires et (iii) d'examiner la relation entre les trajectoires de consommation d'alcool à l'adolescence et la consommation d'alcool excessive épisodique à l'âge jeune adulte. Méthode: Nous avons utilisé des données de l'étude longitudinale (n = 1294, 1999 - 2012) des adolescents âgés de 12 à 13 ans au début de l'étude de NDIT (Dépendance de la nicotine chez les adolescents). Les 1245 participants qui ont complété au moins trois des 22 cycles de NDIT ont été stratifiés selon leur statut alcoolique. C’est à dire ceux qui avaient consommé de l'alcool au début de l’étude, les buveurs (n = 497) et ceux qui n'avaient jamais consommé d'alcool au début de l’étude, les abstinents (n=748). Nous avons identifié les trajectoires de développement de la fréquence de la consommation d'alcool sur la base de 19 vagues de collecte de données après le début de l’étude de la 7e année (de 12 à 13 ans) à la 11e année (17-18 ans) en utilisant la modélisation semi-paramétrique basée sur l’approche des trajectoires par groupe (GBTM). Nous avons conduit des séries de régression logistique afin d'étudier l'association entre les trajectoires de développement de la consommation d'alcool et la consommation excessive épisodique à l'âge jeune adulte chez les buveurs d’alcool au début de l’étude et les abstinents au début de l’étude. Résultats: Pour l’ensemble de l’échantillon global (abstinents et buveurs) cinq groupes de trajectoires ont été identifiés. Ensuite, quatre groupes de trajectoires ont été identifiés parmi les abstinents au début de l’étude (‘faible’ consommateurs (28.3%, n=215), consommateurs tardifs croissants (21.5%, n=161), consommateurs modérés (29.9%, n=224) et consommateurs réguliers (20.3%, n=152). Parmi les consommateurs d’alcool (buveurs) au début de l’étude, les groupes de trajectoires comprenaient des consommateurs d’alcool peu fréquents (rares) (15.4%, n=76), des consommateurs en hausse (34.1%, n=170), des consommateurs réguliers (41.7%, n=207) et des consommateurs en baisse (8.8%, n=44). Les adolescents des groupes de trajectoires de fréquence de consommation d’alcool les plus élevées étaient plus susceptibles de pratiquer la consommation d’alcool excessive épisodique à l’âge jeune adulte. Conclusion: Cette étude montre la variabilité des trajectoires de développement de la consommation d'alcool des adolescents. Les données suggèrent que des approches multiples peuvent être nécessaires pour prévenir la consommation problématique d'alcool chez les adolescents et que ces approches devraient être nécessairement adaptées au sexe. / Background: The impetus for this study is that alcohol use among adolescents has increased in recent years and that heavy episodic or binge drinking is increasingly common in young adults. Prevention of problem drinking must begin with appropriate identification of sub-groups of adolescents at higher risk. Objective: This study had three objectives: (i) to identify the developmental trajectories of alcohol consumption among teens; (ii) to examine the influence of sex on trajectories and (iii) to examine the relationship between alcohol consumption trajectories in adolescence and binge drinking in young adulthood. Method: We used data from the NDIT (Nicotine Dependence In Teens) longitudinal study (n=1294; 1999 – 2012) of adolescents ages 12-13 years at inception. The 1245 participants who completed at least three of 22 NDIT cycles were stratified into those who had consumed alcohol at baseline, baseline drinkers (n=497) and those who had never consumed alcohol, baseline nondrinkers (n=748). We identified the developmental trajectories of the frequency of alcohol consumption based on 19 data collection waves after baseline from grade 7 (age 12-13) to grade 11 (age 17-18), using semi-parametric group-based trajectory modeling. Logistic regression was conducted to investigate the association between the alcohol consumption developmental trajectories and binge drinking in young adulthood among baseline drinkers and baseline nondrinkers. Results: Five trajectory were identified for the whole sample (baseline nondrinkers and baseline drinkers, n=1245). Then, four trajectory groups were identified among baseline nondrinkers (low consumers (28.3%, n=211), increasing late consumers (21.5%, n=161), moderate drinkers (29.9%, n=224), and regular users (20.3%, n=152). Among baseline drinkers, trajectory groups included experimenters (15.4%, n=76), increasing (34.1%, n=170), regular (41.7%, n=207) and decreasing consumers (8.8%, n=44). Participants in the higher trajectory groups were more likely to binge drink in young adulthood. Conclusion: This study shows variability among adolescents in alcohol consumption developmental trajectories. The data suggest that multiple approaches may be necessary to prevent problem alcohol consumption among adolescents and that these approaches may need to be sex-sensitive.

Abstract   Mean, A.F. S. (2019). How Student Health Center motivate university students to reduce alcohol consumption? A qualitative interview study was carried out at three selected Swedish universities and four professionals employed were included in this empirical study. Bachelor thesis in Public Health Science. Department of Occupational and Public Health Science. Faculty of Health and Occupational Studies. University of Gävle, Sweden.   Background: Universities and Student Health Centers are arenas that works with motivation methods to reduce student’s alcohol consumption during studies. Previous studies have discussed social norms, alcohol culture and pointed out that nearly half of all Swedes between 18-25 years are university students. Over the years, this age group has had a higher alcohol intake compared to other periods in life. High alcohol consumption can affect health and all three sustainable aspects: social, economic and environmental sustainability that according to SDGs is to be achieved at year end 2030. The Aim of study: was to investigate how Student Health Centers motivate students to reduce alcohol consumption. Method: A qualitative interview study was carried out at three selected Swedish universities and four professionals’ employees at Student health centers were included in this investigation. Result: The Student Health Centers used a number of different evidence-based methods and strategies with motivational interview to motivate university students to reduce their alcohol consumption. Motivational work was focused on both individuals and groups. Motivational work based on personal experiences and the implementation of motivational conversations with students were accordance with students´ health status and their alcohol issues. Discussion: Students search motivational counseling not because of perceived alcohol problem, but due to stress factors and similar problems. A change in attitudes towards less alcohol intake among young adults could be reached due to increased awareness and knowledge of alcohol harm and alcohol-free drinks alternatives. Conclusion: The main task of the student Health Service is to try to reach all university students by using different motivational methods and tools. The main goal is to increase health promotion, reduce alcohol risk, prevent alcohol abuse and injuries at universities and colleges. Further qualitative research is needed to be able to identify patterns of underlying stress factors and alcohol-related ill-health among university students on a larger number of Universities and Student Health Centers. / Sammanfattning   Bakgrund: Universitet och Studenthälsan är arenor som arbetar med motiverande metoder för att minska studenters alkoholkonsumtion under studietiden. Tidigare studier har diskuterat sociala normer, alkoholkultur samt visat att närmare hälften av alla svenskar mellan 18–25 år är universitetsstuderande. Under studieåren hade denna åldersgrupp högre alkoholintag jämfört med andra perioder i livet. Hög alkoholkonsumtion kan förutom hälsa även påverka de sociala, ekonomiska och miljömässiga hållbarhetsperspektiven som enlig SDGs ska uppnås vid årsslut 2030.   Syfte: är att undersöka hur Studenthälsan motiverar studenter till minskad alkoholkonsumtion. Metod: En kvalitativ intervjuundersökning har utförts på tre utvalda svenska universitet där fyra yrkesverksamma på Studenthälsomottagningar har inkluderats.   Resultat: Studenthälsan använder en rad av olika evidensbaserade metoder och strategier för att motivera universitetsstudenter till att minska sin alkoholkonsumtion. Motiverande arbete är inriktat på både individer och grupper. Motiverande arbete bygger ofta på samtal som baseras på aktörernas personliga erfarenheter och studenternas alkoholfrågor kopplat till deras hälsotillstånd.   Diskussion: Studenter söker inte motiverande stödsamtal på grund av alkoholproblem, utan på grund av stressfaktorer och liknande problematik. En förändring i attityd gentemot minskad alkoholkonsumtion bland unga vuxna kan nås genom ökad kunskap och medvetenhet om alkoholskador och alkoholfria alternativ.   Slutsats: Studenthälsans viktigaste uppgift är att försöka nå alla universitetsstuderande genom olika motiverande metoder och verktyg för att utveckla hälsofrämjande insatser, förebygga alkoholmissbruk och alkoholskador på universitet och högskolor. Ytterligare kvalitativ forskning behövs för att kunna identifiera mönster av underliggande stressfaktorer och alkoholrelaterad ohälsa bland universitetsstudenter på ett större antal lärosäten.

Background. Within the South African context there is a large body of research regarding the associations between maternal gestational drinking and diagnosable child FASDs. However, there remains a paucity of local research regarding the impacts of other kinds of maternal drinking behaviours (e.g. past and present maternal drinking) and related socio-demographic factors on developmentally sensitive areas of child neurocognitive functioning, such as executive functioning (EF). Methods. This study was cross-sectional in design, utilising a gender balanced sample of N=464 children between the ages of 9.00 and 15.12 (year.months) in three rural areas within the Western Cape. Information regarding maternal drinking behaviours (before, during and after pregnancy) and related socio-demographic factors was collected via structured interviews with mothers or proxy respondents. Six subtests from the Cambridge Automated Neuropsychological Battery (CANTAB), were used to assess three aspects of child EF namely: (1) processing speed, assessed by the MOT and RTI subtests, (2) attention, assessed by the MTT and RVP subtests and (3) memory, assessed by the SWM and PAL subtests. Findings. For all three maternal alcohol use behaviours examined, there was an apparent non-significant trend whereby children of mothers who reported alcohol use (before, during and after pregnancy) performed worse (on average) than children of mothers reporting non-alcohol use on the EF subtests. Several of the socio-demographic factors were found to act as significant predictors of subtest specific EF performance including child sex (RTI: B=.46, p<. 01; MTT: B=.05, p<.05), child age (RTI: B=.27, p<.05; MTT: B=.11, p<.01), home language (MOT: B=- .13, p<.05), maternal employment (MTT: B=-.04, p<.05) and household size (SWM: B=-1.29, p<.05). Conclusions. These study findings provide initial insights into the impacts of different types of maternal drinking behaviours and related socio-demographic factors on child EF outcomes within the context of an LMIC, South Africa.

Souvent diagnostiqué à un stade avancé, le cancer du pancréas (CP) est un cancer particulièrement létal pour lequel il n’y a, à ce jour, que très peu de possibilités de traitement et de diagnostic anticipé. L’identification de facteurs de risque modifiables pourrait fournir des données épidémiologiques nécessaires au soutien de la mise en place de mesures préventives. Cette thèse a pour but d’étudier l’étiologie du CP en évaluant le rôle de la consommation d’alcool et du mode de vie dans l’étude prospective européenne sur le cancer et la nutrition (EPIC), cohorte multicentrique de plus de 500,000 sujets provenant de 10 pays européens. La consommation d’alcool a d’abord été évaluée en regard du risque de CP. Les rôles des différents types d’alcools ainsi que du tabagisme dans la relation entre l’alcool et le CP ont été examinés. Cette évaluation a montré qu’une consommation d’alcool élevée était associée à une augmentation du risque de CP. Ensuite, la relation entre le Healthy Lifestyle Index, un indicateur combinant le passé tabagique, la consommation d’alcool, l’alimentation, l’anthropométrie et l’activité physique, et le risque de CP a été étudiée. Pour quantifier l’impact de l’amélioration de ces facteurs, des fractions de CP attribuables ont été estimées en considérant des scénarios hypothétiques où les participants adopteraient des modes de vie plus sains. L’adhérence à des habitudes saines était fortement et inversement associée au risque de CP. Ces travaux ont apporté des connaissances informatives sur l’étiologie du CP, et soutiennent le développement de mesures de santé publique promouvant la prévention du CP par l’adoption de modes de vie sains / Commonly diagnosed at late stage, pancreatic cancer (PC) is a highly fatal cancer with limited opportunities for early detection and effective treatment. The identification of modifiable risk factors may offer relevant scientific evidence for PC prevention. This doctoral research program investigated PC etiology through a comprehensive examination of the role of alcohol consumption and other lifestyle determinants in the occurrence of PC within the European Prospective Investigation into Cancer and nutrition (EPIC) study, a multi-center cohort involving more than 500,000 participants from 10 European countries. Alcohol intake was evaluated with respect to the risk of PC. The role of different alcoholic beverages and potential effect modification by smoking habits on PC risk were also examined. Findings from this evaluation provided epidemiological evidence that large intakes of alcohol were associated with an increased risk of PC.The association between the healthy lifestyle index, a score combining information on smoking history, alcohol intake, diet, obesity, and physical activity and the risk of PC was examined. To quantify the impact of modifying several lifestyle factors, population attributable fractions were estimated assuming counterfactual scenarios whereby study participants hypothetically moved towards healthier behaviors. Adherence to healthy lifestyle habits was strongly inversely related to PC. This comprehensive evaluation provides informative insights on the etiology of PC and supports the development and implementation of public health guidelines to promote individuals’ adoption of healthy lifestyle habits for PC prevention

Indiana University-Purdue University Indianapolis (IUPUI) / In order to elucidate the role of classical conditioning in food and alcohol co-consumption, the present study examined: (1) the effects of alcohol odor cues on alcohol and food cravings and attentional bias (bias in selective attention toward either food or alcohol pictures relative to neutral pictures); and (2) the role of alcohol odor cue elicited cravings and attentional biases on subsequent consumption. Participants (n = 77; mean age = 30.84, SD = 9.46; 51.9% female, 83.1% Caucasian) first completed the lab portion of the study. In this portion, they were exposed to alcohol and neutral odorants, after which their food and alcohol cravings and attentional bias were assessed. Participants then received an online survey the next day, on which they reported their level of food and alcohol consumption following the lab portion of the study. Using repeated measures analysis of covariance, alcohol odor cues were differentially effective in increasing food and alcohol attentional bias and cravings (Fs= 0.06 to 2.72, ps= 0.03 to 0.81). Using logistic and multiple regressions, alcohol odor cue elicited alcohol attentional bias, food attentional bias, and food cravings were associated with later alcohol consumption, but not with later food consumption or concurrent consumption (βs = -0.28 to 0.48, ps = 0.02 to 0.99; Exp(B)s = 0.95 to 1.83, ps = 0.33 to 0.91). Overall, alcohol odor cues can become conditioned stimuli that elicit conditioned food-related and alcohol-related responses, both of which persist long enough to motivate later alcohol consumption; however, these conditioned responses might not persist long enough to motivate later food or concurrent consumption. These findings serve as a first step in clarifying the role of classical conditioning in concurrent consumption. In particular, they suggest that additional empirical investigations are needed to: (1) clarify the classical conditioning mechanisms underlying concurrent consumption; and (2) examine whether interventions targeting classical conditioning mechanisms are effective for reducing alcohol use.

Background: Over the long term, unhealthy lifestyles can lead to many health problems, especially type 2 diabetes (T2D). The aim of the present study was to determine associations between lifestyle factors (smoking, alcohol consumption, physical activity, and diet) and T2D in American adults (aged ≥20 years) in a nationally representative sample. Methods: Data for 12 987 American adults participating in the National Health and Nutrition Examination Survey 2005–2014 were evaluated. Weighted multiple logistic regression models were used to examine associations between the four lifestyle factors and T2D after adjusting for demographics and socioeconomic status (SES). Prevalence trends for T2D were examined using Cochran–Armitage tests. Results: There was a significant increasing prevalence trend for T2D among American adults. Smokers and individuals consuming >12 alcoholic drinks in the past year were less likely to report having T2D than non‐smokers (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.35–0.48) and those consuming(OR 0.46; 95% CI 0.39–0.55). Participants with light physical activity have a greater likelihood of having T2D than those engaging in vigorous physical activity (OR 5.72; 95% CI 4.30–7.60). Individuals consuming a poor diet were more likely to report having T2D than those eating an excellent diet (OR 1.18; 95% CI 1.02–1.41). All these relationships remained significant after adjustment for demographics and SES. Conclusion: All four lifestyle factors were significantly associated with T2D among American adults. The findings of the present study provide useful information for healthcare providers that may help them promote specific lifestyle modifications.

[pt] Os ratos Carioca com alto condicionamento (CAC) e Carioca com baixo condicionamento (CBC) são duas linhagens que são criadas seletivamente para altos e baixos níveis de congelamento, em resposta a sugestões contextuais previamente associadas ao estímulos elétricos nos membros. Essas duas linhas têm traços significativamente diferentes de respostas semelhantes à ansiedade, em diferentes protocolos comportamentais. O presente estudo utilizou ratos machos e fêmeas de CAC e CBC para investigar possíveis associações entre comportamento relacionado à ansiedade e ingestão de álcool. Quinina e sacarina foram utilizadas como soluções de controle do paladar. Os resultados indicaram que os ratos CAC tinham um fenótipo ansioso mais alto e os animais CBC tinham um fenótipo ansioso mais baixo, quando as duas linhagens foram comparadas com uma linhagem, selecionada aleatoriamente, que foi usada como grupo controle (CTR). Os ratos machos exibiram consistentemente maior congelamento condicionado do que as fêmeas. Os ratos CAC consumiram mais concentrações de álcool de 6 porcento e 10 porcento do que os ratos CBC em um teste de livre escolha de consumo e maior consumo na concentração de álcool 10 porcentp em um teste de escolha forçada. Ratos fêmeas CAC exibiram a maior quantidade de ingestão de álcool durante essas três condições, em comparação com ratos machos CAC e também consumiram mais quinina que ratos machos. Finalmente, ratos CAC exibiram menor consumo de sacarina em comparação com CBC e animais controle. No total, esses resultados revelaram diferenças entre os sexos no comportamento semelhante ao da ansiedade e no consumo de álcool, corroborando a hipótese de que existe uma relação positiva entre ansiedade e ingestão de álcool. / [en] Carioca High-conditioned Freezing (CHF) and Carioca Low-conditioned Freezing (CLF) rats are two linesthat are selectively bred for high and low levels of freezing in response to contextual cues that are previously associated with footshock. These two lines have significantly different traces of anxiety-like responses in different behavioral protocols. The present study used male and female CHF and CLF rats to investigate possible associations between anxietyrelated behavior and alcohol intake. Quinine and saccharin were used as taste control solutions.The results indicated that CHF rats had a higher anxious phenotype and CLF animals had a lower anxious phenotype when both breeding lines were compared with a randomly selected line that was used as a control group. Male rats consistently exhibitedmore conditioned freezing than females. CHF rats consumed more 6 percent and 10 percent alcohol concentrations than CLF rats in a free-choice test and more of a 10 percent alcohol concentration in a forcedchoice test. Female CHF rats exhibited the highest amount of alcohol intake during these three conditions compared with male CHF rats. Female rats also consumed more quinine than male rats. Finally, CHF rats exhibited lower saccharin consumption compared with CLF and control animals. Altogether, these results revealed sex differences in anxiety-like behavior and alcohol consumption,supporting the hypothesis that there is a positive relationship between anxiety and alcohol intake. The Carioca breeding lines were developed for high and low defensive behavior in response to diffusecontextual cues that are associated with footshock but not to well-defined danger-related stimuli, corroborating the view that anxiety but not fear is associated with alcohol consumption.

Hintergrund. Deutschland gehörte im Jahr 2019 zu den Ländern mit dem weltweit höchsten Pro-Kopf-Alkoholkonsum, welcher wesentlich zur Krankheitslast beiträgt. Fragestellung. In dieser Modellierungsstudie schätzen wir, wie viele alkoholbedingte inzidente Krankheits- sowie Todesfälle in Deutschland im Jahr 2019 hätten vermieden werden können, wenn die derzeitigen Verbrauchssteuern auf Alkohol um 20%, 50% und 100%erhöht worden wären. Methodik. Ausgangspunkt für die Modellierung sind die spezifischen Verbrauchssteuern auf alkoholische Getränke in Deutschland. Drei Szenarien wurden unter der Annahme, dass die resultierende Steuererhöhung vollständig in den Verkaufspreis übertragen wird, und unter Verwendung von getränkespezifischen Preiselastizitäten modelliert. Mittels des sich daraus ergebenden Rückgangs im jährlichen Pro-Kopf-Konsum und der krankheitsspezifischen Risikofunktionen wurde die vermeidbare alkoholbedingte Inzidenz bzw. Mortalität geschätzt. Berücksichtigt wurden alkoholbedingte Erkrankungen des Herz-Kreislauf- und Verdauungssystems, Alkoholabhängigkeit, Epilepsie, Infektionskrankheiten sowie Verletzungen und Unfälle. Ergebnisse. Insgesamt hätten durch eine Verdoppelung der spezifischen Verbrauchssteuern auf Alkohol im Jahr 2019 bis zu 200.400 alkoholbedingte Erkrankungs- und Verletzungsfälle sowie 2800 Todesfälle vermieden werden können. Dies entspricht knapp 7% der berücksichtigten alkoholbedingten Krankheits- bzw. Todesfälle in Deutschland. Diskussion. Alkoholbedingte Erkrankungen und Verletzungen sind vermeidbar und eine Erhöhung der spezifischen Verbrauchssteuern auf alkoholische Getränke in Deutschland könnte die alkoholbedingte Krankheitslast substanziell reduzieren. / Background. In 2019, Germany was among the countries with the highest alcohol per capita consumption in the world, which contributes significantly to the burden of disease. Aim. In this modelling study, we estimate how many alcohol-attributable diseases and deaths in Germany could have been avoided in 2019 if current alcohol excise taxes were increased by 20%, 50%, and 100%. Methods. The starting point for the modelling was the national beverage-specific alcohol taxes. Three scenarios were modelled under the assumption that the resulting tax increase would be fully transferred to the retail prices. Beverage-specific price elasticities were used. Based on the estimated resulting decline in annual per capita consumption and the disease-specific risk functions, we modelled the avoidable incidence and mortality for alcohol-attributable diseases for 2019. Alcohol-attributable diseases of the cardiovascular and digestive systems, alcohol dependence, epilepsy, and infectious diseases as well as injuries and accidentswere considered. Results. Overall, doubling the beveragespecific alcohol taxes could have avoided up to 200,400 alcohol-attributable cases of disease and injury as well as 2800 deaths in Germany in 2019. This corresponds to just under 7% of the modelled new alcohol-attributable cases of disease and death in Germany. Discussion. Alcohol-attributable diseases and injuries are preventable and an increase in the alcohol taxes could substantially reduce the alcohol-attributable burden of disease in Germany.