French government is urged to fight alcohol misuse.
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ABSTRACT:
SUBMITTER: Spurgeon B
PROVIDER: S-EPMC1298880 | biostudies-literature | 2005 Dec
REPOSITORIES: biostudies-literature
Publications
French government is urged to fight alcohol misuse.
BMJ (Clinical research ed.) 20051201 7528
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Project description: Not available
| S-EPMC1410854 | biostudies-literature
Project description:(1) Background: We collected COVID-19 mortality data and the age distribution of the deceased in France and other European countries, as well as specifically in the cities of Paris and Marseille, and compared them. (2) Methods: Data on mortality related to COVID-19 and the associated age distribution were collected from government institutions in various European countries. In France, data were obtained from INSEE and Santé Publique France. All-cause mortality was also examined in order to study potential excess mortality using EuroMOMO. The Marseille data came from the epidemiological surveillance system. (3) Results: France is one of the European countries most impacted by COVID-19. Its proportion of deaths in people under 60 years of age is higher (6.5%) than that of Italy (4.6%) or Spain (4.7%). Excess mortality (5% more deaths) was also observed. Ile-de-France and the Grand-Est are the two French regions with the highest mortality. The proportion of deaths in the under-60 age group was considerable in Ile-de-France (9.9% vs. 4.5% in the Southern region). There are significantly higher numbers of patients hospitalized, in intensive care and deceased in Paris than in Marseille. (4) Conclusions: No patient management, i.e., from screening to diagnosis, including biological assessment and clinical examination, likely explains the high mortality associated with COVID-19.
| S-EPMC8268313 | biostudies-literature
Project description:Background & aimsBariatric surgery is common, but alcohol misuse has been reported following these procedures. We aimed to determine if bariatric surgery is associated with increased risk of alcohol-related cirrhosis (AC) and alcohol misuse.MethodsRetrospective observational analysis of obese adults with employer-sponsored insurance administrative claims from 2008 to 2016. Subjects with diagnosis codes for bariatric surgery were included. Primary outcome was risk of AC. Secondary outcome was risk of alcohol misuse. Bariatric surgery was divided into before 2008 and after 2008 to account for patients who had a procedure during the study period. Cox proportional hazard regression models using age as the time variable were used with interaction analyses for bariatric surgery and gender.ResultsA total of 194 130 had surgery from 2008 to 2016 while 209 090 patients had bariatric surgery prior to 2008. Age was 44.1 years, 61% women and enrolment was 3.7 years. A total of 4774 (0.07%) had AC. Overall risk of AC was lower for those who received sleeve gastrectomy and laparoscopic banding during the study period (HR 0.4, P <.001; HR 0.43, P =.02) and alcohol misuse increased for Roux-en-Y and sleeve gastrectomy recipients (HR 1.86 and 1.35, P <.001, respectively). In those who had surgery before 2008, women had increased risk of AC and alcohol misuse compared to women without bariatric surgery (HR 2.1 [95% CI: 1.79-2.41] for AC; HR 1.98 [95% CI 1.93-2.04]).ConclusionsBariatric surgery is associated with a short-term decreased risk of AC but potential long-term increased risk of AC in women. Post-operative alcohol surveillance is necessary to reduce this risk.
| S-EPMC8204517 | biostudies-literature
Project description:BackgroundOvercrowding in emergency department (EDs) is partly due to the use of EDs by nonurgent patients. In France, the authorities responded to the problem by creating primary care units (PCUs): alternative structures located near hospitals. The aims of the study were to assess the willingness of nonurgent patients to be reoriented to a PCU and to collect the reasons that prompted them to accept or refuse.MethodsWe carried out a cross sectional survey on patients' use of EDs. The study was conducted in a French hospital ED. Patients were interviewed about their use of health services, ED visits, referrals, activities of daily living, and insurance coverage status. Patients' medical data were also collected.Results85 patients considered nonurgent by a triage nurse were asked to respond to a questionnaire. Sex ratio was 1.4; mean age was 36.3 +/- 11.7 years.Most patients went to the ED autonomously (76%); one third (31.8%) had consulted a physician. The main reasons for using the ED were difficulty to get an appointment with a general practitioner (22.3%), feelings of pain (68.5%), and the availability of medical services in the ED, like imaging, laboratory tests, and drug prescriptions (37.6%). Traumatisms and wounds were the main medical reasons for going to the ED (43.5%).More than two-thirds of responders (68%) were willing to be reoriented towards PCUs. In the multivariate analysis, only employment and the level of urgency perceived by the patient were associated with the willingness to accept reorientation. Employed persons were 4.5 times more likely to accept reorientation (OR = 4.5 CI (1.6-12.9)). Inversely, persons who perceived a high level of urgency were the least likely to accept reorientation (OR = 0.9 CI (0.8-0.9).ConclusionsOur study provides information on the willingness of ED patients to accept reorientation and shows the limits of its feasibility. Alternative structures such as PCUs near the ED seem to respond appropriately to the growing demands of nonurgent patients. Reorientation, however, will be successful only if the new structures adapt their opening hours to the needs of nonurgent patients and if their physicians can perform specific technical skills.
| S-EPMC2846926 | biostudies-literature
Project description:BackgroundThe alcohol industry uses many of the tobacco industry's strategies to influence policy-making, yet unlike the Framework Convention on Tobacco Control, there is no intergovernmental guidance on protecting policies from alcohol industry influence. Systematic assessment of alcohol industry penetration and government safeguards is also lacking. Here, we aimed to identify the nature and extent of industry penetration in a cross-section of jurisdictions. Using these data, we suggested ways to protect alcohol policies and policy-makers from undue industry influence.MethodsAs part of the International Alcohol Control Study, researchers from 24 jurisdictions documented whether 22 indicators of alcohol industry penetration and government safeguards were present or absent in their location. Several sources of publicly available information were used, such as government or alcohol industry reports, websites, media releases, news articles and research articles. We summarised the responses quantitatively by indicator and jurisdiction. We also extracted examples provided of industry penetration and government safeguards.ResultsThere were high levels of alcohol industry penetration overall. Notably, all jurisdictions reported the presence of transnational alcohol corporations, and most (63%) reported government officials or politicians having held industry roles. There were multiple examples of government partnerships or agreements with the alcohol industry as corporate social responsibility activities, and government incentives for the industry in the early COVID-19 pandemic. In contrast, government safeguards against alcohol industry influence were limited, with only the Philippines reporting a policy to restrict government interactions with the alcohol industry. It was challenging to obtain publicly available information on multiple indicators of alcohol industry penetration.ConclusionGovernments need to put in place stronger measures to protect policies from alcohol industry influence, including restricting interactions and partnerships with the alcohol industry, limiting political contributions and enhancing transparency. Data collection can be improved by measuring these government safeguards in future studies.
| S-EPMC11590778 | biostudies-literature
Project description:Alcohol misuse during adolescence (AAM) has been associated with disruptive development of adolescent brains. In this longitudinal machine learning (ML) study, we could predict AAM significantly from brain structure (T1-weighted imaging and DTI) with accuracies of 73 -78% in the IMAGEN dataset (n∼1182). Our results not only show that structural differences in brain can predict AAM, but also suggests that such differences might precede AAM behavior in the data. We predicted 10 phenotypes of AAM at age 22 using brain MRI features at ages 14, 19, and 22. Binge drinking was found to be the most predictable phenotype. The most informative brain features were located in the ventricular CSF, and in white matter tracts of the corpus callosum, internal capsule, and brain stem. In the cortex, they were spread across the occipital, frontal, and temporal lobes and in the cingulate cortex. We also experimented with four different ML models and several confound control techniques. Support Vector Machine (SVM) with rbf kernel and Gradient Boosting consistently performed better than the linear models, linear SVM and Logistic Regression. Our study also demonstrates how the choice of the predicted phenotype, ML model, and confound correction technique are all crucial decisions in an explorative ML study analyzing psychiatric disorders with small effect sizes such as AAM.
| S-EPMC9255959 | biostudies-literature
Project description:BackgroundEarly midlife individuals (ages 30-40) experience demographic shifts that may influence the remainder of adult life. Although new or persistent alcohol misuse is common during this period, early midlife is understudied in alcohol use literature. We examined the heritability of alcohol misuse; the associations between alcohol misuse and sociodemographic factors, physical health, and well-being; and whether these associations were robust in cotwin comparisons.MethodsParticipants were 1446 Finnish twin pairs and 748 nonpaired Finnish twins with mean age 34 years. The alcohol misuse index was a composite measure of frequency of use, intoxication, heavy episodic drinking, and alcohol problems assessed with the Malmö-modified Michigan Alcoholism Screening Test and the Rutgers Alcohol Problem Index. Early midlife correlates included relationship status and length, family formation, unemployment status, education level, self-rated health, pain, sleeping difficulties, life satisfaction, psychological health, and other substance use. We employed a sex-limitation model to estimate early midlife heritability. Linear and fixed effects regression models were used for individual and cotwin comparison analyses, respectively.ResultsAdditive genetic (A) and unique environmental (E) components of alcohol misuse variance differed across sex (Females: A = 62%, E = 38%; Males: A = 49%, E = 51%). In individual-based analyses, higher scores on the alcohol misuse index were associated with lower relationship stability, financial situation, education level, self-rated health, physical fitness, life satisfaction and psychological health, and higher self-reported pain, sleep difficulties, unemployment rates and other substance use (R2 = 0.008-0.12). Associations remained significant in cotwin comparison analyses (R2 = 0.004-0.10) except for financial situation and education level.ConclusionsThere is evidence of sex differences in the etiological factors that influence early midlife drinking. After controlling for confounding familial factors, associations between alcohol misuse and poorer early midlife functioning largely remained, suggesting that alcohol misuse may play a role in poorer functioning across several outcomes.
| S-EPMC11828966 | biostudies-literature
Project description:BackgroundCurrent modes of identifying alcohol misuse in hospitalized patients rely on self-report questionnaires and diagnostic codes that have limitations, including low sensitivity. Information in the clinical notes of the electronic health record (EHR) may further augment the identification of alcohol misuse. Natural language processing (NLP) with supervised machine learning has been successful at analyzing clinical notes and identifying cases of alcohol misuse in trauma patients.MethodsAn alcohol misuse NLP classifier, previously developed on trauma patients who completed the Alcohol Use Disorders Identification Test, was validated in a cohort of 1000 hospitalized patients at a large, tertiary health system between January 1, 2007 and September 1, 2017. The clinical notes were processed using the clinical Text Analysis and Knowledge Extraction System. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for alcohol misuse were used during annotation of the medical records in our validation dataset.ResultsThe alcohol misuse classifier had an area under the receiver operating characteristic curve of 0.91 (95% CI 0.90-0.93) in the cohort of hospitalized patients. The sensitivity, specificity, positive predictive value, and negative predictive value were 0.88 (95% CI 0.85-0.90), 0.78 (95% CI 0.74-0.82), 0.85 (95% CI 0.82-0.87), and 0.82 (95% CI 0.78-0.86), respectively. The Hosmer-Lemeshow Test (p = 0.13) demonstrates good model fit. Additionally, there was a dose-dependent response in alcohol consumption behaviors across increasing strata of predicted probabilities for alcohol misuse.ConclusionThe alcohol misuse NLP classifier had good discrimination and test characteristics in hospitalized patients. An approach using the clinical notes with NLP and supervised machine learning may better identify alcohol misuse cases than conventional methods solely relying on billing diagnostic codes.
| S-EPMC7101259 | biostudies-literature
Project description:PurposeTo investigate the role of consumption phenotypes as genetic proxies for alcohol misuse and nicotine dependence.MethodsWe leveraged GWAS data from well-powered studies of consumption, alcohol misuse, and nicotine dependence phenotypes measured in individuals of European ancestry from the UK Biobank (UKB) and other population-based cohorts (largest total N = 263,954), and performed genetic correlations within a medical-center cohort, BioVU (N = 66,915). For alcohol, we used quantitative measures of consumption and misuse via AUDIT from UKB. For smoking, we used cigarettes per day from UKB and non-UKB cohorts comprising the GSCAN consortium, and nicotine dependence via ICD codes from UKB and Fagerström Test for Nicotine Dependence from non-UKB cohorts.ResultsIn a large phenome-wide association study, we show that smoking consumption and dependence phenotypes show similar strongly negatively associations with a plethora of diseases, whereas alcohol consumption shows patterns of genetic association that diverge from those of alcohol misuse.ConclusionsOur study suggests that cigarette smoking consumption, which can be easily measured in the general population, may be good a genetic proxy for nicotine dependence, whereas alcohol consumption is not a direct genetic proxy of alcohol misuse.
| S-EPMC8026738 | biostudies-literature
Project description:Analgesic opioid (AO) misuse by patients ranges from 0% to 50%. General practitioners are the first prescribers of AO. Our objective was to validate the Prescription Opioid Misuse Index (POMI) in primary care. We conducted a psychometric study in patients with chronic pain who had been taking AOs for at least 3 months and were followed in general practice. Patients responded to the POMI at inclusion and after 2 weeks. The reference used was the DSM-V. Sixty-nine GPs included 160 patients (87 women, 54.4%), mean age 56.4 ± 15.2 years. The total POMI score was 1.50 ± 1.27, and 73/160 (45.6.0%) had a score ≥ 2 (misuse threshold). Internal validity was measured with the Kuder-Richardson coefficient, which was 0.44. Correlations between each item and the total score ranged from 0.06 to 0.35. Test-retest reliability was determined from 145 patients: Lin's concordance coefficient was 0.57 [0.46, 0.68]. Correlation with the DSM-V (Spearman's coefficient) was 0.52. The POMI does not have sufficient psychometric properties to be recommended as a tool to identify the misuse of AOs in primary care. This study clearly showed that there is a need to create a monitoring tool specific to primary care.
| S-EPMC9690529 | biostudies-literature