ISSN:0965-2140    

DOI:10.1080/09652149640419

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0965-2140    

DOI:10.1080/09652149640428

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis paper addresses some issues related to the hypothesis that the risk for premature death is a J‐shaped function of alcohol intake. The first part of the paper contains a discussion of the individual level epidemiological evidence. It is argued that the evidence is not yet good enough to allow precise statements about ‘safe limits’, nor does it allow a precise location of the ‘optimum’ consumption level. Measurement errors and confounding variables not yet controlled for remain substantial problems. In particular, future studies need to control for social integration, as this factor may affect both health status and alcohol consumption. The second part of the paper discusses the population level relationship. It is argued that, typically, what is optimum for an individual is too much for a population. Unintended side effects of major public health importance should be expected in this area. In the last section, a plea is made for aggregate level studies as a way of addressing the public health side of

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9133253.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractSince total mortality is a classical proxy for the overall health status of the population, its degree of association with per capita alcohol consumption is of great interest. Existing evidence, based on historical data from the turn of the century, is mostly in graphical form. These data arc analysed using modern statistical tools. The results suggest a significant alcohol effect; a 1‐l increase in consumption is expected to increase mortality (middle‐aged men) by about 1 %. This effect might seem fairly modest but it is noted that it may well be locally substantial because of its concentration to specific categories of the population. The alcohol effect is also compared with the impact of a factor that is a surrogate for a large number of etiological agents, namely real wages. Although the latter factor seems to be the more important one the difference is not overwhelming. The shift in the cause of the death panorama during this century, with an increasing share of CHD‐mortality, may well have attenuated the aggregate relationship between alcohol and mort

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9133394.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractRecognizing the need to offer alternative methods of brief interventions, this study developed correspondence treatments for low‐dependent problem drinkers and evaluated their impact. One hundred and twenty‐one problem drinkers were recruited by media advertisements and were randomly allocated to a full cognitive‐behavioural treatment programme (CBT) or to a minimal intervention condition (MI) that gave information regarding alcohol misuse and instructions to record drinking. As predicted, CBT was more effective than MI in reducing alcohol consumption over the 4‐month controlled trial period. CBT produced a 50% fall in consumption, bringing the average intake of subjects within recommended maximum levels. Treatment gains at 6 months were well maintained to 12 months. High levels of consumer satisfaction, a high representation of women and a substantial participation from isolated rural areas attested to the feasibility of the correspondence programme as an alternative treatment. However, some drinking occasions still involved high intake for a significant subgroup of subjects, and this issue will be addressed in future programmes. The results supported the use of correspondence delivery as a means of promoting early engagement and equity of access between city and countr

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9133455.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractGender differences in drinking behavior are analysed with emphasis on their relationship with changes in roles and positions of men and women in society. The ‘convergence hypothesis’ is used as a starting point. From its implications, a number of specific hypotheses are derived and tested using data from six surveys of the general population of the Netherlands, held between 1958 and 1993. No convergence of gender differences is found for abstinence and heavy frequent drinking. Convergence of male‐female differences in average weekly consumption appeared in the 1980s, but it is no longer significant at 5% level after controlling for age, education and family situation. Further elaboration of the gender by year interaction shows that convergence is related to a decrease in consumption among higher educated men. Contrary to expectation, an increase in consumption has occurred among women over 40 years of age. No relationship appears with female employment and religion. Having a family is related to lower consumption among women, while it has no significant effect on men's consumption. Although some evidence for convergence was found, results are not in agreement with expectations formulated from the perspective of the convergence hypot

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9133576.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe goal of this paper is in present data regarding the occurrence of alcohol consumption and the relative prevalences and the factorial structure of DSM‐IV symptoms of alcohol abuse/dependence in a sample of 1507 older (14–18 years) community adolescents. Participants were diagnostically assessed at two time points, approximately 1 year apart. Three‐quarters of the sample had tried alcohol. Boys in general had greater usual frequency and quantity of alcohol consumption than girls and began drinking at an earlier age; girls with a diagnosis of alcohol abuse/dependence had a significantly earlier mean age of alcohol disorder onset and were more likely to have a relapse of alcohol disorder. However, gender differences in symptom prevalence were non‐significant. Seventeen per cent of the sample had at least one alcohol abuse/dependence symptom. The most frequent symptoms included reduced activities because of alcohol use, consumed more than intended, and tolerance. Eight of the 11 symptoms made a unique contribution to the prediction of diagnosis in a multiple logistic regression analysis. Components analysis supported the general division of symptoms into the categories of abuse and dep

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9133757.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractSociologists who embrace the stress or alienation paradigms generally focus on explaining problem drinking in low status occupations. By contrast, this paper argues that a broadened conceptualization of stress and alienation which incorporates abusive work relationships has utility for explaining male and female drinking outcomes in both high and low status occupations. We provide empirical data on the relationship between perceived abusive experiences and drinking outcomes in a cohort of male and female physicians in their internship year of training. The data show that perceived sexual harassment, discriminatory treatment and psychological humiliation relate to various drinking outcomes in men and women, controlling for drinking prior to the internship year. While females were more likely to report experiencing abuse, these perceived experiences had deleterious effects on drinking outcomes for both genders. Personal vulnerability (narcissism) brought into the training environment somewhat influenced the later reporting of abusive experiences by males but not by females. Regression analyses showed that, for both males and females, work‐place abusive experiences in interaction with personality vulnerability best explained drinking outcomes. The implications of these results far the design of future alcohol‐related work‐place studies are disc

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9133918.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA sample of 329 heroin users were interviewed regarding their personal experience of non‐fatal heroin overdose. Experience of overdose was widespread, with two‐thirds of subjects (68%) reporting having overdosed. The median number of life‐time overdoses was three, with males and females equally likely to have overdosed. The majority (62%) of most recent heroin overdoses occurred in conjunction with the consumption of other central nervous system depressants (alcohol, benzodiazepines and other opioids). Logistic regression analyses indicated three independent factors associated with having overdosed: longer heroin using careers, greater heroin dependence and higher levels of alcohol consumption. Implications for the reduction in the prevalence and frequency of overdose are disc

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9134059.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA sample of 329 heroin users were interviewed about their experiences at other peoples' heroin overdoses. The overwhelming majority (86%) had witnessed a heroin overdose, on a median of six occasions. Heroin users were reluctant to seek medical attention, with an ambulance being called on only half (56%) of the most recent overdose occasions. At only 17% of most recent overdoses was calling an ambulance the first action taken. Males reported taking significantly longer than females to call an ambulance. Nearly half (44%) of subjects reported that there were factors that had delayed or stopped them seeking medical assistance, the most common impediment being a fear of police involvement. The importance of interventions to encourage help‐seeking at overdoses are discusse

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.91341310.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY