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AUDIT Alcohol Use Disorder Identification Test [keywords]
- Screening and Brief Interventions for Hazardous and Harmful Alcohol Use among University Students in South Africa: Results from a Randomized Controlled Trial. [Journal Article]
- Int J Environ Res Public Health 2013 May; 10(5):2043-57.
The aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI) for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus. University students were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counseling session on alcohol risk reduction, while the control group received a health education leaflet. Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 (21.1%) tested positive for the Alcohol Use Disorder Identification Test (AUDIT) (score 8 or more). Among the 147 (96.7%) university students who also attended the 12-month follow-up session, the intervention effect on the AUDIT score was -1.5, which was statistically significant (P = 0.009). Further, the depression scores marginally significantly decreased over time across treatment groups, while other substance use (tobacco and cannabis use), self-rated health status and Posttraumatic Stress Disorder (PTSD) scores did not change over time across treatment groups. The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa. The short duration of the brief intervention makes it a realistic candidate for use in a university setting.
- Prevalence of ultrasound diagnosed nonalcoholic fatty liver disease among rural indigenous community of Sarawak and its association with biochemical and anthropometric measures. [Journal Article, Research Support, Non-U.S. Gov't]
- Southeast Asian J Trop Med Public Health 2013 Mar; 44(2):309-17.
Although the association between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome has been previously firmly established, the prevalence of NAFLD and its risk factors in rural communities remains incompletely defined. This study aimed to determine the prevalence and factors associated with ultrasound-diagnosed NAFLD amongst a rural community in Sarawak. An indigenous village was randomly selected where all adults aged 21 years and above underwent an abdominal ultrasound, biochemical tests and an anthropometric assessment. Respondents with a score > or =8 on an alcohol-use disorders-identification test (AUDIT) indicating harmful or hazardous drinking were excluded. Seventy-seven respondents (46.8% male, mean age 48.4 SD 16.64), met inclusion criteria. The prevalence of ultrasound diagnosed NAFLD was 44.2% (n=34), among them 52.9% had moderate NAFLD. There were no significant age or gender differences between respondents with and without NAFLD, although those with NAFLD were older. Respondents with NAFLD had a significantly higher BMI t,han those without NAFLD (p<0.001). Both male and female respondents with NAFLD had a significantly higher waist circumference than those without NAFLD (p<0.001). Prevalence of diabetes, hypertension, hyperglycemia and hypertriglyceridemia were significantly higher among those with NAFLD. However, there were no significant differences in terms of percentage of unhealthy body fat and muscle, and serum HDL levels. Risk factors independently associated with NAFLD included male gender (odd ratio 0.06; 95% CI 0.008-0.523) and waist circumference (odd ratio 1.2; 95% CI 1.036-1.421). There was a high prevalence of NAFLD and the presence of more severe stages of disease in this indigenous population. Life-style related diseases, such as fatty liver disease, can occur in rural as well as urban populations.
- Assessment of Psychiatric Symptoms at a Level I Trauma Center Surgery Follow-up Clinic: A Preliminary Report. [Journal Article]
- Am Surg 2013 May; 79(5):492-4.
At Level I trauma centers, psychiatric consultation is readily available to inpatient surgical services. This study sought to characterize the psychiatric symptoms present in the surgical follow-up clinic. Patients aged 18 years and older were assessed over one month for symptoms of posttraumatic stress disorder (PTSD) with the Short PTSD Rating Interview (SPRINT), depression with the Patient Health Questionnaire (PHQ-9), alcohol abuse with the Alcohol Use Disorder Identification Test (AUDIT), and the presence of violence using the MacArthur Community Violence Instrument (MCVIa [victimization] MCVIb [perpetration]). Twenty-five individuals participated. Using the SPRINT, 13 (52.0%) met the cutoff for PTSD. For PHQ-9 depression, 11 (44%) were in the moderate to severe range. For AUDIT, five (20.0%) likely had an alcohol problem. Using the MCVI, 15 (60.0%) reported victimization and 12 (48.0%) reported perpetration. Elevated levels of psychiatric symptoms were found in the trauma surgery follow-up clinic. Psychiatric care embedded in this setting may be warranted.
- Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: a cross sectional study. [Journal Article]
- BMC Public Health 2013.:396.
Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs.A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART.The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use.A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV). The treatment care package needs to involve not only the health sector but other relevant government sectors, such as social development.
- Prevalence of bipolar disorder in a HIV-infected outpatient population. [JOURNAL ARTICLE]
- AIDS Care 2013 Mar 26.
Abstract This study assesses the prevalence of bipolar disorder (BD) among 196 HIV-infected adult outpatients attending in a specialized unit in Fortaleza, Brazil. Patients were interviewed with the Mood Disorder Questionnaire (MDQ), the Mini International Neuropsychiatric Interview (MINI), the Alcohol Use Disorders Identification Test (AUDIT), and a socio-demographic questionnaire based on WHO's behavioral surveillance surveys. Positive MDQ screening was found in 13.2% (N=26) and the BD diagnosis was confirmed in 8.1% (N=16) of the sample. There is an almost four times higher prevalence of BD among the HIV-infected patients of the sample (8.1%) than in the general population from the USA (2.1%). The prevalence of BD type I in the HIV patients was 5.6% (N=11) which is almost six times higher than the US general population (1%). The odds ratios of sexual behaviors and substance abuse variables correlated with BD were calculated. The variables associated with the diagnoses of BD were sex with commercial partners, sex outside the primary relationship, alcohol use disorders, and illicit drug abuse. The most common psychiatric comorbidity in the BD group was substance abuse (61.5%). A better understanding of psychiatric comorbidities and behavioral aspects of HIV-positive patients may help in improving long-term outcome of these patients.
- Alcohol use, military sexual trauma, expectancies, and coping skills in women veterans presenting to primary care. [JOURNAL ARTICLE]
- Addict Behav 2013 Feb 26.
BACKGROUND:Little is known regarding alcohol use and its correlates in women veterans. An understanding of these variables is of utility to providers in primary care at Veterans Affairs (VA) hospitals, who are among the first to identify and intervene for problem drinking.
OBJECTIVE:The objective of this study was to describe and explore the associations between posttraumatic stress disorder symptoms, experience of military sexual trauma (MST), expectancies for alcohol use, and coping skills in predicting drinking behavior.
DESIGN:Each month all women veterans attending appointments in primary care were mailed a letter alerting them to the study. Women then received a call asking them to participate, and many were directly recruited at their primary care appointment. Participants then completed a survey of current alcohol use and related variables in a private room.
PARTICIPANTS:Participants were 93 women veterans seeking care at VA.
MAIN MEASURES:Measures included the Alcohol Use Disorders Identification Test, a modified version of the VA MST screen, the Davidson Trauma Scale; the Coping Inventory for Stressful Situations, and the Brief Comprehensive Effects of Alcohol Questionnaire. KEY
RESULTS:Positive expectancies and evaluations emerged as significant correlates of AUDIT scores, while PTSD symptoms were not related to AUDIT scores. A hierarchical regression revealed a significant positive interaction between avoidance coping and positive evaluations. Depression, positive evaluations and avoidance coping were significant independent predictors of AUDIT scores in the final model, but MST was not.
CONCLUSIONS:Findings highlight the importance of considering of the function of alcohol use when delivering clinical interventions and the need for further research on the association between MST and drinking in women veterans.
- Alcohol consumption and 5-year change in left atrial volume among patients with coronary heart disease: results from the Heart and Soul study. [Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.]
- J Card Fail 2013 Mar; 19(3):183-9.
Heavy alcohol consumption is a risk factor for developing atrial fibrillation, but whether chronic alcohol use affects left atrial volume is unknown. We evaluated the association of self-reported alcohol consumption with 5-year change in left atrial volume among patients with coronary heart disease (CHD).We studied 601 participants with stable CHD who underwent 2-dimensional echocardiography at baseline (2000-2002) and after 5 years of follow-up (2005-2007). Alcohol consumption was determined at baseline with the use of the Alcohol Use Disorders Identification Test consumption questions (AUDIT-C), with a standard cutoff point of ≥3 used to define at-risk drinking. We used logistic regression to evaluate the association of baseline alcohol use with 5-year increase in left atrial end-systolic volume index (defined as being in the highest tertile of percent change).After adjustment for covariates, each standard deviation (2.4-point) increase in AUDIT-C score was associated with a 24% greater odds of experiencing a 5-year increase in left atrial volume index (adjusted odds ratio [OR] 1.24, 95% confidence interval [CI] 1.04-1.48; P = .02). Compared with the 369 participants who had AUDIT-C scores of <3, the 171 participants with scores of 3-5 had a 51% greater odds (OR 1.51, 95% CI, 1.11-2.25) and the 61 participants with scores of >5 a 98% greater odds (OR 1.98, 95% CI, 1.10-3.56) of experiencing a 5-year increase in left atrial volume index.In patients with CHD, heavier alcohol consumption is associated with a 5-year increase in left atrial volume. Whether greater left atrial volume contributes to the increased risk of atrial fibrillation associated with alcohol use deserves further study.
- Prevalence and Patterns of Hazardous and Harmful Alcohol Consumption Assessed Using the AUDIT among Bhutanese Refugees in Nepal. [Journal Article]
- Alcohol Alcohol 2013 May-Jun; 48(3):349-55.
Aims:This study sought to ascertain the prevalence of hazardous and harmful alcohol consumption among Bhutanese refugees in Nepal and to identify predictors of elevated risk in order to better understand intervention need.
Methods:Hazardous and harmful alcohol consumption was assessed using the Alcohol Use Disorder Identification Test (AUDIT) administered in a face-to-face interview in a census of two camps comprising ∼8000 refugees.
Results:Approximately 1/5 men and 1/14 women drank alcohol and prevalence of hazardous drinking among current drinkers was high and comparable to that seen in Western countries with longstanding alcohol cultures. Harmful drinking was particularly associated with the use of other substances including tobacco.
Conclusions:Assessment of the alcohol-related needs of Bhutanese refugees has permitted the design of interventions. This study adds to the small international literature on substance use in forced migration populations, about which there is growing concern.
- A Longitudinal Investigation of Alcohol Use over the Course of the Year Following Medical-Surgical Intensive Care Unit Admission. [JOURNAL ARTICLE]
- Psychosomatics 2013 Feb 13.
BACKGROUND:There have been no studies describing post-intensive care unit (ICU) alcohol use among medical-surgical ICU survivors.
OBJECTIVE:To examine alcohol use and identify potentially modifiable risk factors, such as in-hospital probable acute stress disorder, for increased alcohol use following medical-surgical ICU admission.
METHOD:This longitudinal investigation included 150 medical-surgical ICU survivors. In-hospital interviews obtained baseline characteristics including pre-ICU alcohol use with the Alcohol Use Disorders Identification Test (AUDIT) and in-hospital probable acute stress disorder with the Post-traumatic Stress Disorder Checklist-civilian version. Clinical factors were obtained from medical records. Post-ICU alcohol use was ascertained via telephone interviews at 3 and 12 months post-discharge using the AUDIT. Mixed-model linear regression was used to examine potential risk factors for increased post-ICU alcohol use.
RESULTS:There was a significant decline in the mean AUDIT score from baseline (3.9, 95% confidence interval [95% CI]: 2.9, 5.0) to 3 months post-ICU (1.5, 95% CI: 1.0, 2.1) (P < 0.001 by one-way analysis of variance [ANOVA]), with a significant increase between 3 and 12 months post-ICU (2.7, 95% CI: 1.8, 3.5) (P < 0.001 by one-way ANOVA). After adjusting for patient and clinical factors, in-hospital probable acute stress disorder (beta: 3.0, 95% CI: 0.9, 5.0) and pre-ICU unhealthy alcohol use (beta: 5.4, 95% CI: 3.4, 7.4) were independently associated with increased post-ICU alcohol use.
CONCLUSIONS:Alcohol use decreases in the early aftermath of medical-surgical ICU admission and then increases significantly by one year post-ICU. Interventions for unhealthy alcohol use among medical-surgical ICU survivors that take into account comorbid psychiatric symptoms are needed.
- Alcohol use behaviors, fat intake and the function of pancreatic β-cells in non-obese, healthy Korean males: findings from 2010 Korea National Health and Nutrition Examination Survey. [Journal Article, Research Support, Non-U.S. Gov't]
- Ann Nutr Metab 2013; 62(2):129-36.
In the present study, we aimed to identify dietary factors related to insulin secretion function especially in healthy, non-obese Korean males.Data were obtained from the Korea National Health and Nutrition Examination Survey V-1 (KNHANES V-1). Nine hundred and twenty male adults aged >30 years of normal weight were included, excluding those with type 2 diabetes mellitus and liver disease. Alcohol use disorders identification test (AUDIT) score which represents alcohol use behaviors and nutrient intakes was used, and homeostasis model assessment of β-cell function (HOMA-B score) was calculated.HOMA-B score was associated with age (p < 0.001), AUDIT score (p = 0.030), and percentage of fat from total energy intake (p = 0.002). HOMA-B scores in the problematic AUDIT group were significantly lower than those in the normal AUDIT group. In addition, HOMA-B scores in the lowest fat intake group were significantly lower than those in the medium fat intake group, but similar to those in the highest fat intake group. There was an interaction between alcohol use behaviors and percentage of fat from energy intake in determining HOMA-B score (p for interaction = 0.034).Alcohol use behaviors and percentage of fat from energy intake were found to be associated with HOMA-B score in healthy, non-obese Korean males.