How well does the theory of planned behaviour predict alcohol consumption? A systematic review and meta-analysis

This study aimed to quantify correlations between theory of planned behaviour (TPB) variables and (i) intentions to consume alcohol and (ii) alcohol consumption. Systematic literature searches identified 40 eligible studies that were meta-analysed. Three moderator analyses were conducted: pattern of consumption, gender of participants and age of participants. Across studies, intentions had the strongest relationship with attitudes (r+ = .62), followed by subjective norms (r+ = .47) and perceived behavioural control (PBC; r+ = .31). Self-efficacy (SE) had a stronger relationship with intentions (r+ = .48) compared with perceived control (PC; r+ = −.10). Intention had the strongest relationship with alcohol consumption (r+ = .54), followed by SE (r+ = .41). In contrast, PBC and PC had negative relationships with alcohol consumption (r+ = −.05 and −.13, respectively). All moderators affected TPB relationships. Patterns of consumption with clear definitions had stronger TPB relations, females reported stronger attitude–intention relations than males, and adults reported stronger attitude–intention and SE–intention relations than adolescents. Recommendations for future research include targeting attitudes and intentions in interventions to reduce alcohol consumption, using clear definitions of alcohol consumption in TPB items to improve prediction and assessing SE when investigating risk behaviours.

Changes in heart rate variability associated with moderate alcohol consumption

Technological advances have driven some attempt of vital parameters monitoring in adverse environments; these improvements will make possible to monitor cardiac activity also in automotive environments. In this scenario, heart rate changes associated with alcohol consumption, become of great importance to assess the drivers state during time. This paper presents the results of a first set of experiments aimed to discover heart rate variability modification induced by moderate assumption of alcoholic drink (i.e. single draft beer) as that typically occurs in weekend among some people. In the study, twenty subjects were enrolled and for each of them two electrocardiographic recordings were carried out: the first before alcohol ingestion and the second after 25-30 minutes. Each participant remained fasting until the second ECG acquisition was completed. ECG signal were analyzed by typical timedomain, frequency and non linear analysis. Results showed a small increase in LF/HF ratio which reflects a dominance of the sympathetic system over the parasympathetic system, and an increase in signal complexity as proven by non linear analysis. However, the study highlighted the need to monitor HRV starting from alcohol ingestion until its complete metabolization to allow a more precise description of its variation. © Springer International Publishing Switzerland 2014.

Prevalence of alcohol consumption and pattern of use among the elderly in the WHO European Region

BACKGROUND/AIMS: Alcohol-related problems are relevant in the elderly, particularly in developed countries, but there is a lack of cross-country comparisons. The present work aims to examine the frequency and patterns of alcohol consumption in older adults across different European countries, and to analyze the relationship between socioeconomic status and gender with alcohol consumption. METHODS: General population-based household surveys of randomly selected adults over 60 years of age in 14 European countries. PARTICIPANTS: 10,119 subjects [mean age: 70.4 (SD = 7.1)], 61.9% women. RESULTS: There are marked differences in alcohol consumption across countries. Except for three countries from eastern regions, most people in all countries present moderate consumption regarding the amount of alcohol and pattern of use. However, there are marked gender differences, with a higher intake in men (effect sizes ranging from 0.57 to 1.27), although these differences are relatively proportional across countries. Finally, a higher socioeconomic status is positively related (B = 0.845, 95% CI: 0.30/1.40) with alcohol consumption after controlling for gender, age, health-functioning status and the country's development level. CONCLUSIONS: There are marked differences in consumption of alcohol in the elderly between the different countries, and male gender, as well as a higher SES, were associated with higher alcohol consumption.

Under the influence? The construction of foetal alcohol syndrome in UK newspapers

Today, alongside many other proscriptions, women are expected to abstain or at least limit their alcohol consumption during pregnancy. This advice is reinforced through warning labels on bottles and cans of alcoholic drinks. In most (but not all) official policies, this is linked to a risk of Foetal Alcohol Syndrome (FAS) or one of its associated conditions. However, given that there is little medical evidence that low levels of alcohol consumption have an adverse impact on the foetus, we need to examine broader societal ideas to explain why this has now become a policy concern. This paper presents a quantitative and qualitative assessment of analysis of the media in this context. By analysing the frames over time, this paper will trace the emergence of concerns about alcohol consumption during pregnancy. It will argue that contemporary concerns about FAS are framed around a number of pre-existing discourses including alcohol consumption as a social problem, heightened concerns about children at risk and shifts in ideas about the responsibility of motherhood including during the pre-conception and pregnancy periods. Whilst the newspapers regularly carried critiques of the abstinence position now advocated, these challenges focused did little to refute current parenting cultures.

Advocating alcohol abstinence to pregnant women: some observations about British policy

In 2007, the English Department of Health (DH) issued advice stating 'pregnant woman' and 'those trying to conceive' should abstain from drinking alcohol. As others have noted, this advice was issued despite their being no new evidence about the deleterious effects of low levels of alcohol consumption. In this paper, we argue this development is significant for the social construction of 'risk', since in advocating abstinence without an evidence base for this advice, policy makers formalise a connection between uncertainty and danger. We suggest this development has important implications, most obviously for pregnant women, certainly impacting on the nature of the advice they will now receive and likely more generally on their experience of the transition to motherhood. We suggest it has wider implications for individuals' experience also, as policy makers appear to be advocating the same approach to risk to non-pregnant people. Further, it suggests a noteworthy formalisation of a new definition of risk, which should be debated far more extensively, as it matters for the future development of health policy.

Using alcohol unit-marked glasses enhances capacity to monitor intake:evidence from a mixed-method intervention trial

AIMS: In the UK, people tend to have poor knowledge of government guidelines for alcohol use, and lack the motivation and skills required to use them to monitor their drinking. The study aim was to determine whether using glasses marked with such guidelines would improve knowledge and attitudes, increase frequency of counting units and lower alcohol intake. METHODS: A total of 450 adults in the UK participated in an intervention vs control study with 1-month follow-up. The intervention group was encouraged to use glasses supplied by the researchers that indicated the unit content of drinks of different strengths and volumes, and stated the intake guidelines. Data were collected online. A further more in-depth interview with 13 intervention group participants enquired into their experiences of using the glasses. RESULTS: Analyses adjusted for baseline variables showed that the intervention improved the following: knowledge of unit-based guidelines, ability to estimate the unit content of drinks, attitudes toward the guidelines and frequency of counting unit intake. However, there was no significant difference in alcohol consumption between the groups at follow-up. Interviews suggested that the glasses encouraged people to think about their drinking and to discuss alcohol with other people. The design of the glasses was not appealing to all, and their initial impact did not always persist. CONCLUSION: Use of unit-marked glasses led to changes in people's reported use of unit-based guidelines to monitor their drinking but, in the short term, no change in consumption. Qualitative data suggested that the glasses could have an impact at the individual level (on knowledge and attitudes) and at a broader level (by prompting discussion of alcohol use).

Prenatal alcohol exposure and childhood balance ability:findings from a UK birth cohort study

OBJECTIVE: To investigate the association of prenatal alcohol exposure with balance in10-year-old children. DESIGN: Population-based prospective longitudinal study. SETTING: Former Avon region of UK (Southwest England). PARTICIPANTS: 6915 children from the Avon Longitudinal Study of Parents and Children who had a balance assessment at age 10 and had data on maternal alcohol consumption. OUTCOME MEASURES: 3 composite balance scores: dynamic balance (beam-walking), static balance eyes open, static balance eyes closed (heel-to-toe balance on a beam and standing on one leg, eyes open or closed). RESULTS: Most mothers (95.5%) consumed no-to-moderate amounts (3-7 glasses/week) of alcohol during pregnancy. Higher total-alcohol consumption was associated with maternal-social advantage, whereas binge drinking (≥4 units/day) and abstinence were associated with maternal social disadvantage. No evidence was found of an adverse effect of maternal-alcohol consumption on childhood balance. Higher maternal-alcohol use during pregnancy was generally associated with better offspring outcomes, with some specific effects appearing strong (static balance eyes open and moderate total alcohol exposure at 18 weeks, adjusted OR 1.23 (95% CI 1.01 to 1.49); static balance eyes closed and moderate total alcohol exposure at 18 weeks, adjusted OR 1.25 (95% CI 1.06 to 1.48). Similar results were found for both paternal and postnatal maternal alcohol exposure. A Mendelian-randomization approach was used to estimate the association between maternal genotype and offspring balance using the non-synonymous variant rs1229984*A (ADH1B) to proxy for lower maternal alcohol consumption; no strong associations were found between this genotype/proxy and offspring balance. CONCLUSIONS: No evidence was found to indicate that moderate maternal alcohol consumption in this population sample had an adverse effect on offspring balance at age 10. An apparent beneficial effect of higher total maternal alcohol consumption on offspring balance appeared likely to reflect residual confounding.

Creating demand for better health by using social marketing techniques

The most significant environmental change to support people who want to give up smoking is the legislation to ban smoking in public places. Following Scotland in March 2006, and Wales and Northern Ireland in April 2007, England moves one step closer to being smoke free on 1 July 2007, when it becomes illegal to smoke in almost every enclosed public place and workplace. Social marketing will be used to support this health promoting policy and will become more prominent in the design of health promotion campaigns of the future. Social marketing is not a new approach to promoting health but its adoption by the Government does represent a paradigm shift in the challenge to change public opinion and social norms. As a result some behaviours, like smoking or excessive alcohol consumption, will no longer be socially acceptable. The Department of Health has decided that social marketing should be used in England to guide all future health promotion efforts directed at achieving behavioural goals. This paradigm shift was announced in Chapter 2 of the “Choosing health” White Paper with its emphasis on the consumer, noting that a wide range of lifestyle choices are marketed to people, although health as a commodity itself has not been marketed. The DoH has an internal social marketing development unit to integrate social marketing principles into its work and ensure that providers deliver. The National Centre for Social Marketing has funding to provide ongoing support, to build capacity and capability in the workforce. This article describes the distinguishing features of the social marketing approach. It seeks to answer some questions. Is this really a new idea, a paradigm shift, or simply a change in terminology? What do the marketing principles offer that is new, or are they merely familiar ideas repackaged in marketing jargon? Will these principles be more effective than current health promotion practice and, if so, how does it work? Finally, what are the implications for community pharmacy?

Wide variation in understanding about what constitutes 'binge-drinking'

Two studies investigated undergraduates' knowledge of the UK government recommendations about binge drinking and sensible drinking, and also examined how labelling oneself as a binge drinker is associated with binge drinking perceptions. In Study 1, 325 undergraduates reported how many units constitute binge drinking, and labelled themselves as a 'binge drinker' or 'non-binge drinker'. Participants overestimated how many units constitute binge drinking relative to the UK government recommendations. Also, 59 labelled themselves as 'non-binge drinkers' and gave significantly higher estimates compared with 'binge drinkers'. In Study 2, 386 undergraduates defined binge drinking and reported how many units constitute sensible drinking. Only 13 of undergraduates defined binge drinking in terms of units of alcohol, and undergraduates overestimated how many units constitute sensible drinking. This research found wide variation in personal understanding of the term binge drinking and suggests a review of how to communicate recommendations about alcohol consumption to young people is needed. © 2010 Informa UK Ltd.

Requirement for and optimisation of premium intraocular lenses

Premium intraocular lenses (IOLs) aim to surgically correct astigmatism and presbyopia following cataract extraction, optimising vision and eliminating the need for cataract surgery in later years. It is usual to fully correct astigmatism and to provide visual correction for distance and near when prescribing spectacles and contact lenses, however for correction with the lens implanted during cataract surgery, patients are required to purchase the premium IOLs and pay surgery fees outside the National Health Service in the UK. The benefit of using toric IOLs was thus demonstrated, both in standard visual tests and real-world situations. Orientation of toric IOLs during implantation is critical and the benefit of using conjunctival blood vessels for alignment was shown. The issue of centration of IOLs relative to the pupil was also investigated, showing changes with the amount of dilation and repeat dilation evaluation, which must be considered during surgery to optimize the visual performance of premium IOLs. Presbyopia is a global issue, of growing importance as life expectancy increases, with no real long-term cure. Despite enhanced lifestyles, changes in diet and improved medical care, presbyopia still presents in modern life as a significant visual impairment. The onset of presbyopia was found to vary with risk factors including alcohol consumption, smoking, UV exposure and even weight as well as age. A new technique to make measurement of accommodation more objective and robust was explored, although needs for further design modifications were identified. Due to dysphotopsia and lack of intermediate vision through most multifocal IOL designs, the development of a trifocal IOL was shown to minimize these aspects. The current thesis, therefore, emphasises the challenges of premium IOL surgery and need for refinement for optimum visual outcome in addition to outlining how premium IOLs may provide long-term and successful correction of astigmatism and presbyopia.

Resveratrol and the eye:activity and molecular mechanisms

Purpose: Alcohol consumption is inversely correlated with the incidence of cardiovascular disease. It is thought that red wine is specifically responsible for these cardiovascular benefits, due to its ability to reduce vascular inflammation, facilitate vasorelaxation, and inhibit angiogenesis. This is because of its high polyphenolic content. Resveratrol is the main biologically active polyphenol within red wine. Owing to its vascular-enhancing properties, resveratrol may be effective in the microcirculation of the eye, thereby helping prevent ocular diseases such as age-related macular degeneration, diabetic retinopathy, and glaucoma. Such conditions are accountable for worldwide prevalence of visual loss. Method: A review of the relevant literature was conducted on the ScienceDirect, Web of Science, and PubMed databases. Key words used to carry out the searches included 'red wine', 'polyphenols', 'resveratrol', 'eye' and 'ocular'. Articles relating to the effects of resveratrol on the eye were reviewed. Results: The protective effects of resveratrol within the eye are extensive. It has been demonstrated to have anti-oxidant, anti-apoptotic, anti-tumourogenic, anti-inflammatory, anti-angiogenic and vasorelaxant properties. There are potential benefits of resveratrol supplementation across a wide range of ocular diseases. The molecular mechanisms underlying these protective actions are diverse. Conclusion: Evidence suggests that resveratrol may have potential in the treatment of several ocular diseases. However, while there are many studies indicating plausible biological mechanisms using animal models and in-vitro retinal cells there is a paucity of human research. The evidence base for the use of resveratrol in the management of ocular diseases needs to be increased before recommendations can be made for the use of resveratrol as an ocular supplement. © 2014 Springer-Verlag.

The goal-dependent automaticity of drinking habits

In recent treatments of habitual social behaviour, habits are conceptualized as a form of goal-directed automatic behaviour that are mentally represented as goal-action links. Three experiments tested this conceptualization in the context of students' drinking (alcohol consumption)habits. Participants were randomly assigned to conditions where either a goal related to drinking behaviour (socializing) was activated, or an unrelated goal was activated. In addition, participants' drinking habits were measured. The dependent variable in Experiments 1 and 2 was readiness to drink, operationalized by speed of responding to the action concept 'drinking' in a verb verification task. Experiment 3 used the uptake of a voucher to measure drinking behaviour. Findings supported the view that when habits are established, simply activating a goal related to the focal behaviour automatically elicits that behaviour. These findings are consistent with a goal-dependent conception of habit. Possibilities for interventions designed to attenuate undesirable habitual behaviours are considered.

Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis:results from the WHO World Health Survey

This study explored whether physical health problems are related to psychotic symptoms independently of a mental disorder diagnosis. A total of 224,254 subjects recruited for the World Health Organization World Health Survey were subdivided into those with both a lifetime diagnosis of psychosis and at least one psychotic symptom in the 12 months prior to the evaluation, those with at least one psychotic symptom in the past 12 months but no lifetime diagnosis of psychosis, and those without psychotic symptoms in the past 12 months and without a lifetime diagnosis of psychosis. The three groups were compared for the presence of medical conditions, health problems, and access to health care. Medical conditions and health problems (angina, asthma, arthritis, tuberculosis, vision or hearing problems, mouth/teeth problems, alcohol consumption, smoking, and accidents), medication consumption, and hospital admissions (but not regular health care visits) were more frequent in individuals with psychotic symptoms but no psychosis diagnosis, compared to those with no symptoms and no diagnosis. The number of medical conditions increased with the number of psychotic symptoms. Given the sample analyzed, this trend seems to be independent from the socio-economic development of the country or the specific health care system.

Overview of risk factors for age-related macular degeneration

Age related macular degeneration (AMD) is the leading cause of blindness in individuals older than 65 years of age. It is a multifactorial disorder and identification of risk factors enables individuals to make life style choices that may reduce the risk of disease. This review discusses the role of genetics, sunlight, diet, cardiovascular factors, smoking, and alcohol as possible risk factors for AMD. Genetics plays a more significant role in AMD than previously thought, especially in younger patients, histocompatibility locus antigen (HLA) and complement system genes being the most significant. Whether the risk of AMD is increased by exposure to sunlight, cardiovascular risk factors, and diet is more controversial. Smoking is the risk factor most consistently associated with AMD. Current smokers are exposed to a two to three times higher risk of AMD than non-smokers and the risk increases with intensity of smoking. Moderate alcohol consumption is unlikely to increase the risk of AMD. Optometrists as front-line informers and educators of ocular health play a significant role in increasing public awareness of the risks of AMD. Cessation of smoking, the use of eye protection in high light conditions, dietary changes, and regular use of dietary supplements should all be considered to reduce the lifetime risk of AMD.

Overview of risk factors for age-related macular degeneration (AMD)

Age related macular degeneration (AMD) is the leading cause of blindness in individuals older than 65 years of age. It is a multifactorial disorder and identification of risk factors enables individuals to make life style choices that may reduce the risk of disease. This review discusses the role of genetics, sunlight, diet, cardiovascular factors, smoking, and alcohol as possible risk factors for AMD. Genetics plays a more significant role in AMD than previously thought, especially in younger patients, histocompatibility locus antigen (HLA) and complement system genes being the most significant. Whether the risk of AMD is increased by exposure to sunlight, cardiovascular risk factors, and diet is more controversial. Smoking is the risk factor most consistently associated with AMD. Current smokers are exposed to a two to three times higher risk of AMD than non-smokers and the risk increases with intensity of smoking. Moderate alcohol consumption is unlikely to increase the risk of AMD. Optometrists as front-line informers and educators of ocular health play a significant role in increasing public awareness of the risks of AMD. Cessation of smoking, the use of eye protection in high light conditions, dietary changes, and regular use of dietary supplements should all be considered to reduce the lifetime risk of AMD.