Alcohol consumption and related harm among university students in Ireland

Aim: Alcohol consumption is a leading cause of global suffering. The harms caused by alcohol to the individual, their peers and the society in which they live provokes public health concern. Elevated levels of consumption and consequences have been noted in those aged 18-29 years. University students represent a unique subsection of society within this age group. University authorities have attempted to tackle this issue throughout the past decade. However, the issue persists. Thus, the aim of this study is to contribute to the evidence base for policy and practice in relation to alcohol harm reduction among third-level students in Ireland. Methods: A mixed methods approach was employed. A systematic review of the prevalence of hazardous alcohol consumption among university students in Ireland and the United Kingdom from 2002 to 2014 was conducted. In addition, a narrative synthesis of studies of drinking types evidenced among youths in western societies was undertaken. A cross-sectional study focused on university students’ health and lifestyle behaviours with particular reference to alcohol consumption was undertaken using previously validated instruments. Undergraduate students registered to one university in Ireland were recruited using two separate modes; classroom and online. Studies investigated the impact of mode of data collection, the prevalence of hazardous alcohol consumption and resultant adverse consequences for mental health and wellbeing. In addition a study using a Q-methodology approach was undertaken to gain a deeper understanding of the cultural factors influencing current patterns of alcohol consumption. Data were analysed using IBM SPPS statistics 20, Stata 12, MPLUS and PQ Method. Results: The literature review focusing on students’ alcohol consumption found that there has been both an increase in hazardous alcohol consumption among university students and a convergence of male and female drinking patterns throughout the past decade. Updating this research, the thesis found that two-thirds of university students consume alcohol at a hazardous level, detailing the range of adverse consequences reported by university students in Ireland. Finally, the heterogeneous nature of this drinking was described in a narrative synthesis exposing six types of consumption. The succeeding chapters develop this review further by describing three typologies of consumption, two quantitative and one quali-quantilogical. The quantitative typology describes three types of drinking for men (realistic hedonist, responsible conformer and guarded drinker) and four types for women (realistic hedonist, peer-influenced, responsible conformer and guarded drinker). The quali-quantilogical approach describes four types of consumption. These are defined as the ‘guarded drinker’, the ‘calculated hedonist’, the ‘peer-influenced drinker’ and the ‘inevitable binger’. Discussion: The findings of this thesis highlight the scale of the issue and provide up-to-date estimates of alcohol consumption among university students in Ireland. Hazardous alcohol consumption is associated with a range of harms to self and harms to others in proximity to the alcohol consumer. The classification of drinkers into types signal the necessity for university management, health promotion practitioners and public health policy makers to tackle this issue using a multi-faceted approach.

The reliability and factorial validity of the Adolescent Alcohol Involvement Scale in a large sample in the United Kingdom

The assessment of adolescent drinking behavior is a complex task, complicated by variability in drinking patterns, the transitory and developmental nature of the behavior and the reliance (for large scale studies) on self-report questionnaires. The Adolescent Alcohol Involvement Scale (Mayer & Filstead, 1979) is a 14-item screening tool designed to help to identify alcohol misusers or more problematic drinkers. The present study utilized a large sample (n = 4066) adolescents from Northern Ireland. Results of Confirmatory Factor Analyses and reliability estimates revealed that the 14-items share sufficient common variance that scores can be considered to be reliable and that the 14 items can be scored to provide a composite alcohol use score.

Alcohol-Related Problems in Eastern Europe : A Comparative Perspective

This thesis investigates the association between alcohol consumption and alcohol-related harm in Eastern Europe. The main aim was to estimate to what extent changes in per capita alcohol consumption have an impact on different forms of alcohol-related mortality, and to put the results in an international comparative perspective. The thesis includes four papers; the first two papers use aggregate time-series analysis to assess how changes in per capita consumption affect rates in suicide mortality and fatal non-intentional injuries in several Eastern European countries, respectively. The third paper applies the same methodological approach to analyse the population-level relationship between alcohol and homicide in Russia and the U.S.. The fourth paper employs survey data to assess how the risk of experiencing alcohol-related problems in relation to volume of consumption in the Baltic countries compares to Sweden and Italy. The results of the first three papers suggests: (i) that changes in per capita consumption are significantly related to changes in mortality rates of suicide, non-intentional injuries and homicide in the countries under study; (ii) that the relationship is stronger for men than for women, and (iii) that the relationship tends to be stronger in the countries with more detrimental drinking patterns, e.g. Russia. The results of the fourth paper suggest that the risk of experiencing alcohol-related problems in relation to level of drinking in the Baltic countries is similar to the corresponding risk in Sweden, but considerably stronger than in Italy. In conclusion, the findings support the significance of a public health approach to alcohol-related problems in Eastern Europe, i.e., policy measures directed towards total alcohol consumption. In addition, strategies aimed at reducing the occurrence of binge drinking seem to have great potential for reducing alcohol-related harm and mortality in Eastern European countries.

Alcohol consumption and the sense of coherence in young people in educational training

The rate of consumption of alcoholic beverages has undergone changes as well as the factors that influence it. In order to understand the significance of drinking patterns, this study was conducted with a sample of young adults (N = 260) ages 20 to 30, in Lisbon. The instruments used were The Alcohol Use Disorders Identification Test and the Sense of Coherence Questionnaire. The results show that 10.8% had problems with alcohol. Those who had a lower sense of coherence, especially in the dimension of investment capacity, presented with more harmful and risky consumption patterns. We conclude that health promotion behaviors should include measures to strengthen a sense of coherence

The families and friends of heavy drinkers: Caught in the cross-fire of policy change?

INTRODUCTION AND AIMS: Research highlights the need to better understand the impact of alcohol-related harm on families and communities. Scottish policy initiatives to reduce alcohol consumption and alcohol-related harm include the planned introduction of a minimum unit price for alcohol. We aimed to explore existing and proposed changes in alcohol policy, from the standpoint of heavy drinkers, through accounts of their involvement and repercussions for family and friends. DESIGN AND METHODS: Interviews were conducted with 20 heavy drinkers, recruited from hospital alcohol treatment centres in Scotland's two largest cities. Participants were part of a larger longitudinal mixed methods study. Interviews explored experiences of alcohol-related harm and the impact, or potential impact, of alcohol policy changes on drinking patterns, risk-taking, consumption and wellbeing. Data coded for 'family and friends' were thematically analysed using a constant comparison method. RESULTS: Family and friends were portrayed as important for aiding moderation and abstinence, but more often for sustaining continued heavy drinking. Heavy drinkers with complex needs and those living in deprived communities suggested that increased alcohol prices could exacerbate the detrimental effect on their health and social circumstances, and that of their family, should their consumption remain excessive. DISCUSSION AND CONCLUSIONS: Population level policy initiatives to reduce alcohol consumption, such as minimum unit pricing, will impact on the families and social networks of heavy drinkers in addition to the drinker. The most vulnerable may be affected disproportionately. Alcohol policy changes and evaluations need to consider consequences for drinkers, families and communities. [O'May F, Whittaker A, Black H, Gill J. The families and friends of heavy drinkers: Caught in the cross-fire of policy change?

Environmental monitoring of bacterial contamination and antibiotic resistance patterns of the fecal coliforms isolated from Cauvery River, a major drinking water source in Karnataka, India

The present study focuses prudent elucidation of microbial pollution and antibiotic sensitivity profiling of the fecal coliforms isolated from River Cauvery, a major drinking water source in Karnataka, India. Water samples were collected from ten hotspots during the year 2011-2012. The physiochemical characteristics and microbial count of water samples collected from most of the hotspots exhibited greater biological oxygen demand and bacterial count especially coliforms in comparison with control samples (p <= 0.01). The antibiotic sensitivity testing was performed using 48 antibiotics against the bacterial isolates by disk-diffusion assay. The current study showed that out of 848 bacterial isolates, 93.51 % (n=793) of the isolates were found to be multidrug-resistant to most of the current generation antibiotics. Among the major isolates, 96.46 % (n=273) of the isolates were found to be multidrug-resistant to 30 antibiotics and they were identified to be Escherichia coli by 16S rDNA gene sequencing. Similarly, 93.85 % (n=107), 94.49 % (n=103), and 90.22 % (n=157) of the isolates exhibited multiple drug resistance to 32, 40, and 37 antibiotics, and they were identified to be Enterobacter cloacae, Pseudomonas trivialis, and Shigella sonnei, respectively. The molecular studies suggested the prevalence of blaTEM genes in all the four isolates and dhfr gene in Escherichia coli and Sh. sonnei. Analogously, most of the other Gram-negative bacteria were found to be multidrug-resistant and the Gram-positive bacteria, Staphylococcus spp. isolated from the water samples were found to be methicillin and vancomycin-resistant Staphylococcus aureus. This is probably the first study elucidating the bacterial pollution and antibiotic sensitivity profiling of fecal coliforms isolated from River Cauvery, Karnataka, India.

The Drinking Expectancy Questionnaire for Men who have Sex with Men (DEQ-MSM): A measure of substance-related beliefs

Introduction and Aims. Alcohol expectancies are associated with drinking behaviour and post-drinking use thoughts, feelings and behaviours. The expectancies held by specific cultural or sub-cultural groups have rarely been investigated. This research maps expectancies specific to gay and other men who have sex with men (MSM) and their relationship with substance use. This study describes the specific development of a measure of such beliefs for alcohol, the Drinking Expectancy Questionnaire for Men who have Sex with Men (DEQ-MSM). Design and Methods. Items selected through a focus group and interviews were piloted on 220 self-identified gay or other MSM via an online questionnaire. Results. Factor analysis revealed three distinct substance reinforcement domains ('Cognitive impairment', 'Sexual activity' and 'Social and emotional facilitation'). These factors were associated with consumption patterns of alcohol, and in a crucial test of discriminant validity were not associated with the consumption of cannabis or stimulants. Similarities and differences with existing measures will also be discussed. Discussion and Conclusions. The DEQ-MSM represents a reliable and valid measure of outcome expectancies, related to alcohol use among MSM, and represents an important advance as no known existing alcohol expectancy measure, to date, has been developed and/or normed for use among this group. Future applications of the DEQ-MSM in health promotion, clinical settings and research may contribute to reducing harm associated with alcohol use among MSM, including the development of alcohol use among young gay men.

Drinking and driving in Vietnam : perceptions and risk

Road traffic injuries are a major global public health problem but continue to receive inadequate attention. Alcohol influences both risk and consequence of road traffic injury but the scale of the problem is not well understood in many countries. In Vietnam, economic development has brought a substantial increase in the number of registered motorcycles as well as alcohol consumption. Traffic injury is among the leading causes of death in Vietnam but there is little local information regarding alcohol related traffic injuries. The primary goal of this study is to explore the drinking and driving patterns of males and their perceptions towards drink-driving and to determine the relationship between alcohol consumption and road traffic injuries. Furthermore, this thesis aims to present the situation analysis for choosing priority actions to reduce drinking and driving in Vietnam. The study is a combination of two cross-sectional surveys and a pilot study. The pilot study, involving 224 traffic injured patients, was conducted to test the tools and the feasibility of approach methods. In the first survey, male patrons (n=464) were randomly selected at seven restaurants. Face-to-face interviews were conducted when patrons just arrived and breath tests were collected when they were about to leave the restaurant. In the second survey, male patients admitted to hospital following a traffic injury (n=480, of which 414 were motorcycle or bicycle riders) were interviewed and their blood alcohol concentration (BAC) measured by breathalyzer. The results show broadly similar patterns of drinking and driving among male patrons and male traffic injured patients with a high frequency of drinking and drink-driving reported among the majority of the two groups. A high proportion of male patrons were leaving restaurants with a BAC over the legal limit. Factors that significantly associate with the number of drinks and BAC were age, hazardous drinking, frequency of drink-driving in the past year, self-estimated number of drinks consumed to drive legally, perceived family’s disapproval of drink-driving, and perceived legal risk and physical risk. The proportion of patrons and patients with BAC above the legal limit of 0.05 were 86.7% and 60.4% respectively, which was much higher than found in previous studies. In addition, both groups had a high prevalence of BAC over 0.15g/100ml (39.7% of patrons and 45.6% patients), a level that can seriously affect driving capacity. Results from the case-crossover analysis for patients indicate a dose-response relationship between alcohol consumption and the risk of traffic injury. The risk of traffic injury increased when alcohol was consumed before driving and there was a more than 13 fold increase when six or more drinks were consumed. Regarding perceptions towards drinking and driving, findings corroborate the low awareness among males in Vietnam, with a majority of respondents holding a low knowledge of safe and legally permissible alcohol use, and a low perceived risk of drinking and driving. The results also indicate a huge gap in prevention skills in terms of planning ahead or using alternative transport to avoid drink-driving and a perception by patrons and patients of a low rate of disapproval of drink-driving from peers and family. Findings in this study have considerable implications for national policy, injury prevention, clinical practice, reporting systems, and for further research. The low rate of compliance with existing laws and a generally low perceived legal risk toward drink-driving in this study call for the strengthening of enforcement along with mass media campaigns and news coverage in order to decrease the widespread perception of impunity and thereby, to reduce the level of drink-driving. In addition, no significant difference was found in this study on risk of traffic injuries between car drivers and motorcycle drivers. The current inconsistency between legal BAC for drivers of motorcycles, compared to cars, thus needs addressing. Furthermore, as drinking was found to be very common, rather than solely targeting drink-driving, it is important to call for a more strategic and comprehensive approach to alcohol policy in Viet Nam. This study also has considerable implications for clinical practice in terms of screening and brief interventions. Our study suggests that the short form of the AUDIT (AUDIT-C) screening tool is appropriate for use in busy emergency departments. The high proportion of traffic injured patients with evidence of alcohol abuse or hazardous drinking suggests that brief interventions by alcohol and drug counselors in emergency departments are a sensible option to addressing this important problem. The significance of this study is in the combination of the systematic collection of breath test and use of case-crossover design to estimate the risk of traffic injuries after alcohol consumption. The results provide convincing evidence to policy makers, health authorities and the media to help raise community awareness and policy advocacy toward the drinkdriving problem in Vietnam. The findings suggest an urgent need for a multi-sectoral approach to curtail drink-driving in Vietnam, especially programs to raise community awareness and effective legal enforcement. Furthermore, serving as a situation analysis, the thesis should inform the formulation of interventions designed to curtail drinking and driving in Vietnam and other developing countries.

Valuing drinking water provision as an ecosystem service in the neuse river basin

The valuation of ecosystem services such as drinking water provision is of growing national and international interest. The cost of drinking water provision is directly linked to the quality of its raw water input, which is itself affected by upstream land use patterns. This analysis employs the benefit transfer method to quantify the economic benefits of water quality improvements for drinking water production in the Neuse River Basin in North Carolina. Two benefit transfer approaches, value transfer and function transfer, are implemented by combining the results of four previously published studies with data collected from eight Neuse Basin water treatment plants. The mean net present value of the cost reduction estimates for the entire Neuse Basin ranged from $2.7 million to $16.6 million for a 30% improvement in water quality over a 30-year period. The value-transfer approach tended to produce larger expected benefits than the function-transfer approach, but both approaches produced similar results despite the differences in their methodologies, time frames, study sites, and assumptions. © 2010 ASCE.

Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: The Prospective Epidemiological Study of Myocardial Infarction (PRIME)

Objective: To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France.
Design: Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox's proportional hazards regression analysis.
Setting: One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse).
Participants: 9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994.
Main outcome measures: Incident myocardial infarction and coronary death ("hard" coronary events), and incident angina pectoris.
Results: A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95% confidence interval 4.69 to 6.69) in Belfast and 2.78 (95% CI 2.41 to 3.20) in France. After multivariate adjustment for classic cardiovascular risk factors and centre, the hazard ratio for hard coronary events compared with regular drinkers was 1.97 (95% CI 1.21 to 3.22) for binge drinkers, 2.03 (95% CI 1.41 to 2.94) for never drinkers, and 1.57 (95% CI 1.11 to 2.21) for former drinkers for the entire cohort. The hazard ratio for hard coronary events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking. Only wine drinking was associated with a lower risk of hard coronary events, irrespective of the country.
Conclusions: Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischaemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.

Association between 5-HTTLPR genotypes and persisting patterns of anxiety and alcohol use : results from a 10-year longitudinal study of adolescent mental health

The serotonin transporter gene (5-HTT) encodes a transmembrane protein that plays an important role in regulating serotonergic neurotransmission and related aspects of mood and behaviour. The short allele of a 44 bp insertion/deletion polymorphism (S-allele) within the promoter region of the 5-HTT gene (5-HTTLPR) confers lower transcriptional activity relative to the long allele (L-allele) and may act to modify the risk of serotonin-mediated outcomes such as anxiety and substance use behaviours. The purpose of this study was to determine whether (or not) 5-HTTLPR genotypes moderate known associations between attachment style and adolescent anxiety and alcohol use outcomes. Participants were drawn from an eight-wave study of the mental and behavioural health of a cohort of young Australians followed from 14 to 24 years of age (Victorian Adolescent Health Cohort Study, 1992 - present). No association was observed within low-risk attachment settings. However, within risk settings for heightened anxiety (ie, insecurely attached young people), the odds of persisting ruminative anxiety (worry) decreased with each additional copy of the S-allele (B30% per allele: OR 0.77, 95% CI 0.62–0.97, P¼0.029). Within risk settings for binge drinking (ie, securely attached young people), the odds of reporting persisting high-dose alcohol consumption (bingeing) decreased with each additional copy of the S-allele (B35% per allele: OR 0.74, 95% CI 0.64–0.86, Po0.001). Our data suggest that the S-allele is likely to be important in psychosocial development, particularly in those settings that increase risk of anxiety and alcohol use problems.

Young adolescents' perceptions, patterns, and contexts of energy drink use. A focus group study

Caffeinated energy drinks (EDs) are purported to increase energy and improve performance, but have been associated with adverse health effects and death. EDs are popular among adolescents and young adults, yet little is known about their use among young adolescents. This study explored perceptions, patterns, and contexts of ED use in six focus groups with 40 adolescents aged 12-15 years from two regional Australian schools. A thematic analysis of the data was used to investigate knowledge about ED brands and content, ED use, reasons for ED use, physiological effects, and influences on ED use. Participants were familiar with EDs and most had used them at least once but had limited knowledge of ED ingredients, and some had difficulty differentiating them from soft and sports drinks. EDs were used as an alternative to other drinks, to provide energy, and in social contexts, and their use was associated with short-term physiological symptoms. Parents and advertising influenced participants' perceptions and use of EDs. These findings suggest young adolescents use EDs without knowing what they are drinking and how they are contributing to their personal risk of harm. The advertising, appeal, and use of EDs by adolescents appear to share similarities with alcohol and tobacco. Further research is needed to replicate and extend the current findings, informed by the lessons learned in alcohol research.

Linking masculinity to negative drinking consequences : the mediating roles of heavy episodic drinking and alcohol expectancies

This study extends previous research on masculinity and negative drinking consequences among young men by considering mediating effects of heavy episodic drinking (HED) and alcohol expectancies. We hypothesized that masculinity would have a direct relationship with negative consequences from drinking as well as indirect relationships mediated by HED and alcohol expectancies of courage, risk, and aggression.

Peer group patterns of adolescent alcohol using behaviours in Victoria, Australia and Washington State, US

 The goal of this study was to examine and cross-nationally compare the peer group patterns of alcohol-drinking behaviors among cohorts of early adolescents (ages 11–14 years) in Victoria, Australia, and Washington State, United States. Latent transition analysis revealed that after 1 year, transitions congruent with peer influence (whereby non-drinking adolescents initiated alcohol use in the presence of drinking peers) and reverse peer influence were observed in both states; however, transitions congruent with peer selection (whereby drinking adolescents self-selected into drinking peer groups) were only observed among Victorian early adolescents. Findings were interpreted to suggest that Australian family and cultural norms that more commonly allow early adolescent alcohol use lead to a higher rate of peer selection.