Is the Full Version of the AUDIT Really Necessary? Study of the Validity and Internal Construct of Its Abbreviated Versions

Background: This study was aimed at assessing the psychometric qualities of the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT-3, AUDIT-4, AUDIT-C, AUDIT-PC, AUDIT-QF, FAST, and Five-Shot) and at comparing them to the 10-item AUDIT and the CAGE in 2 samples of Brazilian adults. Methods: The validity and internal consistency of the scales were assessed in a sample of 530 subjects attended at an emergency department and at a Psychosocial Care Center for Alcohol and Drugs. The Structured Clinical Interview for DSM-IV was used as the diagnostic comparative measure for the predictive validity assessment. The concurrent validity between the scales was analyzed by means of Pearson`s correlation coefficient. Results: The assessment of the predictive validity of the abbreviated versions showed high sensitivity (of 0.78 to 0.96) and specificity (of 0.74 to 0.94) indices, with areas under the curve as elevated as those of the AUDIT (0.89 and 0.92 to screen for abuse and 0.93 and 0.95 in the screening of dependence). The CAGE presented lower indices: 0.81 for abuse and 0.87 for dependence. The analysis of the internal consistency of the AUDIT and its versions exhibited Cronbach`s alpha coefficients between 0.83 and 0.94, while the coefficient for the CAGE was 0.78. Significant correlations were found between the 10-item AUDIT and its versions, ranging from 0.91 to 0.99. Again, the results for the CAGE were satisfactory (0.77), although inferior to the other instruments. Conclusions: The results obtained in this study confirm the validity of the abbreviated versions of the AUDIT for the screening of alcohol use disorders and show that their psychometric properties are as satisfactory as those of the 10-item AUDIT and the CAGE.

A formação em rastreio e intervenções breves do álcool muda as atitudes dos profissionais de saúde ocupacional? : estudo quasi experimental exploratório para uma estratégia para o meio laboral

RESUMO - Estudos anteriores nos Cuidados de Saúde Primários (CSP) apontam para um incremento da Deteção Precoce (DP) e Intervenções Breves (IB) em pacientes com Problemas Ligados ao Álcool (PLA) após formação apropriada dos profissionais de saúde (com melhoria das suas atitudes). Este estudo quasi experimental, exploratório, é pioneiro no âmbito da Saúde Ocupacional (SO) para a implementação de Rastreio/DP e IB nos PLA. O objetivo principal foi avaliar se uma formação sobre Rastreio/DP e IB pode melhorar as atitudes dos profissionais de SO ao lidar com os PLA em Meio Laboral (PLAML). Foi aplicado um questionário em duas partes: Q1/pré-formação (variáveis sociodemográficas, profissionais, competências em alcoologia, experiência pessoal com álcool/familiares com PLA, dificuldades em lidar com trabalhadores com PLA, AUDIT-C e SAAPPQ) e Q2/pós-formação (avaliação da formação e das atitudes SAAPPQ - Adequação, Legitimidade, Motivação, Autoestima e Satisfação). Os resultados na amostra (N=39) revelaram um aumento sobretudo na Adequação e Satisfação. No entanto, naqueles com níveis baixos das atitudes pré-formação constou-se melhoria das atitudes à excepção da Autoestima e foram encontradas algumas associações com as características do perfil inicial dos participantes. Sugerem-se estudos posteriores para identificação de pacotes formativos mais efetivos e propostas para um Plano integrador de RIB para PLAML

The association between alcohol screening scores and health status in male veterans.

OBJECTIVES: Alcohol use is associated with self-reported health status. However, little is known about the concurrent association between alcohol screening scores and patient perception of health. We evaluated this association in a sample of primarily older male veterans.METHODS: This secondary, cross-sectional analysis included male general medicine outpatients from 7 VA medical centers who returned mailed questionnaires. Screening scores from the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questionnaire were divided into 6 categories (0, 1­3, 4­5, 6­7, 8­9, and 10­12). Outcomes included scores on the 8 subscales and 2 component scores of the 36-item Short Form Health Survey (SF-36). Unadjusted and adjusted linear regression models were fit to characterize the association between AUDIT-C categories and SF-36 scores. Models were adjusted for demographic characteristics, smoking, and site?both alone and in combination with 14 self-reported comorbid conditions.RESULTS: Male respondents (n = 24,531; mean age = 63.6 years) represented 69% of those surveyed with the SF-36. After adjustment, a quadratic (inverted U-shaped) relationship was demonstrated between AUDIT-C categories and all SF-36 scores such that patients with AUDIT-C scores 4­5 or 6­7 reported the highest health status, and patients with AUDIT-C scores 0, 8­9, and =10 reported the lowest health status.CONCLUSIONS: Across all measures of health status, patients with the most severe alcohol misuse had significantly poorer health status than those who screened positive for alcohol misuse at mild or moderate levels of severity. The relatively good health status reported by patients with mild-moderate alcohol misuse might interfere with clinicians' acceptance and adoption of guidelines recommending that they counsel these patients about their drinking.

Alcohol use and frailty in community-dwelling older persons aged 65 to 70 years.

Background: Alcohol use has beneficial as well as adverse consequences on health, but few studies examined its role in the development of age-related frailty. Objectives: To describe the cross-sectional and longitudinal association between alcohol intake and frailty in older persons. Design: The Lausanne cohort 65+ population-based study, launched in 2004. Setting: Community. Participants: One thousand five hundred sixty-four persons aged 65-70 years. Measurements: Annual data collection included demographics, health and functional status, extended by a physical examination every 3 years. Alcohol use (AUDIT-C), and Fried's frailty criteria were measured at baseline and 3-year follow-up. Participants were categorized into robust (0 frailty criterion) and vulnerable (1+ criteria). Results: Few participants (13.0%) reported no alcohol consumption over the past year, 57.8% were light-to-moderate drinkers, while 29.3% drank above recommended thresholds (18.7% "at risk" and 10.5% "heavy" drinkers). At baseline, vulnerability was most frequent in non-drinkers (43.0%), least frequent in light-to-moderate drinkers (26.2%), and amounted to 31.9% in "heavy" drinkers showing a reverse J-curve pattern. In multivariate analysis, compared to light-to-moderate drinkers, non-drinkers had twice higher odds of prevalent (adjOR: 2.24; 95%CI:1.39-3.59; p=.001), as well as 3-year incident vulnerability (adjOR: 2.00; 95%CI:1.02-3.91; p=.043). No significant association was observed among "at risk" and "heavy" drinkers. Conclusion: Non-drinkers had two-times higher odds of prevalent and 3-year incident vulnerability, even after adjusting for their baseline poorer health status. Although residual confounding is still possible, these results likely reflect a healthy survival effect among drinkers while those who experienced health- or alcohol-related problems stopped drinking earlier.

Use of alcohol before and after bariatric surgery

OBJECTIVE: to assess alcohol intake in the bariatric surgery pre and postoperative periods. METHODS: Patients were interviewed atSurgery Clinic of the Hospital das Clínicas da Universidade Federal de Pernambuco - HC/UFPE (Brazil) from July 2011 to March 2012. We analyzed socioeconomic, anthropometric and clinical variables. We used the Alcohol Use Disorders Identification Test (AUDIT C). RESULTS: One hundred nineteen patients were enrolled (mean age: 41.23+11.30 years), with a predominance of the female gender (83.2%), non-Caucasian race (55%), married individuals or in a stable union (65.5%), with a high school education (40.3%)and active in the job market (37%). Weight and body mass index (BMI) were 128.77+25.28Kg and 49.09+9.26Kg/m2,respectively in the preoperative period (class II obesity) and 87.19+19.16Kg and 33.04+6.21Kg/m2, respectively in the postoperative period (class I obesity) (p<0.001). Hypertension was the most frequent disease in the pre (66.6%) and postoperative (36.5%) periods. The prevalence of alcohol use was 26.6% in the preoperative period, of which 2.2% of high risk, and 35.1% in the postoperative period, of which 1.4% of probable dependence; this difference did not achieve statistical significance (p=0.337). CONCLUSION: The prevalence of abusive alcohol intake and/or probable dependence was low in both the pre and postoperative periods, with little evidence of risky consumption among the patients submitted to bariatric surgery.

Detecção de Binge drinking em estudantes do ensino médio: efetividade de diferentes métodos

Pós-graduação em Alimentos e Nutrição - FCFAR

Uso do álcool em estudantes do município de Botucatu-SP: prevalência e fatores de risco

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effectiveness of different methods for the detection of binge drinking in dentistry students

The purpose of this study was to estimate the alcoholic beverage consumption among undergraduate students of a Dentistry Course and compare the effectiveness of screening methods for the detection of binge drinking. A total of 284 undergraduate students participated in the research. We used the full AUDIT and their reduced forms (AUDIT-3 and AUDIT-C). In addition, a ROC curve was created and its area was calculated. Of the students, 91.0% and 90.6% of the male and female genders, respectively, reported alcohol beverage consumption. Bing-drinking behavior occurred in 69.2% of the men and in 52.4% of the women. The 3 methods showed good discriminatory ability. For the women, there was a significant difference between the AUDIT-3 and AUDIT-C. Both the complete version of AUDIT and its reduced forms presented good discriminatory ability

Deteção dos consumos excessivos de álcool nos adultos da USF Sete Caminhos - Gondomar

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

(MIS)PERCEIVED DRINKING NORMS AND HAZARDOUS DRINKING BEHAVIOURS IN UNIVERSITY FIRST-YEAR UNDERGRADUATE STUDENTS AND THE EFFECTS OF GENDER

Purpose: Across Canada, undergraduate university students are one of the highest alcohol-consuming populations. Many students engage in hazardous drinking and are at risk for negative health and social consequences. Social Norms Theory suggests that students’ overestimation of drinking norms can result in an increase in their drinking behaviour. As of yet, none of the literature addresses the possible link between drinking norm (mis)perception and hazardous drinking in a Canadian undergraduate context. This is the first Canadian study to examine this potential association in first-year undergraduate students across multiple universities using gender as an effect modifier. Methods: Using data collected by the Caring Campus Project, for 2347 first-year students from three Canadian universities, I evaluated the prevalence of drinking norm misperceptions by site and gender. Using multiple-logistic regression models, I analyzed the relationship between misperceived drinking norms and hazardous drinking behaviours (assessed via AUDIT-C). Results: The proportion of students who overestimated drinking and binge drinking frequency norms varied by site and gender. There was a positive relationship between overestimated drinking/ binge drinking frequency norms and hazardous drinking, modified by gender. Controlling for living arrangement and site, the odds of female students being hazardous drinkers increased by a factor of 2.27 (CI: 1.73-2.99) when the drinking frequency norm was overestimated. A non-significant association was found for male students. Among female students, when living arrangement and site were controlled, the odds of being a hazardous drinker were 1.83 (0.84-3.95) and 2.69 (1.24-5.83) times greater when the drinking frequency norm was perceived at “2-4 times per month” and “2 or more times per week”, respectively. Among male students, when living arrangement, previous residence and site were controlled, the odds of being a hazardous drinker were 4.03 (2.62-6.19) and 8.54 (5.41-13.49) times greater when the binge drinking frequency norm was perceived at “2-4 times per month” and “2 or more times per week”, respectively. Conclusion: This novel study enhances the understanding of the association between (mis)perceived drinking norms and drinking behaviours in Canadian undergraduate students. The demonstrated importance of gender and site provides a strong impetus for Canadian universities to develop targeted alcohol reduction interventions.

Hazardous alcohol consumption among university students in Ireland: a cross-sectional study

Objective: There is considerable evidence of a cultural shift towards heavier alcohol consumption among university students, especially women. The aim of this study is to investigate the prevalence and correlates of hazardous alcohol consumption (HAC) among university students with particular reference to gender and to compare different modes of data collection in this population. Setting: A large Irish university. Design: A cross-sectional study using a classroom distributed paper questionnaire. Participants: A total of 2275 undergraduates completed the classroom survey, 84% of those in class and 51% of those registered for the relevant module. Main outcome measures: Prevalence of HAC measured using the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) and the proportion of university students reporting 1 or more of 13 adverse consequences linked to HAC. HAC was defined as an AUDIT-C score of 6 or more among males and 5 or more among females. Results: In the classroom sample, 66.4% (95% CI 64.4 to 68.3) reported HAC (65.2% men and 67.3% women). In women, 57.4% met HAC thresholds for men. Similar patterns of adverse consequences were observed among men and women. Students with a hazardous consumption pattern were more likely to report smoking, illicit drug use and being sexually active. Conclusions: The findings highlight the high prevalence of HAC among university students relative to the general population. Public policy measures require review to tackle the short-term and long-term risks to physical, mental and social health and well-being.

Prevention of binge drinking in young adolescents through the promotion of a balanced level of psychological well-being: be-dry

This doctoral thesis presents a project carried out in secondary schools located in the city of Ferrara with the primary objective of demonstrating the effectiveness of an intervention based on Well-Being Therapy (Fava, 2016) in reducing alcohol use and improving lifestyles. In the first part (chapters 1-3), an introduction on risky behaviors and unhealthy lifestyle in adolescence is presented, followed by an examination of the phenomenon of binge drinking and of the concept of psychological well-being. In the second part (chapters 4-6), the experimental study is presented. A three-arm cluster randomized controlled trial including three test periods was implemented. The study involved eleven classes that were randomly assigned to receive well-being intervention (WBI), lifestyle intervention (LI) or not receive intervention (NI). Results were analyzed by linear mixed model and mixed-effects logistic regression with the aim to test the efficacy of WBI in comparison with LI and NI. AUDIT-C total score increased more in NI in comparison with WBI (p=0.008) and LI (p=0.003) at 6-month. The odds to be classified as at-risk drinker was lower in WBI (OR 0.01; 95%CI 0.01–0.14) and LI (OR 0.01; 95%CI 0.01–0.03) than NI at 6-month. The odds to use e-cigarettes at 6-month (OR 0.01; 95%CI 0.01–0.35) and cannabis at post-test (OR 0.01; 95%CI 0.01–0.18) were less in WBI than NI. Sleep hours at night decreased more in NI than in WBI (p = 0.029) and LI (p = 0.006) at 6-month. Internet addiction scores decreased more in WBI (p = 0.003) and LI (p = 0.004) at post-test in comparison with NI. Conclusions about the obtained results, limitations of the study, and future implications are discussed. In the seventh chapter, the data of the project collected during the pandemic are presented and compared with those from recent literature.

Road Safety Audit for Intersection of US 218 and County Road C-57 (West Cedar Wapsi Road) in Black Hawk County, Iowa, 2009

Beginning on June 22, 2009, a road safety audit was initiated for the intersection of US 218 and County Road C-57 in Black Hawk County, Iowa. Due to the traffic volumes and the number of conflicting traffic movements on these two roadways, this intersection has developed a crash history that concerns the Iowa Department of Transportation (Iowa DOT), Iowa State Patrol, and local agencies. This intersection is ranked seventh in Iowa for the highest number of at-grade expressway intersection crashes. Considering this, Black Hawk County and the Iowa DOT requested that a road safety audit be conducted to address the safety concerns and recommend possible mitigation strategies.

Animadversiones de libris raris. Quarum partem priorem cons. ampl. fac. phil. Aboënsis praeside m. Henrico Gabriele Porthan, eloq. prof. reg. [et] ord. R. Acad. litt. hum. hist. [et] antiquitt. membro. Publico examini modeste submittit Petrus Johannes Alopaeus, Wiburgensis, in audit. maj. die XVI Jun. MDCCXCI, h. a. m. c

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