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Biomedical subjects

J Rehm

Publications and source records attributed to J Rehm.

At least 73 records · Page 4Linked to original sources
PubMed1998

The economic costs of alcohol abuse in Ontario.

The abuse of alcohol causes health and social problems, such as sickness, death, injury, pain, suffering and crime. These harms impose an economic burden on society. Resources are used or foregone as a consequence of alcohol abuse. This article provides an estimate of the economic cost of alcohol abuse in Ontario in 1992. It uses the cost-of-illness method, in particular, the human-capital approach to estimate the prevalence-based economic costs of alcohol abuse. This methodology is consistent with international guidelines formulated at the 1994 International Symposium on Economic and Social Costs of Substance Abuse. The direct and indirect economic costs of alcohol abuse are identified and estimated. The total economic cost of alcohol abuse, from a societal perspective, is estimated to be US$2261.10 million in Ontario in 1992.

Alcoholism↗
PubMed1998

Implications of privatizing/deregulating alcohol retail sales: projections of alcohol consumption in Ontario.

PURPOSE: To project the consequences of privatizing or deregulating current alcohol retail monopolies in Ontario, Canada. METHODS: The projection is based on a multiplicative model and applied to estimate per capita alcohol consumption for four hypothetical scenarios, including both partial and complete privatization for the Province of Ontario, Canada. Those scenarios are mainly focused on the two dimensions of changes affected by privatization: alcohol physical availability and economic availability (i.e., retail prices). Various assumptions involving availability and prices are largely based on the Canadian and international research literature on deregulation/privatization. RESULTS AND IMPLICATIONS: The study showed that per capita alcohol consumption in the short/medium term is expected to increase in all four hypothetical scenarios examined, with the magnitude ranging from 11% to 27%. The sensitivity analysis also revealed a similar increase in alcohol consumption, even though the magnitude of the increase would be less for some scenarios. Therefore, any deliberations on modifying alcohol control policies are well advised to proceed with caution, since an increase in alcohol consumption is likely to be associated with elevated levels of drinking-related problems.

Adult↗
PubMed1998

Blame and punishment for intoxicated aggression: when is the perpetrator culpable?

AIM: To systematically test the hypothesis that intoxicated individuals are viewed as less culpable than relatively sober individuals for engaging in aggressive behaviour. DESIGN: A series of experimental vignettes depicted alcohol use in the context of unwanted touching, date rape, assault and rape, vandalism and common assault. Each vignette manipulated drinking of the perpetrator and selected contextual variables using between-subjects experimental designs. SETTING: A stratified random sample of 994 Ontario residents responded to these scenarios in the course of a telephone interview. MEASUREMENTS: Three measures were analysed in this study: (1) judgements of the causal role of the perpetrator's drinking in leading to each outcome, (2) perceived blameworthiness of the perpetrator, and (3) appropriate punishment for the perpetrator. FINDINGS: Drinking was believed to play a greater causal role in leading to each outcome when the perpetrator was portrayed as "drunk" as opposed to merely "feeling the effects". However, intoxication did not attenuate perceived blameworthiness and only inconsistently reduced punishment assigned to perpetrators. Instead, intoxication interacted with premeditation, criminal history and gender to determine perceived culpability of perpetrators. In some scenarios, victim intoxication reduced perceived culpability of the perpetrator. CONCLUSIONS: Legal, anthropological, and attributional accounts may overestimate the extent to which perpetrator intoxication--in and of itself--determines perceived culpability for alcohol-related aggression.

Adult↗
PubMed1998

The economic costs of alcohol, tobacco and illicit drugs in Canada, 1992.

UNLABELLED: AIMS, DESIGN AND SETTING: The economic costs of alcohol, tobacco and illicit drugs in Canadian society in 1992 are estimated utilizing a cost-of-illness framework and recently developed international guidelines. MEASUREMENTS: For causes of disease or death (using ICD-9 categories), pooled relative risk estimates from meta-analyses are combined with prevalence data by age, gender and province to derive the proportion attributable to alcohol, tobacco and/or illicit drugs. The resulting estimates of attributable deaths and hospitalizations are used to calculate associated health care, law enforcement, productivity and other costs. The results are compared wit other studies, and sensitivity analyses are conducted on alternative measures of alcohol consumption, alternative discount rates for productivity costs and the use of diagnostic-specific hospitalization costs. FINDINGS: The misuse of alcohol, tobacco and illicit drugs cost more than $18.4 billion in Canada in 1992, representing $649 per capita or 2.7% of GDP. Alcohol accounts for approximately $7.52 billion in costs, including $4.14 billion for lost productivity, $1.36 billion for law enforcement and $1.30 billion in direct health care costs. Tobacco accounts for approximately $9.56 billion in costs, including $6.82 billion for lost productivity and $2.68 billion for direct health costs. The economic of illicit drugs are estimated at $1.4 billion. CONCLUSIONS: Substance abuse exacts a considerable toll to Canadian society in terms of illness, injury, death and economic costs.

Alcohol Drinking↗
PubMed1998

Alcohol and all-cause mortality in Europe 1982-1990: a pooled cross-section time-series analysis.

AIM: To test the relationship between alcohol consumption and all-cause mortality. DESIGN DATA: Yearly mortality rates and per capita consumption from 25 European countries between 1982 and 1990. STATISTICAL MODELS: This paper employs time-series cross-sectional data to model the relationships between alcohol consumption and all-cause mortality. The data are derived from 25 European countries in the 1980s. The statistical analyses controlling cross-sectional correlation and timewise autoregression were used to implement the econometric modelling. FINDINGS: Increases (decreases) in the per capita consumption of 1 litre of pure alcohol were associated with increases (decreases) of 1.3% in all-cause mortality rates. The beverage-specific analyses indicated a significant relationship between consumption of beer and all-cause mortality only. CONCLUSION: The data show that per capita alcohol consumption, according to reported levels in Europe, is related to all-cause mortality and is thus of relevance to public health.

Alcohol Drinking↗
PubMed1998

The interplay of drinking patterns and other determinants of health.

The health effects of alcohol are determined not only by level of intake but also by patterns of alcohol use and many other health determinants. This study seeks to identify groups of individuals who share various features in terms of drinking styles and other health indicators. Data used are a subset of the 1990 Ontario Health Survey, corresponding to men and women aged 20-64 with complete data in four substantive areas: alcohol use; demographic characteristics; current health status; and various behavioural risk factors for chronic disease. Cluster analysis was used to groups of male and female respondents who were similar in terms of their style of alcohol use, along with other constructs relevant to health risk and health status. For both sexes, clusters were identified which matched expectation in terms of drinking patterns and other relevant variables. For both sexes, clusters were found with generally higher social class indicators, generally positive health behaviours and health status and drinking patterns which did not include drinking to excess. Clusters were also found for which high-volume drinking occasions corresponded with poor health status and high levels of risk factors for chronic disease. Other unanticipated patterns were also identified. This information may assist in identifying confounding effects in epidemiological studies as well as identifying the characteristics of unique sub-populations which are likely to be the focus of primary prevention efforts.

Journal Article↗
PubMed1998

Alcohol and suicide in Switzerland--an aggregate-level analysis.

At the aggregate-data level, time-series analysis of annual data for the period 1950-90 gives little support for a relation between alcohol consumption and suicide in Switzerland. Input series in the analysis were per capita consumption and rates of unemployment and divorce. Output series were gender-specific and age-adjusted suicide rates. Different time-series techniques were used to assure stationarity and to avoid spurious correlation because of common trends. The Box-Jenkins approach on differenced data was compared with simultaneous equation modelling, where time trends were modeled by means of dummy variables. The effects were weak and unstable for different methods. The advantage of simultaneous equation models is discussed. Furthermore, a single "harmonic" long-term wave explained more of the variance in the suicide rates than any input variable examined. Its implication for a "natural suicide rate" is considered.

Journal Article↗
PubMed1998

Production of 1-kestose in transgenic yeast expressing a fructosyltransferase from Aspergillus foetidus.

Sucrose-inducible secretory sucrose:sucrose 1-fructosyltransferase (1-SST) from Aspergillus foetidus has been purified and subjected to N-terminal amino acid sequence determination. The enzyme is extensively glycosylated, and the active form is probably represented by a dimer of identical subunits with an apparent molecular mass of 180 kDa as judged from mobility in seminative acrylamide gels. The enzyme catalyzes fructosyl transfer from sucrose to sucrose producing glucose and 1-kestose. Oligosaccharides with a higher degree of polymerization are not obtained with sucrose as the substrate. The cDNA encoding the A. foetidus 1-SST has been cloned and sequenced. Sequence homology was found to be highest to levanases, but no hydrolytic activity was observed when levan was incubated with the enzyme. Expression of the cloned gene in an invertase-deficient mutant of Saccharomyces cerevisiae resulted in 1-kestose production, with 6-kestose and neokestose being side products of the reaction. Products were well distinguishable from those formed by yeast transformants expressing a cytosolic invertase.

Amino Acid Sequence↗
PubMed1998

Intoxication, the law and criminal responsibility--a sparkling cocktail at times: the case studies of Canada and Germany.

The combination of intoxication and criminal responsibility has been a problem field for legal theory and practice for quite some time. While it has been argued in certain contexts that intoxication reduces or denies criminal responsibility, elsewhere it has been reasoned that intoxicated offenders should be held as (or even more so) legally responsible as sober ones. But even in legal systems where the criminal responsibility of intoxicated offenders is emphasized, legal theory and practice are confronted with the challenge of converting such values into workable jurisprudence, since many intoxicated offenders naturally lack one of the key premises for responsibility for a criminal act, namely mens rea. This article compares the very different legal philosophies and practices that have evolved around the issue of intoxication and criminal responsibility in Canada and Germany. While the Canadian system has long and in a variety of ways tried to reconcile the inherent tensions between the principles of legal culpability and the intent to punish intoxicated offenders in material law, the German system has produced a set of legal tools that allow for a pragmatic and ends-oriented approach. This article concludes that the evolution and profile of these legal schemes is likely linked to the cultural status of alcohol and drinking in the respective system context.

Canada↗
PubMed1998

Systematic gain-of-function genetics in Drosophila.

A modular misexpression system was used to carry out systematic gain-of-function genetic screens in Drosophila. The system is based on inducible expression of genes tagged by insertion of a P-element vector carrying a GAL4-regulated promoter oriented to transcribe flanking genomic sequences. To identify genes involved in eye and wing development, the 2300 independent lines were screened for dominant phenotypes. Among many novel genes, the screen identified known genes, including hedgehog and decapentaplegic, implicated in these processes. A genetic interaction screen for suppressors of a cell migration defect in a hypomorphic slow border cells mutant identified known genes with likely roles in tyrosine kinase signaling and control of actin cytoskeleton, among many novel genes. These studies demonstrate the ability of the modular misexpression system to identify developmentally important genes and suggest that it will be generally useful for genetic interaction screens.

Animals↗
PubMed1997

Charting WHO--goals for licit and illicit drugs for the year 2000: are we 'on track'?

Both on a global and a regional basis, the World Health Organization (WHO) has set prominent goals for the turn of the millennium on the reduction of harms associated with licit and illicit drugs. Gauging what the world and its different regions are doing with respect to these specific public health goals is hindered by a conceptual problem: there is no clear concept and consistent way of defining or measuring 'harm' related to drugs, licit or illicit. In many instances, 'harm' is equated with substance use prevalence. Often, especially outside the developed world, basic harm data is not even available. Globally, a conceptually clear and consistently applied scheme of harm measurement related to licit and illicit drugs is needed, acknowledging the fact that drug-related harms occur at different individual and social levels as well as over different periods of time. Harms must also be recognized as an outcome of interactions between the substance user, the drug itself, and the physical and social environment. Looking at available macro-indicators of harm, it must be concluded with, we do not seem to be 'on track' globally in reducing harms related to drugs in accordance with the WHO goals. For alcohol and tobacco, trends for increased harm are just starting to show in the developing world, and will worsen over the next couple of decades. For illicit drugs, failing drug control policies have result in dramatically negative developments for public health, especially with respect to HIV infections and drug-related deaths, in the developed as well as developing world.

Alcohol Drinking↗
PubMed1997

Moderate drinking and health. Implications of recent evidence.

OBJECTIVE: To address three questions (Is moderate drinking good for health? Should people drink to prevent heart disease? What is moderate drinking?) and to examine and compare two recent Canadian guidelines on low-risk drinking in the context of counseling patients. DATA SOURCES: English-language data sources were searched, particularly peer-reviewed health and social science literature and recent expert reports. STUDY SELECTION: Studies and reports were selected for their scientific merit and direct relevance to the three questions addressed and to the formulation of guidelines on low-risk drinking. SYNTHESIS: While moderate drinking might protect some older people against coronary heart disease, it is associated with increased risk of hemorrhagic stroke, certain cancers, accidents and injuries, and a range of social problems. For most health outcomes, risk increases as consumption of alcohol increases. CONCLUSIONS: While the data have limitations, they provide a basis for formulating guidelines on low-risk drinking. The two Canadian guidelines, one developed from the perspective of health recovery, the other from the perspective of health promotion, complement each other in the context of counseling patients.

Accidents↗
PubMed1997

Alcohol and health: individual and population perspectives.

This paper summarizes the relationships between alcohol consumption and health from both the individual and the population perspectives. On the individual level adverse consequences of alcohol consumption on mortality, morbidity and social harm are summarized. The potential health benefits of drinking are listed next, especially in the context of trying to balance positive and negative consequences. Even though the final decision rests with the individual it is suggested that from a health perspective light drinking on a regular basis is most advisable. In terms of advice to populations it should be noted that, due to the mutual interdependence of drinking behaviour in a society, the average individual consumption associated with the lowest individual risk is not necessarily the average per capita consumption associated with the lowest population risk. Thus, research at the population level has to be integrated with individual epidemiological research in order to come up with the best advice for the population in any given society.

Alcohol Drinking↗
PubMed1996

[Estimating the age of start of drug abuse in cross-sectional surveys exemplified by the Swiss Health Survey].

This paper is based on data from the first Swiss Health Survey, but deals with a more general problem; the estimation of age of onset in illegal substance consumption. First, it is shown that taking the arithmetic mean for different age-groups as estimator leads to an underestimation of age of onset in the younger groups. Consequently, an alternative method is proposed based on survival models with right censoring. The prediction of age of onset is modeled with nonlinear functions. Results show for cannabis consumption in Switzerland that age of onset did not decrease notably during the past decade.

Adolescent↗
PubMed1996

[Construction and validation of an indicator for alcohol problems in the Swiss Health Survey].

A proposed scale for alcohol problems which consisted of five items, was psychometrically examined and validated. Latent class analysis was used in addition to classic psychometric measures. The use of this scale in health surveys of the general population seems to be justified, as it offers a reliable and very economic method to measure alcohol induced problems. It is therefore proposed that this scale should continue to be used in future rounds of the Swiss Health Survey. The context of the questioning has to be taken into account when interpreting the summary score, as items showed different patterns of response in personal vs interview questionnaires.

Alcoholism↗