Search PubMed⌕ Search

Biomedical subjects

John B Saunders

Publications and source records attributed to John B Saunders.

29 records · Page 2Linked to original sources
PubMed2003

Aldehyde dehydrogenase 2 genotypes, alcohol flushing symptoms and drinking patterns in Thai men.

The drinking behavior, alcohol-induced facial flushing and ALDH2 genotypes were determined in 283 Thai men comprising 85 who were alcohol-dependent, 62 hazardous/harmful drinkers and 136 non-drinkers or infrequent drinkers. A structured interview questionnaire, containing the 'tri-level' method and the Alcohol-Use Disorders and Associated Disabilities Schedule, was used to determine the quantity of drinking and the number of alcohol-related adverse experiences. The study revealed the mutant ALDH2*2 allele in 44 (15.5%) subjects. The risks of being alcohol-dependent and of having hazardous/harmful drinking were lower in individuals with heterozygous ALDH2*1/*2, compared with homozygous ALDH2*1/*1 [relative probability ratios (95% CI) 0.14 (0.05-0.41) and 0.23 (0.08-0.61), respectively]. Eighty percent of those who were heterozygous and 28% of those who were homozygous ALDH2*1 reported flush symptoms after drinking alcohol. Twenty-nine percent of homozygous ALDH2*1 individuals, but only 9% of heterozygous subjects, drank almost everyday (24-30 days/month). Similarly, higher percentages of people drinking beyond the safety limit (>60 g/day) and having alcohol-related problems were observed in homozygous ALDH2*1 compared with heterozygous individuals: 32% vs. 5% and 27% vs. 12%, respectively. Overall, the study supports the role of the mutant ALDH2*2 allele in preventing high alcohol consumption and the development of alcohol dependence in a Thai population.

Adult↗
PubMed2002

Effects of paternal drinking, conduct disorder and childhood home environment on the development of alcohol use disorders in a Thai population.

AIMS: To identify influences on the development of alcohol use disorders in a Thai population, particularly parental drinking and childhood environment. DESIGN: Case-control study. SETTING: A university hospital, a regional hospital and a community hospital in southern Thailand. PARTICIPANTS: Ninety-one alcohol-dependents and 77 hazardous/harmful drinkers were recruited as cases and 144 non- or infrequent drinkers as controls. MEASUREMENTS: Data on parental drinking, family demographic characteristics, family activities, parental disciplinary practice, early religious life and conduct disorder were obtained using a structured interview questionnaire. The main outcome measure was the subject's classification as alcohol-dependent, hazardous/harmful drinker or non-/infrequent drinker. FINDINGS: A significant relationship was found between having a drinking father and the occurrence of hazardous/harmful drinking or alcohol dependence in the subjects. Childhood factors (conduct disorder and having been a temple boy, relative probability ratios, RPRs and 95% CI: 6.39, 2.81-14.55 and 2.21, 1.19-4.08, respectively) also significantly predicted alcohol dependence, while perceived poverty and ethnic alienation was reported less frequently by hazardous/harmful drinkers and alcohol-dependents (RPRs and 95% CIs=0.34, 0.19-0.62 and 0.59, 0.38-0.93, respectively) than the controls. The relative probability ratio for the effect of the father's infrequent drinking on the son's alcohol dependence was 2.92 (95% CI=1.42-6.02) and for the father's heavy or dependent drinking 2.84 (95% CI=1.31-6.15). CONCLUSIONS: Being exposed to a light-drinking father increases the risk of a son's alcohol use disorders exhibited either as hazardous-harmful or dependent drinking. However, exposure to a heavy- or dependent-drinking father is associated more uniquely with an increased risk of his son being alcohol-dependent. The extent to which this is seen in other cultures is worthy of exploration.

Adolescent↗
PubMed2002

The long-term effectiveness of brief interventions for unsafe alcohol consumption: a 10-year follow-up.

AIMS: To examine the long-term impact of brief and early interventions for hazardous and harmful alcohol consumption. DESIGN: A 9-month and 10-year follow-up of subjects recruited into a randomized controlled trial of a range of alcohol-related brief interventions. SETTING: General practices, the outpatient or acute care services of a major city hospital, and a privately run health screening programmeme. PARTICIPANTS: The cohort of 554 (non-dependent) hazardous and harmful drinkers recruited into the Australian arm of the Phase II World Health Organization collaborative project on identification and treatment of persons with harmful alcohol consumption. INTERVENTION: The effectiveness of three forms of intervention, ranging from 5 to 60 minutes in duration, were compared with a no-treatment control condition. MEASUREMENTS: Included drinking behaviour and biological markers of alcohol use. In addition, at 10 years subjects were asked about symptoms of diagnosable alcohol use disorders and their experience of alcohol-related psychological, social and physical harm. Mortality was also assessed. FINDINGS: Results provide further evidence for the short-term effectiveness of alcohol-related brief interventions. In comparison to controls, subjects offered intervention: (1) report significantly lower consumption; and (2) less unsafe drinking at 9-month follow-up. The intensity of intervention was not related to the amount of change in drinking behaviour. Analysis at 10 years failed to find any differences in outcomes between intervention and control groups in median consumption, mean reduction in consumption from baseline to follow-up, mortality and ICD-10 diagnoses of alcohol dependence or harmful alcohol use. CONCLUSIONS: This study failed to find evidence that brief advice and counselling without regular follow-up and reinforcement can sustain significant long-term reductions in drinking behaviour at 10-year follow-up.

Adult↗
PubMed2002

Substance misuse in patients with schizophrenia: epidemiology and management.

Substance misuse in individuals with schizophrenia is very common, especially in young men, in communities where use is frequent and in people receiving inpatient treatment. Problematic use occurs at very low intake levels, so that most affected people are not physically dependent (with the exception of nicotine). People with schizophrenia and substance misuse have poorer symptomatic and functional outcomes than those with schizophrenia alone. Unless there is routine screening, substance misuse is often missed in assessments. Service systems tend to be separated, with poor inter-communication, and affected patients are often excluded from services because of their comorbidity. However, effective management of these disorders requires a fully integrated approach because of the close inter-relationship of the disorders. Use of atypical antipsychotics may be especially important in this population because of growing evidence (especially on clozapine and risperidone) that nicotine smoking, alcohol misuse and possibly some other substance misuse is reduced. Several pharmacotherapies for substance misuse can be used safely in people with schizophrenia, but the evidence base is small and guidelines for their use are necessarily derived from experience in the general population.

Alcohol Deterrents↗
PubMed2002

CDT, GGT, and AST as markers of alcohol use: the WHO/ISBRA collaborative project.

BACKGROUND: Estimates of the performance of carbohydrate deficient transferrin (CDT) and gamma glutamyltransferase (GGT) as markers of alcohol consumption have varied widely. Studies have differed in design and subject characteristics. The WHO/ISBRA Collaborative Study allows assessment and comparison of CDT, GGT, and aspartate aminotransferase (AST) as markers of drinking in a large, well-characterized, multicenter sample. METHODS: A total of 1863 subjects were recruited from five countries (Australia, Brazil, Canada, Finland, and Japan). Recruitment was stratified by alcohol use, age, and sex. Demographic characteristics, alcohol consumption, and presence of ICD-10 dependence were recorded using an interview schedule based on the AUDADIS. CDT was assayed using CDTect and GGT and AST by standard methods. Statistical techniques included receiver operating characteristic (ROC) analysis. Multiple regression was used to measure the impact of factors other than alcohol on test performance. RESULTS: CDT and GGT had comparable performance on ROC analysis, with AST performing slightly less well. CDT was a slightly but significantly better marker of high-risk consumption in men. All were more effective for detection of high-risk rather than intermediate-risk drinking. CDT and GGT levels were influenced by body mass index, sex, age, and smoking status. CONCLUSIONS: CDT was little better than GGT in detecting high- or intermediate-risk alcohol consumption in this large, multicenter, predominantly community-based sample. As the two tests are relatively independent of each other, their combination is likely to provide better performance than either test alone. Test interpretation should take account sex, age, and body mass index.

Adolescent↗
PubMed2002

Alcohol misuse and dependence. Assessment and management.

BACKGROUND: General practitioners play a vital role in the prevention of alcohol related morbidity and mortality. The earlier an alcohol problem is diagnosed, the better the treatment outcome. OBJECTIVE: This article aims to provide GPs with practical guidelines on the assessment and management of patients with hazardous alcohol use and dependence. DISCUSSION: There is good evidence that early and brief intervention by a GP is most effective in reducing alcohol consumption in patients with hazardous or harmful drinking. In patients with alcohol dependence, pharmacotherapies such as naltrexone and acamprosate, in conjunction with a comprehensive rehabilitation program, are beneficial in a proportion of patients.

Alcohol Deterrents↗
PubMedDate not supplied

Religious beliefs and practice, and alcohol use in Thai men.

Buddhism, the Thai state religion, teaches that use of intoxicants should be avoided. Nonetheless, many Thai people drink alcohol, and a proportion are alcohol-dependent or hazardous or harmful drinkers. This study examines the relationship between Buddhist upbringing and beliefs and alcohol use disorders in Thai men. Three groups, comprising 144 non/infrequent/light drinkers, 77 hazardous/ harmful drinkers and 91 alcohol dependents were interviewed regarding their early religious life and current religious practices and beliefs. No protective association was shown between early religious life and later alcohol use disorders; indeed, having lived as a boy in a temple for a period was commoner in those with adult alcohol problems. Few subjects reported frequent involvement in current religious activities (9, 8 and 6% in the non/infrequent/light drinkers, hazardous/harmful drinkers, and alcohol dependents respectively). Hazardous/harmful drinkers [odds ratio (OR) = 0.4, 95% confidence interval (CI) = 0.2-0.9] and alcohol dependents (OR = 0.5, 95% CI = 0.2-0.9) were less likely to report being moderately to strongly religious, than were non/infrequent/light drinkers. Understanding the association between religious beliefs and drinking behaviour can potentially assist in the development of prevention and treatment programmes.

Adult↗
PubMedDate not supplied

High prevalence, persistent hazardous drinking among New Zealand tertiary students.

AIMS: To determine the prevalence of hazardous drinking and alcohol-related negative consequences in New Zealand tertiary students, and to identify predictors of hazardous drinking across a 6-month period. METHODS: A total of 1480 tertiary students living in halls of residence was surveyed at the start of the academic year, and a subsample of 967 students was followed up 6 months later. Questionnaire items included quantity and frequency of drinking, alcohol-related problems, use of other substances, and the Alcohol Use Disorders Identification Test (AUDIT). Drinking at follow-up was modelled using demographic characteristics, mental well-being, other substance use, alcohol-related problems, and hall drinking norms, measured at baseline. RESULTS: Among drinkers, mean (+/- SD) weekly consumption was 243 +/- 241 and 135 +/- 157 g of ethanol for males and females respectively. The majority of male (60.0%) and female (58.2%) drinkers typically consumed more than national safe drinking guidelines. Mean (+/- SD) AUDIT scores were 10.9 +/- 7.6 for males and 7.6 +/- 5.9 for females. After controlling for AUDIT scores at baseline, increased AUDIT scores at follow-up were higher with lower age, Maori ethnicity, smoking, cannabis use, high levels of alcohol-related negative consequences, and higher levels of drinking in the student's hall of residence. CONCLUSIONS: Hazardous drinking is widespread and persistent among students living in the halls of residence. There is a need for university alcohol policies and intervention approaches among New Zealand tertiary students.

Adolescent↗
PubMedDate not supplied

Interpretation of items in the AUDIT questionnaire.

AIMS: To test for the possibility that tertiary students misinterpret certain items on the Alcohol Use Disorders Identification Test (AUDIT). METHODS: Responses to alternative question wordings were compared with responses to standard items. RESULTS: Alterations to items 5 and 9, so that consequences of drinking epitomized in these items were more specifically defined, resulted in markedly different response distributions to the item, but the total AUDIT score was not changed. CONCLUSIONS: Caution is necessary before using individual AUDIT items as measures of consequences in population surveys, and the possibility of false positives in total scores should be borne in mind.

Adolescent↗
PubMedDate not supplied

Acceptability of various brief intervention approaches for hazardous drinking among university students.

AIMS: To determine the acceptability to university students of practitioner-delivered screening and brief intervention (SBI) versus a novel approach-web-based SBI (e-SBI). METHODS: A random sample of 1910 university students was invited to indicate their preferences for various brief intervention approaches in an internet survey. RESULTS: e-SBI was the most popular intervention. It was favoured by 81% of all students and 82% of hazardous drinkers. CONCLUSIONS: e-SBI is a promising approach for the reduction of hazardous drinking among young people.

Adult↗