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Academic Emergency Medicine : Official... Sep 2017The objective was to describe the population utilizing a sobering center for public alcohol intoxication and compare between single-visit users, repeat users, and high...
OBJECTIVE
The objective was to describe the population utilizing a sobering center for public alcohol intoxication and compare between single-visit users, repeat users, and high users.
METHODS
We conducted a secondary analysis of 1,271 adults cared for in a sobering center from July 2014 to June 2015. We divided the population into three groups-single use (one visit), repeat users (two to five visits), and high (six or more) users-and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs.
RESULTS
The population was primarily male, middle-aged, and ethnically diverse. Compared to single-visit users (n = 869), repeat (n = 287) and high users (n = 115) were older, were more likely to be currently homeless, and had spent more time homeless. Repeat and high users had significantly higher rates of hypertension, liver disease, diabetes, depression, psychoses, and drug abuse diagnoses compared to single-visit users. In addition to sobering visits, utilization of ambulance and ED and related costs were significantly greater for the high users compared to repeat and single-visit users.
CONCLUSIONS
From an overall heterogeneous population, more frequent utilizers of the sobering center, both high and repeat users compared to low users, had significantly greater prevalence of chronic disorders, service utilization, and homelessness. Findings indicate that a sobering center can have a prominent role in the care for those with acute alcohol intoxication, particularly those individuals with chronic public intoxication who are likewise homeless. Further longitudinal research could offer important insights as to the population served over time, investigating changes in utilization and efforts toward health and housing stabilization.
Topics: Adult; Age Distribution; Alcoholic Intoxication; Ambulances; Community Health Centers; Comorbidity; Cross-Sectional Studies; Emergency Service, Hospital; Female; Ill-Housed Persons; Humans; Male; Middle Aged; Retrospective Studies; Substance-Related Disorders; Urban Population
PubMed: 28493551
DOI: 10.1111/acem.13219 -
Bulletin of the New York Academy of... 1996The family plays a central role in the use of alcohol by children and adolescents, yet preventive interventions rarely focus on the family. Early drinking and much... (Review)
Review
The family plays a central role in the use of alcohol by children and adolescents, yet preventive interventions rarely focus on the family. Early drinking and much subsequent use of alcohol by children and adolescents is sanctioned and sometimes encouraged by their families. Unlike experimentation with alcohol, problem drinking is associated with low levels of family social support and with dysfunctional coping strategies of families that may lead children to use drinking as an adaptive behavior. While risk-factor research has advanced understanding of alcohol use by children and youth, the poor predictive power of individual risks has limited its contribution to successful interventions. On the other hand, protective factors, provided by relationships within and outside the family, can be preventive and health promoting. Parents influence their children's drinking through family interactions, modeling and reinforcing standards, and attitudes that children learn and use to guide their behavior in new situations. Thus, parental influences endure. This article argues that interventions to prevent alcohol abuse should be designed to help parents to carry out their parental functions. This can be accomplished by providing social support, resources, and education for parents, as well as developing extra-familial sources of social support and socialization for children and adolescents.
Topics: Adaptation, Psychological; Adolescent; Adolescent Behavior; Alcohol Drinking; Alcoholic Intoxication; Attitude to Health; Child; Child Behavior; Ethanol; Family; Family Health; Health Promotion; Humans; Parent-Child Relations; Parents; Risk-Taking; Social Environment; Social Support; Social Values; Socialization
PubMed: 8982525
DOI: No ID Found -
Drug and Alcohol Review Jun 2012In order to better understand the social context of barroom aggression, the aim was to identify common locations ('hotspots') for aggression in bars and examine the...
INTRODUCTION AND AIMS
In order to better understand the social context of barroom aggression, the aim was to identify common locations ('hotspots') for aggression in bars and examine the association of hotspots with aggression severity and environmental characteristics.
DESIGN AND METHODS
Aggression hotspots were identified using narrative descriptions and data recorded on premises' floor plans for 1057 incidents of aggression collected in the Safer Bars evaluation. Hierarchical Linear Modelling was used to identify bar-level and night-level characteristics associated with each hotspot.
RESULTS
The most common location for aggression was the dance floor (20.0% of incidents) or near the dance floor (11.5%), followed by near the serving bar (15.7%), at tables (13.1%), aisles, hallways and other areas of movement (6.2%), entrance (4.5%) and the pool playing area (4.1%). Hotspots were predicted mainly by bar-level characteristics, with dance floor aggression associated with crowded bars, a high proportion of female and young patrons, lots of sexual activity, a large number of patrons and staff, security staff present, better monitoring and coordination by staff, and people hanging around at closing. Incidents at tables and pool tables tended to occur in bars with the opposite characteristics. Nightly variations in patron intoxication and rowdiness were associated with aggression at tables while variations in crowding and sexual activity were associated with aggression in areas of movement. Incidents outside tended to be more severe.
DISCUSSION AND CONCLUSIONS
Each aggression location and their associated environments have somewhat different implications for staff training, premises design, policy and prevention.
Topics: Adolescent; Age Factors; Aggression; Alcohol Drinking; Alcoholic Intoxication; Female; Humans; Licensure; Male; Sex Factors; Social Behavior; Social Environment; Violence
PubMed: 22050319
DOI: 10.1111/j.1465-3362.2011.00377.x -
BMC Neurology Jan 2019The signs and symptoms of acute alcohol intoxication resemble those of vertebrobasilar stroke. Due to their shared symptoms including double vision, nystagmus,...
BACKGROUND
The signs and symptoms of acute alcohol intoxication resemble those of vertebrobasilar stroke. Due to their shared symptoms including double vision, nystagmus, dysarthria, and ataxia, the differential diagnosis of alcohol intoxication and vertebrobasilar stroke may pose a challenge. Moreover, if alcohol intoxication and stroke occur simultaneously, the signs and symptoms of stroke may be attributed to the effects of alcohol, leading to delayed stroke diagnosis and failure to perform reperfusion therapy.
CASE PRESENTATIONS
Three cases of alcohol intoxication and stroke are presented. The first patient (female, 50 years old) had dysarthria, nystagmus and trunk ataxia on admission. Her blood alcohol level was 2.3‰. The symptoms improved after forced diuresis, but 5.5 h later progression was observed, and the patient developed diplopia and dysphagia in addition to her initial symptoms. Angiography showed occlusion of the basilar artery. Intraarterial thrombolysis was performed. The second patient (male, 62 years old) developed diplopia, dysarthria and trunk ataxia after consuming 4-units of alcohol, and his symptoms were attributed to alcohol intoxication. Two hours later, neurological examination revealed dysphagia and mild right-sided hemiparesis, which questioned the causal relationship between the symptoms and alcohol consumption. Cerebral CT was negative, and intravenous thrombolysis was administered. The third patient (male, 55 years old) consumed 10 units of alcohol before falling asleep. Three hours later, his relatives tried to wake him up. He was unresponsive, which was attributed to alcohol intoxication. When he woke up 8 h later, right-sided hemiparesis and aphasia were observed, and cerebral CT already revealed irreversible ischemic changes.
CONCLUSIONS
Our cases show that alcohol consumption may interfere with stroke diagnosis by mimicking the signs and symptoms of vertebrobasilar stroke. Moreover, attributing the symptoms of stroke to alcohol intoxication may delay stroke diagnosis resulting in failure of reperfusion therapy. Based on our observations we conclude that stroke should be considered in the case of worsening symptoms, dysphagia, hemiparesis and disproportionately severe signs that cannot be attributed to the amount of alcohol consumed. In the case of ambiguity, ambulance should be called, and if stroke cannot be excluded, specific therapy should be administered.
Topics: Alcoholic Intoxication; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Stroke; Thrombolytic Therapy; Time-to-Treatment
PubMed: 30696413
DOI: 10.1186/s12883-019-1241-6 -
Experimental and Clinical... Jun 2014Existing literature supports the five-factor model (FFM) of personality (i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Intellect or...
Existing literature supports the five-factor model (FFM) of personality (i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Intellect or Openness) as a comprehensive representation of stable aspects of mood, affect, and behavior. This study evaluated the FFM as a framework for both self-perceptions of drunkenness (i.e., individual changes in mood, affect, and behavior associated with one's own intoxication), as well "drinking buddies'" perceptions of their friends' drunkenness (i.e., changes in mood, affect, and behavior associated with friends' intoxication) and the association of reported sober-to-drunk differences with negative alcohol-related consequences. College-student drinkers (N = 374; 187 drinking buddy pairs) reported on their sober and drunk levels of the 5 factors, as well as those of their drinking buddies. Buddies completed parallel assessments for themselves and their friends to ensure rater agreement. All participants completed assessments of harmful alcohol outcomes experienced within the past year. Regardless of reporter, differences between drunken and sober states were found across all 5 factors and agreement between self and informant reports was consistently significant and comparable across sober and drunk conditions. Low levels of drunk Conscientiousness and drunk Emotional Stability were associated with experiencing more alcohol-related consequences, even when controlling for sober factor levels and binge-drinking frequency. Findings support the use of the FFM as a clinically relevant framework for organizing differences in personality expression associated with intoxication and the validity of self-reports of drunk personality.
Topics: Adolescent; Alcohol Drinking; Alcoholic Intoxication; Binge Drinking; Female; Friends; Humans; Male; Personality; Self Concept; Self Report; Students; Young Adult
PubMed: 24796850
DOI: 10.1037/a0036607 -
Alcoholism, Clinical and Experimental... Oct 2011The meta-analysis by Quinn and Fromme (2011) is reviewed and integrated into the larger field. Guidelines for future research are presented.
BACKGROUND
The meta-analysis by Quinn and Fromme (2011) is reviewed and integrated into the larger field. Guidelines for future research are presented.
RESULTS
With results of the meta-analysis along with those of a recent comprehensive prospective study by our group (King et al., 2011), there is a call to the field to specify terms and integrate theoretical frameworks to advance our knowledge and improve comparisons across trials.
CONCLUSIONS
The meta-analysis is both timely and thorough and will provide clinical researchers with important information to move the field forward.
Topics: Alcohol Drinking; Alcoholic Intoxication; Alcoholism; Female; Humans; Male
PubMed: 21919923
DOI: 10.1111/j.1530-0277.2011.01629.x -
Nature Nanotechnology Mar 2013Organisms have sophisticated subcellular compartments containing enzymes that function in tandem. These confined compartments ensure effective chemical transformation...
Organisms have sophisticated subcellular compartments containing enzymes that function in tandem. These confined compartments ensure effective chemical transformation and transport of molecules, and the elimination of toxic metabolic wastes. Creating functional enzyme complexes that are confined in a similar way remains challenging. Here we show that two or more enzymes with complementary functions can be assembled and encapsulated within a thin polymer shell to form enzyme nanocomplexes. These nanocomplexes exhibit improved catalytic efficiency and enhanced stability when compared with free enzymes. Furthermore, the co-localized enzymes display complementary functions, whereby toxic intermediates generated by one enzyme can be promptly eliminated by another enzyme. We show that nanocomplexes containing alcohol oxidase and catalase could reduce blood alcohol levels in intoxicated mice, offering an alternative antidote and prophylactic for alcohol intoxication.
Topics: Alcohol Oxidoreductases; Alcoholic Intoxication; Alcohols; Animals; Antidotes; Biomimetics; Catalase; Macromolecular Substances; Mice
PubMed: 23416793
DOI: 10.1038/nnano.2012.264 -
Forensic Science International Jun 1994A retrospective study of spleen findings in 42 victims of drowning and a comparison group of 42 cases of asphyxiation due to other causes (hanging, ligature... (Comparative Study)
Comparative Study
A retrospective study of spleen findings in 42 victims of drowning and a comparison group of 42 cases of asphyxiation due to other causes (hanging, ligature strangulation and manual strangulation), that were matched for sex, age, body weight and build, was performed. Significantly smaller spleen weights (P < 0.05), spleen weight:body weight ratios (P < 0.01) and spleen weight:liver weight ratios (P < 0.01) were found in the victims of drowning. The difference in weight was approximately 18%. A significant negative correlation between spleen weight and blood alcohol concentration was found in the study group (r = -0.44; P < 0.01), but not in the control group. The possibility that the findings are due to a stress reaction caused by hypoxia in the presence of cooling and an influence of alcohol on reflex mechanisms is discussed.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alcoholic Intoxication; Asphyxia; Drowning; Ethanol; Female; Humans; Liver; Male; Middle Aged; Organ Size; Retrospective Studies; Spleen
PubMed: 8063278
DOI: 10.1016/0379-0738(94)90333-6 -
Annals of Epidemiology Aug 2014Few studies have compared acute use of alcohol in suicide decedents with that in a nonsuicide group. This study provides the first national analysis of acute use of...
PURPOSE
Few studies have compared acute use of alcohol in suicide decedents with that in a nonsuicide group. This study provides the first national analysis of acute use of alcohol before suicide compared with an estimate of acute use of alcohol in a living sample.
METHODS
Pooled 2003-2011 National Violent Death Reporting System data were used to estimate the prevalence of postmortem blood alcohol content positivity (blood alcohol content >0.0 g/dL) and intoxication (blood alcohol content ≥0.08 g/dL). Population estimates of comparable use of alcohol (within the past 48 hours) were based on the National Epidemiologic Survey on Alcohol and Related Conditions.
RESULTS
Compared with the living sample, male and female suicide decedents showed, respectively, a 1.83-fold (95% confidence interval [CI], 1.73-1.93) and 2.40-fold (95% CI, 2.24-2.57) increased risk of alcohol ingestion before their death after age, race/ethnicity, and chronic alcohol problems were controlled. Furthermore, male and female decedents exhibited, respectively, a 6.18-fold (95% CI, 5.57-6.86) and a 10.04-fold (95% CI, 8.67-11.64) increased risk of being intoxicated before their death after confounders were considered.
CONCLUSIONS
The findings underscore the crucial need to include among the essential components of suicide prevention policies programs that minimize the use of alcohol, particularly drinking to intoxication.
Topics: Adolescent; Adult; Age Distribution; Aged; Alcoholic Intoxication; Autopsy; Blood Chemical Analysis; Cause of Death; Databases, Factual; Ethanol; Female; Humans; Male; Middle Aged; Prevalence; Sex Distribution; Suicide; United States; Young Adult
PubMed: 24953567
DOI: 10.1016/j.annepidem.2014.05.008 -
Journal of Health Economics May 2014This study investigates whether drinker-drivers attributes are associated with imperfect rationality or irrationality. Using data from eight U.S. cities, we determine...
This study investigates whether drinker-drivers attributes are associated with imperfect rationality or irrationality. Using data from eight U.S. cities, we determine whether drinker-drivers differ from other drinkers in cognitive ability, ignorance of driving while intoxicated (DWI) laws, have higher rates of time preference, are time inconsistent, and lack self-control on other measures. We find that drinker-drivers are relatively knowledgeable about DWI laws and do not differ on two of three study measures of cognitive ability from other drinkers. Drinker-drivers are less prone to plan events involving drinking, e.g., selecting a designated driver in advance of drinking, and are more impulsive. Furthermore, we find evidence in support of hyperbolic discounting. In particular, relative to non-drinker-drivers, the difference between short- and long-term discount rates is much higher for drinker-drivers than for other drinkers. Implications of our findings for public policy, including incapacitation, treatment, and educational interventions, are discussed.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alcoholic Intoxication; Automobile Driving; Cognition; Criminal Law; Data Collection; Decision Making; Economics, Behavioral; Female; Humans; Impulsive Behavior; Judgment; Male; Middle Aged; Socioeconomic Factors; United States; Young Adult
PubMed: 24603444
DOI: 10.1016/j.jhealeco.2014.01.005