The collectivity of British alcohol consumption trends across different temporal processes : a quantile age‐period‐cohort analysis

Background and aims UK alcohol consumption per capita has fallen by 18% since 2004 while the alcohol‐specific death rate has risen by 6%. Inconsistent consumption trends across the population may explain this. Drawing on the theory of the collectivity of drinking cultures and age‐period‐cohort analyses, we tested whether consumption trends are consistent across lighter and heavier drinkers for three temporal processes: (i) the life course, (ii) calendar time, (iii) successive birth cohorts. Design Sex‐specific quantile age‐period‐cohort regressions using repeat cross‐sectional survey data. Setting Great Britain, 1984‐2011. Participants Adult (18+) drinkers responding to 17 waves of the General Lifestyle Survey (total N=175,986). Measurements Dependent variable: The 10th, 25th, 50th, 75th, 90th, 95th and 99th quantiles of the logged weekly alcohol consumption distribution (excluding abstainers). Independent variables: seven age groups (18‐24, 25‐34 … 65‐74, 75+), five time periods (1984‐1988 … 2002‐2006, 2008‐2011) and 16 five‐year birth cohorts (1915‐1919 … 1990‐1994). Additional control variables: ethnicity and UK country. Findings Within age, period and cohort trends, changes in consumption were not consistently in the same direction at different quantiles of the consumption distribution. When they were, the scale of change sometimes differed between quantiles. For example, consumption among women decreased by 18% (CI95: ‐32% ‐ ‐2%) but increased by 11% (CI95: 2% ‐ 21%) at the median and by 28% (CI95: 19%‐38%) at the 99th quantile, implying consumption fell among lighter drinkers and rose among heavier drinkers. This type of polarised trend also occurred between 1984‐1988 and 1996‐2000 for men and women. Age trends showed collectivity but cohort trends showed a mixture of collectivity and polarisation. Conclusions Countervailing alcohol consumption and alcohol‐related harm trends in the UK may be explained by lighter and heavier drinkers having different period and cohort trends as well as by the presence of cohort trends that mean consumption may rise in some age groups while falling in others

Developing a social practice-based typology of British drinking culture in 2009-2011: Implications for alcohol policy analysis

Background and aims: The concept of national drinking culture is well-established in research and policy debate but rarely features in contemporary alcohol policy analysis. We aim to apply the alternative concept of social practices to quantitatively operationalise drinking culture. We discuss how a practice perspective addresses limitations in existing analytical approaches to health-related behaviour before demonstrating its empirical application by constructing a statistical typology of British drinking practices and examining sociodemographic variation in practice. Design: Cross-sectional latent class analysis of drinking occasions derived from one-week drinking diaries collected for market research. Occasions are periods of drinking with no more than two hours between drinks. Setting: Great Britain, 2009-2011. Cases: 187,878 occasions nested within 60,215 nationally-representative adults (18+). Measurements: Beverage type and quantity per occasion. Location, company and gender composition of company. Motivation and reason for occasion. Day, start-time and duration of occasion. Age, sex and social grade. Findings: Eight drinking practices are derived. Three of the four most common practices are low risk, brief, relaxed, home-drinking (46.0% of occasions). The most high risk practices had diverse characteristics and were observed across all sociodemographic groups. Two often-high risk practices identified are rarely acknowledged in policy debate: lengthy weekend domestic gatherings of friends and/or family (14.4% of occasions) and lengthy, typically weekend occasions encompassing both on-trade and off-trade locations (10.4% of occasions). Conclusions: A practice-based perspective offers potential for a step-change in alcohol policy analysis by enabling evaluation of how much and why drinking cultures change in response to public health interventions

How averse are the UK general-public to inequalities in health between socioeconomic groups? A systematic review

There is growing interest in the use of “distributionally-sensitive” forms of economic evaluation that capture both the impact of an intervention upon average population health and the distribution of that health amongst the population. This review aims to inform the conduct of distributionally-sensitive evaluations in the UK by answering three questions: (1) How averse are the UK public towards inequalities in lifetime health between socioeconomic groups? (2) Does this aversion differ depending upon the type of health under consideration? (3) Are the UK public as averse to inequalities in health between socioeconomic groups as they are to inequalities in health between neutrally framed groups? EMBASE, MEDLINE, EconLit, and SSCI were searched for stated preference studies relevant to these questions in October 2017. Of the 2,155 potentially relevant papers identified, fifteen met the predefined hierarchical eligibility criteria. Seven elicited aversion to inequalities in health between socioeconomic groups, and eight elicited aversion between neutrally labelled groups. We find general, although not universal, evidence for aversion to inequalities in lifetime health between socioeconomic groups, albeit with significant variation in the strength of that preference across studies. Secondly, limited evidence regarding the impact of the type of health upon aversion. Thirdly, some evidence that the UK public are more averse to inequalities in lifetime health when those inequalities are presented in the context of socioeconomic inequality than when presented in isolation

The impact of promoting revised UK low-risk drinking guidelines on alcohol consumption: interrupted time series analysis

Background The UK’s Chief Medical Officers revised the UK alcohol drinking guidelines in 2016 to ≤ 14 units per week (1 unit = 10 ml/8 g ethanol) for men and women. Previously, the guideline stated that men should not regularly consume more than 3–4 units per day and women should not regularly consume more than 2–3 units per day. Objective To evaluate the impact of promoting revised UK drinking guidelines on alcohol consumption. Design Interrupted time series analysis of observational data. Setting England, March 2014 to October 2017. Participants A total of 74,388 adults aged ≥ 16 years living in private households in England. Interventions Promotion of revised UK low-risk drinking guidelines. Main outcome measures Primary outcome – alcohol consumption measured by the Alcohol Use Disorders Identification Test – Consumption score. Secondary outcomes – average weekly consumption measured using graduated frequency, monthly alcohol consumption per capita adult (aged ≥ 16 years) derived from taxation data, monthly number of hospitalisations for alcohol poisoning (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision: T51.0, T51.1 and T51.9) and assault (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision: X85–Y09), and further measures of influences on behaviour change. Data sources The Alcohol Toolkit Study, a monthly cross-sectional survey and NHS Digital’s Hospital Episode Statistics. Results The revised drinking guidelines were not subject to large-scale promotion after the initial January 2016 announcement. An analysis of news reports found that mentions of the guidelines were mostly factual, and spiked during January 2016. In December 2015, the modelled average Alcohol Use Disorders Identification Test – Consumption score was 2.719 out of 12.000 and was decreasing by 0.003 each month. After the January 2016 announcement, Alcohol Use Disorders Identification Test – Consumption scores did not decrease significantly (β = 0.001, 95% confidence interval –0.079 to 0.099). However, the trend did change significantly such that scores subsequently increased by 0.005 each month (β = 0.008, 95% confidence interval 0.001 to 0.015). This change is equivalent to 0.5% of the population moving each month from drinking two or three times per week to drinking four or more times per week. Secondary analyses indicated that the change in trend began 6 months before the guideline announcement. The secondary outcome measures showed conflicting results, with no significant changes in consumption measures and no substantial changes in influences on behaviour change, but immediate reductions in hospitalisations of 7.3% for assaults and 15.4% for alcohol poisonings. Limitations The pre-intervention data collection period was only 2 months for influences on behaviour change and the graduated frequency measure. Our conclusions may be generalisable only to scenarios in which guidelines are announced but not promoted. Conclusions The announcement of revised UK low-risk drinking guidelines was not associated with clearly detectable changes in drinking behaviour. Observed reductions in alcohol-related hospitalisations are unlikely to be attributable to the revised guidelines. Promotion of the guidelines may have been prevented by opposition to the revised guidelines from the government's alcohol industry partners or because reduction in alcohol consumption was not a government priority or because practical obstacles prevented independent public health organisations from promoting the guidelines. Additional barriers to the effectiveness of guidelines may include low public understanding and a need for guidelines to engage more with how drinkers respond to and use them in practice. Trial registration Current Controlled Trials ISRCTN15189062. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 14. See the NIHR Journals Library website for further project information

Effects on alcohol consumption of announcing and implementing revised UK low-risk drinking guidelines : findings from an interrupted time series analysis

Background: In January 2016, the UK announced and began implementing revised guidelines for low-risk drinking of 14 units (112 g) per week for men and women. This was a reduction from the previous guidelines for men of 3–4 units (24–32 g) per day. There was no large-scale promotion of the revised guidelines beyond the initial media announcement. This paper evaluates the effect of announcing the revised guidelines on alcohol consumption among adults in England. Methods: Data come from a monthly repeat cross-sectional survey of approximately 1700 adults living in private households in England collected between March 2014 and October 2017. The primary outcomes are change in level and time trend of participants’ Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) scores. Results: In December 2015, the modelled average AUDIT-C score was 2.719 out of 12 and was decreasing by 0.003 each month. After January 2016, AUDIT-C scores increased immediately but non-significantly to 2.720 (β=0.001, CI −0.079 to 0.099) and the trend changed significantly such that scores subsequently increased by 0.005 each month (β=0.008, CI 0.001 to 0.015), equivalent to 0.5% of the population increasing their AUDIT-C score by 1 point each month. Secondary analyses indicated the change in trend began 7 months before the guideline announcement and that AUDIT-C scores reduced significantly but temporarily for 4 months after the announcement (β=−0.087, CI −0.167 to 0.007). Conclusions: Announcing new UK drinking guidelines did not lead to a substantial or sustained reduction in drinking or a downturn in the long-term trend in alcohol consumption, but there was evidence of a temporary reduction in consumption

The impact of changes in COVID‐19 lockdown restrictions on alcohol consumption and drinking occasion characteristics in Scotland and England in 2020 : an interrupted time‐series analysis

Background and Aims Early evidence suggests that COVID-19 lockdown restrictions affect alcohol consumption. However, existing studies lack data on how drinking practices changed as restrictions disrupted people’s work, family life and socializing routines. We examined changes in consumption and drinking occasion characteristics during three periods of changing restrictions in Scotland/England. Design Interrupted time-series analysis of repeat cross-sectional market research data (assessing step-level changes). Setting Scotland/England, January 2009–December 2020. Participants Scotland: 41 507 adult drinkers; England: 253 148 adult drinkers. Measurements Three intervention points: March 2020 lockdown, July 2020 easing of restrictions and October 2020 re-introduction of some restrictions. Primary outcome: mean units consumed per week (total/off-trade/on-trade; 1 unit = 8 g ethanol). Secondary outcomes: drinking > 14 units per week, heavy drinking, drinking days per week, solitary drinking, drinking with family/partners, drinking with friends/colleagues, own-home drinking, drinking in someone else’s home and drinking start times. Findings In Scotland, March 2020’s lockdown was associated with a 2.32 [95% confidence interval (CI) = 0.61, 4.02] increase in off-trade (i.e. shop-bought) units per week, a −2.84 (95% CI = −3.63, −2.06) decrease in on-trade (i.e. licensed venues) units per week, but no statistically significant change in total units per week. July 2020’s easing of restrictions was associated with a 1.33 (95% CI = 0.05, 2.62) increase in on-trade units per week, but no statistically significant total/off-trade consumption changes. October 2020’s re-introduction of some restrictions was not associated with statistically significant consumption changes. Results for England were broadly similar. Lockdown restrictions were also associated with later drinking start times, fewer occasions in someone else’s home and with friends/colleagues, more own-home drinking and (in Scotland only) more solitary drinking. Conclusions Reductions in on-trade alcohol consumption following COVID-19 lockdown restrictions in Scotland/England in 2020 were mainly offset by increased own-home drinking. This largely persisted in periods of greater/lesser restrictions. The shift towards off-trade drinking involved significant changes in the characteristics of drinking occasions

Stable Integration of Transgenes Delivered by a Retrotransposon–Adenovirus Hybrid Vector

Helper-dependent adenoviruses show great promise as gene delivery vectors. However, because they do not integrate into the host chromosome, transgene expression cannot be maintained indefinitely. To overcome these limitations, we have inserted an L1 retrotransposon/transgene element into a helper-dependent adenovirus to create a novel chimeric gene delivery vector. Efficient adenovirus-mediated delivery of the L1 element into cultured human cells results in subsequent retrotransposition and stable integration of the transgene. L1 retrotransposition frequency was found to correlate with increasing multiplicity of infection by the chimeric vector, and further retrotransposition from newly integrated elements was not observed on prolonged culture. Therefore, this vector, which utilizes components of low immunogenic potential, represents a novel two-stage gene delivery system capable of achieving high titers via the initial helper-dependent adenovirus stage and permanent transgene integration via the retrotransposition stage.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63154/1/104303401750298571.pd

MAPO: Mining and Recommending API Usage Patterns

To improve software productivity, when constructing new software systems, programmers often reuse existing libraries or frameworks by invoking methods provided in their APIs. Those API methods, however, are often complex and not well documented. To get familiar with how those API methods are used, programmers often exploit a source code search tool to search for code snippets that use the API methods of interest. However, the returned code snippets are often large in number, and the huge number of snippets places a barrier for programmers to locate useful ones. In order to help programmers overcome this barrier, we have developed an API usage mining framework and its supporting tool called MAPO (Mining API usage Pattern from Open source repositories) for mining API usage patterns automatically. A mined pattern describes that in a certain usage scenario, some API methods are frequently called together and their usages follow some sequential rules. MAPO further recommends the mined API usage patterns and their associated code snippets upon programmers' requests. Our experimental results show that with these patterns MAPO helps programmers locate useful code snippets more effectively than two state-of-the-art code search tools. To investigate whether MAPO can assist programmers in programming tasks, we further conducted an empirical study. The results show that using MAPO, programmers produce code with fewer bugs when facing relatively complex API usages, comparing with using the two state-of-the-art code search tools. ? 2009 Springer Berlin Heidelberg.EI

A latent class analysis of change and continuity in adolescent health and wellbeing in England during the decline in youth alcohol consumption: a repeat cross-sectional study

In England, the proportion of 13-15 year-olds who have ever drunk alcohol fell from 71% in 1999 to 35% in 2019. Despite substantial research literature studying this decline, we know little about connections with concurrent shifts in wider aspects of health and wellbeing. This paper aims to identify how indicators of health and wellbeing cluster within 15-year-olds in England, identify changes in clustering over time, and explore associations with sex and family affluence. We used latent class analysis of cross-sectional data from the Health Behaviours in School-aged Children study (n=5,942; four waves 2001/02-2013/14). Classes were defined by indicators of substance use, sexual activity, diet, exercise, school-related measures, e-media use, parental relationships, and wellbeing. We identified three classes, which we labelled Overall unhealthy, Substance abstainers with behavioural risk indicators, and Overall healthy. The probability of being in the Overall unhealthy class fell (2001/02: 0.39; 2013/14: 0.18) while the probability of being in the Overall healthy class increased (0.21 to 0.41). The probability of weekly alcohol use fell in all classes (e.g. Overall unhealthy: 0.71 to 0.28). Females (female vs male OR: 1.74 95%CI: 1.30 – 2.34) and those with low family affluence (high vs low family affluence OR: 0.18 95%CI: 0.08 – 0.44) had significantly higher odds of being in the Overall unhealthy class. Overall, adolescents became more likely to have co-occurring indicators of good health and wellbeing, including reduced alcohol consumption, sexual activity and cigarette smoking. However, girls and those from poorer families remained more likely to have poor health and wellbeing

Geographies of alcohol and generation: examining the decline in youth drinking in England through a spatial lens

Introduction While international literature addresses the links between youth culture and the decline in youth drinking, little research has engaged with scholarship on youth geographies to more fully disentangle these links. This article explores how the decline is connected to shifts in where young people access and drink alcohol. Methods Qualitative interviews were conducted with young people aged 12–19 (N = 96) and 29–35 (N = 17) years in England. The interviews explored the place of alcohol in everyday life, with younger participants discussing the present and older participants discussing their youth in the late 1990s to early 2000s. Data were analysed thematically. Findings Buying alcohol in shops and licensed premises was a common experience for older participants when they were teenagers but few younger participants discussed buying alcohol from commercial settings. Older participants also reflected positively on drinking in outdoor public spaces whereas younger participants, particularly those from working-class backgrounds, regarded this as morally suspect. Young participants instead accessed alcohol from parents and siblings, and often consumed it in their or others' homes in supervised or moderated ways, seeing this as positive and normative. Discussion and Conclusion Spatial shifts in young people's drinking away from public spaces and toward the home appear an important part of a wider trend that renders youth drinking as increasingly moderate, risk-averse, incidental and mediated by parents, rather than excessive, transgressive and integral to youth culture