Geographical Disparities in Screening and Cancer-Related Health Behaviour.

This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014-2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a sample of randomly selected households. Chi-square tests and adjusted odds ratios from logistic regression models were computed to assess the association between residential location and cancer-related health behaviours including cancer screening participation, alcohol consumption, smoking, exercise, and fruit and vegetable intake, controlling for age, socio-economic status (SES), education, and place of birth. The findings show insufficient exercise, risky alcohol intake, meeting vegetable intake guidelines, and participation in cervical screening are more likely for those living in inner regional areas and in outer regional/remote areas compared with those living in major cities. Daily smoking and participation in prostate cancer screening were significantly higher for those living in outer regional/remote areas. While participation in cancer screening in Australia does not appear to be negatively impacted by regional or remote living, lifestyle behaviours associated with cancer incidence and mortality are poorer in regional and remote areas. Population-based interventions targeting health behaviour change may be an appropriate target for reducing geographical disparities in cancer outcomes

Identifying the motives for and against drinking during pregnancy and motherhood, and factors associated with increased maternal alcohol use

Aim: Maternal drinking (alcohol use during pregnancy/motherhood) is a hidden public health concern which can have significant negative effects on the woman and child. This pilot survey explored several domains that might influence maternal drinking. Subject and methods: Two cross-sectional, online surveys recruited (1) women who were pregnant and (2) mothers who were not pregnant. Surveys captured data on alcohol use and harmful drinking, attitudes on and motives for drinking/not drinking, and perceived barriers to drinking less. Content analysis of free text responses complemented quantitative data. Results: In this convenience sample of 836 pregnant women and 589 mothers, 91% of pregnant women and 28% of mothers reported abstinence. Of those reporting alcohol use, median consumption was 2.3 units/week in pregnant women, and 6.9 units/week in non-pregnant mothers. Of mothers currently drinking, 25.1% reported hazardous or harmful levels. Heavier drinking was associated with numerous motives, including using alcohol as a coping strategy. Child welfare was a key motivating factor for not drinking, as were practical issues of motherhood. The stresses of motherhood were a perceived barrier to reducing drinking, and mothers reported more barriers than pregnant women. Conclusion: Stress reduction motives may be a risk factor for heavier maternal drinking, while motives for not drinking seem to be focused on child welfare and maternal well-being. Stress and a lack of knowledge about how to reduce drinking appear to be barriers for mothers to change their drinking behaviour. These findings can inform the development of effective public health interventions to reduce maternal drinking

The effects of menstrual cycle stage and hormonal contraception on alcohol consumption and craving: A pilot investigation

Background and aims: Although alcohol research often comments on observed sex differences (i.e. patterns of consumption), there is a lack of investigation into the reasons for these differences. For females, the regular hormonal fluctuations across the menstrual cycle are a potential influencing factor for alcohol consumption. In this pilot we aimed to investigate the relationship between menstrual cycle phase (follicular-phase [FP] and luteal-phase [LP]) and status (naturally-cycling [NC] and hormonal-contraception [HC]) on alcohol consumption and craving of casual drinkers, and identify potential influencing factors in this relationship. Methods: Study One: participants (n ​= ​28; 15 HC, 13 NC) were either NC or HC (between subject factor: hormonal status) and attended two lab-based sessions corresponding with their FP and LP (within factor: cycle phase [NC] or time [HC]). Participants completed a mock alcohol taste-test, in addition to pre- and post-consumption measures of craving, anxiety, stress, and mood. Study Two: participants (n ​= ​262; 144 HC, 118 NC) were either NC or HC (between subject factor) and completed an online study assessing menstrual cycle phase, alcohol use, craving, impulsivity, and stress. Results: Study One: A significant effect of cycle phase was found on alcohol craving (p ​= ​.019): craving was higher during the FP compared to the LP for NC participants, with HC participants showing no difference across sessions. There was no effect of phase or status on alcohol consumption, stress, or mood (ps ​> ​.05). Study Two: Regression analyses showed that age, craving, impulsivity and stress were significantly associated with alcohol consumption for NC participants (ps ​< ​.05), however only age and craving were associated with consumption for the HC participants (ps ​< ​.001). Conclusions: Alcohol craving was higher during the follicular, compared to the luteal, phase for the naturally cycling group, and different factors may be associated with drinking behaviour across women who are NC and those using HC. Future alcohol research should consider the menstrual cycle and contraceptive status for females

Alcohol use during pregnancy and motherhood: Attitudes and experiences of pregnant women, mothers, and healthcare professionals

Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering ‘grey area’ drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds

Menstrual Cycle Phase, Hormonal Contraception, and Alcohol Consumption in Premenopausal Females: A Systematic Review

Women may be particularly vulnerable to alcohol harm, but many current theories fail to acknowledge the unique factors that influence female alcohol use. The biological mechanisms underlying female alcohol consumption have largely been unexplored, although recently the menstrual cycle has been highlighted as a potentially important factor. This systematic review, using a narrative synthesis, examined the association between the menstrual cycle phases on alcohol consumption and aimed to determine whether hormonal contraception influences this association. The review follows PRISMA and SWiM guidelines, registration number: CRD42018112744. Electronic searches were conducted in the relevant databases with keyword (e.g., “menstrua*”; “alcohol”). Thousand six hundred and sixty-two titles were identified, 16 of which were included in the review. Results were inconsistent regarding whether an association between menstrual cycle phase and alcohol consumption was found. Furthermore, there was inconsistency regarding which phase was associated with higher consumption, and different factors were reported to have moderated the direction, e.g., family history of alcohol use disorder (AUD), premenstrual syndrome (PMS). These conflicting results may be partly explained by variability in both study quality and design, and differences in measurement of cycle phase and alcohol consumption. More robust research is needed before conclusions can be drawn with regard to the role of the menstrual cycle and hormonal contraception on female drinking behavior. This review provides recommendations to strengthen research in this area

“Drinkers Like Me”: A Thematic Analysis of Comments Responding to an Online Article About Moderating Alcohol Consumption

Background: There has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles’ article, this study aimed to explore (i) posters’ (someone who has posted a comment in response to the article) attitudes or beliefs toward moderating alcohol and (ii) posters’ experiences of moderating or abstaining from alcohol. Method: A secondary qualitative analysis of online comments in response to an article about moderating alcohol consumption. Main outcome measures: Comments (n = 784) in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used. Results: For aim one, two themes were developed; “general attitudes toward drinking” and “general attitudes toward reducing consumption”. These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: “moderation vs. abstention”, “reflection on past drinking behaviours”, and “current drinking behaviours”. These themes represent posters’ experiences and implications changing their drinking habits. Conclusion: Our analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives

Longitudinal associations with alcohol consumption during the first COVID-19 lockdown: Associations with mood, drinking motives, context of drinking, and mental health

Background: Coronavirus (COVID-19) resulted in lockdown measures in the UK, which has impacted alcohol use. Alcohol is often used as a coping mechanism and there are public health concerns regarding excessive consumption due to the pandemic. We aimed to longitudinally assess drinking behaviors, and associated factors, during the first UK government-mandated lockdown. Methods: An online survey was distributed through social media (8th April 2020, onwards). Fortnightly follow up surveys were emailed to participants. The primary outcome measure was ‘weekly unit consumption’ and data was collected on a range of potentially related factors: demographics, factors relating to COVID-19 (e.g., health, work status), drinking motives, context of drinking, drinking intentions, mood, depression and anxiety. Findings: A total of 539 self-selected participants completed the baseline survey, with 186 completing at least 3 follow up surveys for multilevel modelling analysis. Personal coping motives, anxiety, drinking at home alone, and drinking at home with others were positively associated with alcohol consumption during lockdown. The following baseline measures also predicted increased consumption: male gender, lower education, and higher AUDIT scores (based on behavior prior to lockdown). Findings were consistent when utilizing an inverse probability weight to account for predictors of attrition (female, younger age, higher baseline AUDIT scores). Conclusions: Those already drinking at hazardous levels were more likely to increase their consumption, as were those who were drinking to cope. As we recover from the pandemic, there is a need for widespread alcohol support, and certain groups may need targeted support

Specific mediator inhibition by the NO donors SNP and NCX 2057 in the peripheral lung: implications for allergen-induced bronchoconstriction

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to examine potential therapeutic effect of the two NO donors NCX 2057 (3-(4-hydroxy-3-methoxyphenyl)-2-propenoic acid) 4-(nitrooxy)butyl ester) and SNP (sodium nitroprusside) on the early allergic airway response in the peripheral lung.</p> <p>Methods</p> <p>The experiments were performed in guinea pig lung parenchyma (GPLP) derived from ovalbumin (OVA) sensitized guinea pigs. The effects of NCX 2057 and SNP were evaluated by contractile responses and mediator release during OVA challenge. The generation of nitrite and nitrate was assessed by chemiluminescence. Statistical analysis was evaluated by ANOVA.</p> <p>Results</p> <p>Cumulatively increasing concentrations of OVA (1–10,000 ng/ml) induced concentration-dependent contractions of the GPLP that were reduced by NCX 2057 (100 μM, p < 0.001) and SNP (100 μM, p < 0.05). Antigen-induced eicosanoid release was decreased by NCX 2057 (100 μM, p < 0.001) but not by SNP (100 μM), whereas the release of histamine was reduced by SNP (100 μM, p < 0.001) but not by NCX 2057 (100 μM). In addition, NCX 2057 (0.1–100 μM), but not SNP (0.1–100 μM), relaxed leukotriene D₄(10 nM) precontracted GPLP (p < 0.01). The guanylyl cyclase inhibitor ODQ had no effect on the NCX 2057 mediated relaxation. SNP released significantly less nitrite than NCX 2057.</p> <p>Conclusion</p> <p>Although both SNP and NCX 2057 reduced the release of pro-inflammatory mediators, their profiles were distinctly different. Furthermore, NCX 2057 also induced smooth muscle dilation in the GPLP. The findings point to specific anti-inflammatory effects of different NO donors in the peripheral lung tissue.</p

Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-244X/10/41Background: Although often providing more reliable and informative findings relative to other study designs, longitudinal investigations of prevalence and predictors of suicidal behaviour remain uncommon. This paper compares 12-month prevalence rates for suicidal ideation and suicide attempt at baseline and follow-up; identifies new cases and remissions; and assesses the capacity of baseline data to predict serious suicidality at follow-up, focusing on age and gender differences. Methods: 6,666 participants aged 20-29, 40-49 and 60-69 years were drawn from the first (1999-2001) and second (2003-2006) waves of a general population survey. Analyses involved multivariate logistic regression. Results: At follow-up, prevalence of suicidal ideation and suicide attempt had decreased (8.2%-6.1%, and 0.8%-0.5%, respectively). However, over one quarter of those reporting serious suicidality at baseline still experienced it four years later. Females aged 20-29 never married or diagnosed with a physical illness at follow-up were at greater risk of serious suicidality (OR = 4.17, 95% CI = 3.11-5.23; OR = 3.18, 95% CI = 2.09-4.26, respectively). Males aged 40-49 not in the labour force had increased odds of serious suicidality (OR = 4.08, 95% CI = 1.6-6.48) compared to their equivalently-aged and employed counterparts. Depressed/anxious females aged 60-69 were nearly 30% more likely to be seriously suicidal. Conclusions: There are age and gender differentials in the risk factors for suicidality. Life-circumstances contribute substantially to the onset of serious suicidality, in addition to symptoms of depression and anxiety. These findings are particularly pertinent to the development of effective population-based suicide prevention strategies.A Kate Fairweather-Schmidt, Kaarin J Anstey, Agus Salim and Bryan Rodger