318 research outputs found

    The Daily Association Between Affect and Alcohol Use: A Meta-Analysis of Individual Participant Data

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    Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use

    Validity and reproducibility of retinal arteriole and venule diameter measurements : ELSA-Brasil study : a cross-sectional study

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    BACKGROUND: Investigation of alterations to retinal microvasculature may contribute towards understanding the role of such changes in the pathophysiology of several chronic non-communicable diseases. The objective here was to evaluate the validity and reproducibility of retinal arteriole and venule diameter measurements made by Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) graders. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: To evaluate validity, each of 25 retinal images from the University of Wisconsin (gold standard) was measured by five ELSA-Brasil graders. To evaluate reproducibility, 105 images across the spectrum of vessel diameters were selected from 12,257 retinal images that had been obtained between 2010 and 2012, and each image was reexamined by the same grader and by an independent grader. All measurements were made using the Interactive Vessel Analysis (IVAN) software. Bland-Altman plots, paired t tests and intraclass correlation coefficients (ICCs) were analyzed. RESULTS: Mean differences between ELSA-Brasil and gold-standard readings were 0.16 μm (95% CI -0.17‑0.50; P = 0.31) for central retinal artery equivalent (CRAE), -0.21 μm (95% CI -0.56-0.14; P = 0.22) for central retinal vein equivalent (CRVE) and 0.0005 (95% CI -0.008-0.009; P = 0.55) for arteriole/venule ratio (AVR). Intragrader ICCs were 0.77 (95% CI 0.67-0.86) for CRAE, 0.90 (95% CI 0.780.96) for CRVE and 0.70 (0.55‑0.83) for AVR. Intergrader ICCs were 0.75 (95% CI 0.64-0.85) for CRAE, 0.90 (95% CI 0.79-0.96) for CRVE and 0.68 (95% CI 0.55‑0.82) for AVR. CONCLUSIONS: Retinal microvascular diameter measurements are valid and present moderate to high intra and intergrader reproducibility in ELSA-Brasil

    Association between diabetes and cognitive function at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA- Brasil)

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    Diabetes has been associated with cognitive changes and an increased risk of vascular dementia and Alzheimer’s disease, but it is unclear whether there are associations between diabetes and early alterations in cognitive performance. The present study consisted of a cross-section analysis of 14,444 participants aged 35–74 years and from a developing country at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA–Brasil); these participants were recruited between 2008 and 2010. We investigated whether there was an association between diabetes and early changes in the cognitive performance of this Brazilian population. To assess cognitive domains, we used the word-list learning, word-list delayed recall and word recognition tests along. Phonemic verbal fuency tests included semantic phonemic test (animals) and a phonemic test (words beginning with the letter F). Executive functions associated with attention, concentration and psychomotor speed were evaluated using the Trail Making Test B. The exposure variable in the study was defned as diabetes. Multiple linear regression was used to estimate the association between diabetes and cognitive performance. The results were adjusted for age, sex, education, hypertension, coronary disease, depression, physical activity, smoking, alcohol consumption, and the cholesterol/HDL-C ratio. We found a signifcant association between diabetes and decreased memory, language and executive function (attention, concentration and psychomotor speed) performance in this population from a country with a distinct epidemiological profle, even after adjusting for the main intervening variables

    Mortality salience leads to greater consumption of an ostensibly alcoholic beverage on Friday versus other weekdays

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    Objectives We build on findings from terror management theory to examine how non‐conscious mortality concerns may lead individuals to adhere to cultural meanings yoked to discrete time periods, in this case influencing consumption of an ostensibly alcoholic beverage. Design The study took the form of a 2 (death vs. uncertainty reminder) × 3 (Monday vs. Wednesday vs. Friday) between‐subjects laboratory‐based quasi‐experimental design. Methods A total of 210 participants (age: M = 21.92 years, SD = 5.33; 103 males and 107 females) recruited from a UK university answered either an open‐ended question to prime mortality or uncertainty cognition on either a Monday, Wednesday, or Friday. As part of an ostensible taste test, they then consumed as much or as little of a purportedly alcoholic drink as they desired. Results Death reminders (vs. control topic) were found to result in more consumption of the beverage on a Friday, less consumption on a Monday, and no difference in consumption on a Wednesday. Conclusions Findings point to the flexible, time‐contingent nature of culture‐oriented defences against mortality concerns with potential implications for the efficacy of alcohol health warnings featuring mortality‐related stimuli

    Deep neural network-estimated electrocardiographic age as a mortality predictor

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    The electrocardiogram (ECG) is the most commonly used exam for the evaluation of cardiovascular diseases. Here we propose that the age predicted by artificial intelligence (AI) from the raw ECG (ECG-age) can be a measure of cardiovascular health. A deep neural network is trained to predict a patient’s age from the 12-lead ECG in the CODE study cohort (n = 1,558,415 patients). On a 15% hold-out split, patients with ECG-age more than 8 years greater than the chronological age have a higher mortality rate (hazard ratio (HR) 1.79, p < 0.001), whereas those with ECG-age more than 8 years smaller, have a lower mortality rate (HR 0.78, p < 0.001). Similar results are obtained in the external cohorts ELSA-Brasil (n = 14,236) and SaMi-Trop (n = 1,631). Moreover, even for apparent normal ECGs, the predicted ECG-age gap from the chronological age remains a statistically significant risk predictor. These results show that the AI-enabled analysis of the ECG can add prognostic information

    Doenças crônicas não transmissíveis no Brasil: prioridade para enfrentamento e investigação

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    Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fighting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a significant number of scientific studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 Brazilian public servants reflects the reality of high prevalences of diabetes, hypertension and the main chronic diseases risk factors. The diversity of information that the Study will produce can provide important input to better understand the causes of chronic diseases and to support public policies for fighting them.Las enfermedades crónicas no transmisibles representan la mayor carga de morbimortalidad en Brasil. En 2011, el Ministerio de Salud Brasileño lanzó un Plan de Acciones Estratégicas para Enfrentar las enfermedades crónicas no transmisibles, enfatizando acciones poblacionales para controlar las enfermedades cardiovasculares, diabetes, cáncer y enfermedad respiratoria crónica, predominantemente por el control del cigarro, inactividad física, alimentación inadecuada y uso perjudicial de alcohol. A pesar de la producción científica significativa sobre tales enfermedades y sus factores de riesgo en Brasil, pocos son los estudios de cohorte en este tema. En este contexto, el Estudio Longitudinal de la Salud del Adulto (ELSA-Brasil) acompaña 15.105 servidores públicos del país. Sus datos reflejan la realidad brasileña de altas prevalencias de diabetes e hipertensión y de los factores de riesgo. La diversidad de las informaciones producidas permitirá profundizar el entendimiento causal de tales enfermedades y subsidiar políticas públicas para enfrentarlas.As Doenças Crônicas Não Transmissíveis representam a maior carga de morbimortalidade no Brasil. Em 2011, o Ministério da Saúde lançou seu Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis, enfatizando ações populacionais para controlar as doenças cardiovasculares, diabetes, câncer e doença respiratória crônica, predominantemente pelo controle do fumo, inatividade física, alimentação inadequada e uso prejudicial de álcool. Apesar da produção científica significativa sobre essas doenças e seus fatores de risco no Brasil, poucos são os estudos de coorte nessa temática. Nesse contexto, o Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) acompanha 15.105 servidores públicos do País. Seus dados espelham a realidade brasileira de altas prevalências de diabetes e hipertensão e dos fatores de risco. A diversidade das informações produzidas permitirá aprofundar o entendimento causal dessas doenças e subsidiar políticas públicas para seu enfrentamento

    Compliance to the treatment in a peripheric distric of Porto Alegre

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    Adesão ao tratamento é um elo do processo terapêutico do qual depende o sucesso de qualquer prescrição. Dificuldades interpostas ao objetivo de adesão se acentuam junto a populações mais carentes. Neste estudo, avaliou-se o nível de adesão apresentado por 71 pacientes atendidos ambulatorialmente, no período de agosto a novembro de 1986, numa Unidade Sanitária da Secretaria de Saúde e do Meio Ambiente localizada em uma vila popular de Porto Alegre. Só participaram da amostra os pacientes aos quais foram prescritos fármacos. Combinou-se o método de entrevista ao de "contagem de pílulas" em visitas domiciliares de surpresa, metodologia que visou adequarse às peculiaridades do local de realização da pesquisa. O nível de adesão ao tratamento encontrado foi de 53,5%. Não foram encontradas associações estatisticamente significativas entre adesão e várias variáveis pesquisadas. Fatores capazes de influenciar adesão, metodologia empregada e resultados são amplamente discutidos. Conclui-se que o problema de não-adesão a tratamentos prescritos no meio analisado é grave. Propõese que medidas estimuladoras de adesão sejam especificamente desenvolvidas e testadas junto a estas populações.Compliance is a very important link in the therapeutic process. The sucess of any treatment depends on it. This is even a more preocupating problem when medicai assistance is given to deprived communities. The authors measured the levei of compliance of 71 patients attending a government sponsored medicai ambulatory located in a peripheric district of the city of Porto Alegre. Only patients who had drugs prescribed from August/86 to November/86 were included. The methodology employed was conceived to meet special local requirements and combined the method of interview to pill counts conducted at surprise home visits. An overall compliance rate of 53,5% was found. Variables affecting compliance, methodological aspects and results are discussed. lt is concluded that the problem of non-compliance in the situation described is very serious. lt is suggested that compliance improving measures specially developed to these communities be tested in the future as a way to minimize the problem

    Context-dependence of race self-classification : results from a highly mixed and unequal middle-income country

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    Ethnic-racial classification criteria are widely recognized to vary according to historical, cultural and political contexts. In Brazil, the strong influence of individual socio-economic factors on race/colour self-classification is well known. With the expansion of genomic technologies, the use of genomic ancestry has been suggested as a substitute for classification procedures such as self-declaring race, as if they represented the same concept. We investigated the association between genomic ancestry, the racial composition of census tracts and individual socioeconomic factors and self-declared race/colour in a cohort of 15,105 Brazilians. Results show that the probability of self-declaring as black or brown increases according to the proportion of African ancestry and varies widely among cities. In Porto Alegre, where most of the population is white, with every 10% increase in the proportion of African ancestry, the odds of self-declaring as black increased 14 times (95%CI 6.08–32.81). In Salvador, where most of the population is black or brown, that increase was of 3.98 times (95%CI 2.96–5.35). The racial composition of the area of residence was also associated with the probability of selfdeclaring as black or brown. Every 10% increase in the proportion of black and brown inhabitants in the residential census tract increased the odds of self-declaring as black by 1.33 times (95%CI 1.24–1.42). Ancestry alone does not explain self-declared race/colour. An emphasis on multiple situational contexts (both individual and collective) provides a more comprehensive framework for the study of the predictors of self-declared race/colour, a highly relevant construct in many different scenarios, such as public policy, sociology and medicine

    Alcohol-Related Context Modulates Performance of Social Drinkers in a Visual Go/No-Go Task: A Preliminary Assessment of Event-Related Potentials

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    Background Increased alcohol cue-reactivity and altered inhibitory processing have been reported in heavy social drinkers and alcohol-dependent patients, and are associated with relapse. In social drinkers, these two processes have been usually studied separately by recording event-related potentials (ERPs) during rapid picture presentation. The aim of our study was to confront social drinkers to a task triggering high alcohol cue-reactivity, to verify whether it specifically altered inhibitory performance, by using long-lasting background picture presentation. Methods ERP were recorded during visual Go/No-Go tasks performed by social drinkers, in which a frequent Go signal (letter “M”), and a rare No-Go signal (letter “W”) were superimposed on three different types of background pictures: neutral (black background), alcohol-related and non alcohol-related. Results Our data suggested that heavy social drinkers made more commission errors than light drinkers, but only in the alcohol-related context. Neurophysiologically, this was reflected by a delayed No-Go P3 component. Conclusions Elevated alcohol cue-reactivity may lead to poorer inhibitory performance in heavy social drinkers, and may be considered as an important vulnerability factor in developing alcohol misuse. Prevention programs should be designed to decrease the high arousal of alcohol stimuli and strengthen cognitive control in young, at-risk individuals.This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
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