Alcohol Consumption Among Older Adults in Primary Care

BACKGROUND: Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients. OBJECTIVES: To determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients. DESIGN: Cross-sectional analysis of multisite screening data from 6 VA Medical Centers, 2 hospital-based health care networks, and 3 Community Health Centers. PARTICIPANTS: Patients, 43,606, aged 65 to 103 years, with scheduled primary care appointments were approached for screening; 27,714 (63.6%) consented to be screened. The final sample of persons with completed screens comprised 24,863 patients. MEASUREMENTS: Quantity and frequency of alcohol use, demographics, social support measures, and measures of depression/anxiety. RESULTS: Of the 24,863 older adults screened, 70.0% reported no consumption of alcohol in the past year, 21.5% were moderate drinkers (1–7 drinks/week), 4.1% were at-risk drinkers (8–14 drinks/week), and 4.5% were heavy (>14 drinks/week) or binge drinkers. Heavy drinking showed significant positive association with depressive/anxiety symptoms [Odds ratio (OR) (95% CI): 1.79 (1.30, 2.45)] and less social support [OR (95% CI): 2.01 (1.14, 2.56)]. Heavy drinking combined with binging was similarly positively associated with depressive/anxiety symptoms [OR (95%): 1.70 (1.33, 2.17)] and perceived poor health [OR (95% CI): 1.27 (1.03, 1.57)], while at-risk drinking was not associated with any of these variables. CONCLUSIONS: The majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/anxiety symptoms and perceived poor health

A follow-up study of heroin addicts (VEdeTTE2): study design and protocol

BACKGROUND: In Italy, a large cohort study (VEdeTTE1) was conducted between 1998–2001 to evaluate the effectiveness of treatments in reducing mortality and increasing treatment retention among heroin addicts. The follow-up of this cohort (VEdeTTE2) was designed to evaluate the effectiveness of treatments on long-term outcomes, such as rehabilitation and social re-integration. The purpose of this paper is to describe the protocol of the VEdeTTE2 study, and to present the results of the pilot study carried out to assess the feasibility of the study and to improve study procedures. METHODS: The source population for the VEdeTTE2 study was the VEdeTTE1 cohort, from which a sample of 2,200 patients, traced two or more years after enrolment in the cohort, were asked to participate. An interview investigates drug use; overdose; family and social re-integration. Illegal activity are investigated separately in a questionnaire completed by the patient. Patients are also asked to provide a hair sample to test for heroin and cocaine use. Information on treatments and HIV, HBV and HCV morbidity are obtained from clinical records. A pilot phase was planned and carried out on 60 patients. RESULTS: The results of the pilot phase pointed out the validity of the procedures designed to limit attrition: the number of traced subjects was satisfactory (88%). Moreover, the pilot phase was very useful in identifying possible causes of delays and attrition, and flaws in the instruments. Improvements to the procedures and the instruments were subsequently implemented. Sensitivity of the biological test was quite good for heroin (78%) but lower for cocaine (42.3%), highlighting the need to obtain a hair sample from all patients. CONCLUSION: In drug addiction research, studies investigating health status and social re-integration of subjects at long-term follow-up are lacking. The VEdeTTE2 study aims to investigate these outcomes at long-term follow-up. Results of the pilot phase underline the importance of the pilot phase when planning a follow-up study

Mudando o foco: um estudo exploratório sobre uso de drogas e violência no trabalho entre mulheres das classes populares da cidade do Rio de Janeiro, Brasil Cambiando el foco: un estudio exploratorio acerca del uso de drogas y violência en el trabalho de mujeres de las classes populares de Rio de Janeiro, Brasil Changing the focus: an exploratory study of drug use and worplace violence among women of popular classes in Rio de Janeiro, Brazil

Este é um estudo exploratório para o mapeamento de fatores envolvidos na relação entre uso de drogas lícitas e ilícitas e violência no trabalho, em um grupo de mulheres das classes populares da cidade do Rio de Janeiro. Para este estudo foi utilizada uma abordagem quantitativa descritiva e analítica, e também abordagem qualitativa a partir de entrevistas aprofundadas com mulheres que sofrem ou haviam sofrido situações de violência no trabalho, utilizando a metodologia do Discurso do Sujeito Coletivo. Os resultados evidenciam situações sócio-demográficas e de trabalho que podem ser consideradas como possíveis fatores de risco para o consumo de drogas e violência no trabalho. A análise qualitativa mostrou a forma como este grupo de mulheres vê o fenômeno do uso de drogas e da violência no trabalho, ampliando a compreensão sobre estas questões e fornecendo subsídios conceituais e metodológicos para estudos adicionais sobre o tema.<br>La finalidad de este estudio exploratorio fue conocer los factores relacionados con el uso de drogas lícitas e ilícitas y la violencia en el trabajo en un grupo de mujeres de clases populares en la ciudad de Rio de Janeiro. Para este estudio se utilizó una aproximación cuantitativa descriptiva y analítica, además de una aproximación cualitativa a partir de entrevistas en profundidad con mujeres que sufren o habían sufrido situaciones de violencia en el trabajo. Se utilizó la metodología de análisis del discurso del sujeto colectivo. Los resultados evidencian situaciones sociodemográficas y de trabajo que pueden ser consideradas como posibles factores de riesgo para el consumo de drogas y violencia en el trabajo. El análisis cualitativo muestra como este grupo de mujeres percibe el fenómeno del uso de drogas y de violencia en el trabajo, ampliando la comprensión sobre estas cuestiones y dando aportes conceptuales y metodológicos para estudios adicionales sobre el tema.<br>This exploratory study aimed to investigate factors related to the use of illicit and licit drugs and workplace violence in a group of women from popular classes in the city of Rio de Janeiro. We used a descriptive and analytic quantitative approach was used, as well as a qualitative approach through in-depth interviews with women who suffered or were suffering workplace violence, using the collective subject discourse analysis methodology. The results showed sociodemographic and work situations that can be considered as possible risk factors for drug consumption and workplace violence. The qualitative analysis shows how this group perceives the phenomena of drug use and workplace violence, expanding the comprehension about these issues and providing conceptual and methodological elements for additional studies on this subject