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1.
  • Kehoe, Laura, et al. (author)
  • Make EU trade with Brazil sustainable
  • 2019
  • In: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
  • Journal article (other academic/artistic)
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3.
  • Atzendorf, Josefine, et al. (author)
  • Die Nutzung von E-Zigaretten in der deutschen Bevölkerung – Ergebnisse des Epidemiologischen Suchtsurvey 2015
  • 2019
  • In: Das Gesundheitswesen. - : Georg Thieme Verlag KG. - 0941-3790 .- 1439-4421. ; 81:02, s. 137-143
  • Journal article (peer-reviewed)abstract
    • Hintergrund Schätzungen zum E-Zigarettenkonsum in Deutschland variieren erheblich. Die Nutzung von E-Zigaretten zur Tabakentwöhnung wird kritisch diskutiert. Anhand aktueller Daten soll die Verbreitung des Konsums von E-Zigaretten und deren Nutzung in der erwachsenen Allgemeinbevölkerung Deutschlands dargestellt werden.Methoden Als Datenbasis diente der Epidemiologische Suchtsurvey 2015, eine bundesweite Befragung von 18- bis 64-jährigen in Deutschland (n=9,204; Rücklaufquote: 52,2%).Ergebnisse E-Zigaretten waren einem Großteil der Befragten bekannt (85,3%, 43,5 Mio.), wohingegen lediglich 2,9% (1,5 Mio.) E-Zigaretten in den letzten 30 Tagen genutzt hatten. Jüngere Personen (OR=0,95, 95%-KI=(0,93; 0,97)), Männer (OR=1,45, 95%-KI=(1,02; 2,07)) und Raucher (OR=12,53, 95%-KI=(8,71; 18,03)) zeigten ein signifikant höheres Risiko, E-Zigaretten zu konsumieren. Etwa ein Drittel (36,6%) der Raucher und Ex-Raucher konventioneller Zigaretten nutzte E-Zigaretten zur Tabakentwöhnung, wovon ein Fünftel (21,3%) mit dem Rauchen aufhören konnte.Schlussfolgerungen E-Zigarettennutzer scheinen häufiger männlich, jünger und Raucher konventioneller Zigaretten zu sein. Neben Neugierde ist die Veränderung des Rauchverhaltens ein bedeutendes Konsummotiv. Die Ergebnisse deuten darauf hin, dass der Gebrauch von E-Zigaretten vereinzelt zur Tabakentwöhnung beitragen kann, die Mehrheit der Nutzer aber weiterhin konventionelle und/oder E-Zigaretten konsumiert.
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4.
  • Atzendorf, Josefine, et al. (author)
  • Do smoking, nutrition, alcohol use, and physical activity vary between regions in Germany?-results of a cross-sectional study
  • 2020
  • In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
  • Journal article (peer-reviewed)abstract
    • Background: Previous studies on lifestyle risk factors mainly focused on age- or gender-specific differences. However, lifestyle risk factors also vary across regions. Aim of the present study was to examine the extent to which prevalence rates of SNAP (smoking, nutrition, alcohol consumption, physical activity) vary between East and West Germany or North and South Germany.Methods: Data came from the population-representative 2015 Epidemiological Survey of Substance Abuse (ESA) comprising 9204 subjects aged 18 to 64 years. To assess an east-west or south-north gradient, two binary logistic regression models were carried out for each SNAP factor.Results: The logistic regression models revealed statistically significant differences with higher rates of at-risk alcohol consumption and lower rates of unhealthy nutrition in East Germany compared to West Germany. Significant differences between North and South Germany were found for at-risk alcohol consumption with higher rates of at-risk alcohol consumption in South Germany. Daily smoking and low physical activity were equally distributed across regions.Conclusions: The implementation of measures reducing at-risk alcohol consumption in Germany should take the identified east-west and south-north gradient into account. Since the prevalence of unhealthy nutrition was generally high, prevention and intervention measures should focus on Germany as a whole instead of specific regions.
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5.
  • Atzendorf, Josefine, et al. (author)
  • E-Zigaretten : Einschätzung vonGesundheitsgefahren undNutzung zur Tabakentwöhnung
  • 2018
  • In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. - : Springer Science and Business Media LLC. - 1436-9990 .- 1437-1588. ; 61:11, s. 1415-1421
  • Journal article (peer-reviewed)abstract
    • BackgroundThe perception that e-cigarettes are less harmful than traditional tobacco products can influence the consumption of e-cigarettes.ObjectivesThree questions were examined: (1)How do different population groups perceive health risks of e-cigarettes? (2)Do sociodemographic variables explain differences in the risk assessment of e-cigarettes? (3)Does the perception of health risks predict the use of e-cigarettes for smoking cessation?MethodsData came from the 2015 Epidemiological Survey of Substance Abuse (ESA) with asample size of n=9204 participants, aged 18 to 64years (response rate 52.2%). Data were collected by telephone, online, or by written questionnaires. Assessments of risk perception of e-cigarettes and conventional cigarettes (more harmful, just as harmful, less harmful, do not know) were compared. Descriptive statistics and logistic regressions were performed.ResultsIndividuals with lower education rated e-cigarettes as more harmful. Older people and women perceived e-cigarettes as just as harmful. Smokers considered e-cigarettes to be more harmful than or just as harmful as conventional tobacco products. The likelihood of using e-cigarettes for smoking cessation was higher if people thought they were less harmful than conventional cigarettes.ConclusionsOnly one-third of the population knows that e-cigarettes are less harmful to health than conventional cigarettes. The perception of health risks is related to the usage of e-cigarettes for smoking cessation.
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6.
  • Atzendorf, Josefine, et al. (author)
  • Patterns of multiple lifestyle risk factors and their link to mental health in the German adult population : a cross-sectional study
  • 2018
  • In: BMJ Open. - : BMJ. - 2044-6055. ; 8:12
  • Journal article (peer-reviewed)abstract
    • Objectives Lifestyle risk factors, such as drinking or unhealthy diet, can expotentiate detrimental health effects. Therefore, it is important to investigate multiple lifestyle risk factors instead of single ones. The study aims at: (1) identifying patterns of lifestyle risk factors within the adult general population in Germany and (2) examining associations between the extracted patterns and external factors.Design Cross-sectional study.Setting General German adult population (aged 18–64 years).Participants Participants of the 2015 Epidemiological Survey of Substance Abuse (n=9204).Primary outcome measures Lifestyle risk factors (daily smoking, at-risk alcohol consumption, unhealthy diet, low physical activity, weekly use of pharmaceuticals, as well as consumption of cannabis and other illicit drugs).Results A latent class analysis was applied to identify patterns of lifestyle risk factors, and a multinomial logistic regression was carried out to examine associations between the extracted classes and external factors. A total of four classes were extracted which can be described as healthy lifestyle (58.5%), drinking lifestyle (24.4%), smoking lifestyle (15.4%) and a cumulate risk factors lifestyle (1.7%). Individuals who were male, at younger age and single as well as individuals with various mental health problems were more likely to show multiple lifestyle risk factors.Conclusions Healthcare professionals should be aware of correlations between different lifestyle risk factors as well as between lifestyle risk groups and mental health. Health promotion strategies should further focus especially on younger and single men.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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7.
  • Bellm, Eric C., et al. (author)
  • The Zwicky Transient Facility : System Overview, Performance, and First Results
  • 2019
  • In: Publications of the Astronomical Society of the Pacific. - : IOP Publishing. - 0004-6280 .- 1538-3873. ; 131:995
  • Journal article (peer-reviewed)abstract
    • The Zwicky Transient Facility (ZTF) is a new optical time-domain survey that uses the Palomar 48 inch Schmidt telescope. A custom-built wide-field camera provides a 47 deg(2) field of view and 8 s readout time, yielding more than an order of magnitude improvement in survey speed relative to its predecessor survey, the Palomar Transient Factory. We describe the design and implementation of the camera and observing system. The ZTF data system at the Infrared Processing and Analysis Center provides near-real-time reduction to identify moving and varying objects. We outline the analysis pipelines, data products, and associated archive. Finally, we present on-sky performance analysis and first scientific results from commissioning and the early survey. ZTF's public alert stream will serve as a useful precursor for that of the Large Synoptic Survey Telescope.
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8.
  • Bloomfield, Kim, et al. (author)
  • Drinking patterns at the sub-national level : What do they tell us about drinking cultures in European countries?
  • 2017
  • In: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 34:4, s. 342-352
  • Journal article (peer-reviewed)abstract
    • Aim:A drinking pattern is not only a major drinking variable, but is also one indicator of a country's drinking culture. In the present study, we examine drinking patterns within and across the neighbouring countries of Denmark and Germany. The aim of the research is to determine to what extent drinking patterns differ or are shared at the sub-national level in the two countries.Method:Data came from the German 2012 Epidemiological Survey of Substance Use (n = 9084) 18-64 years (response rate 54%), and the Centre for Alcohol and Drug Research's 2011 Danish national survey (n = 5133) 15-79 years (response rate 64%), which was reduced to a common age range, producing a final n = 4016. The drinking pattern variable included abstention, moderate drinking, heavy drinking, risky single occasion drinking (RSOD), and was investigated with bivariate statistics and gender-specific hierarchical cluster analysis.Results:For men three clusters emerged: one highlighting abstention and RSOD, moderate/heavy drinking, RSOD and RSOD + heavy drinking. For women, two clusters appeared: one highlighting abstention and moderate/heavy drinking and the other highlighting RSOD and RSDO + heavy drinking. The clusters revealed different geographical patterning: for men, a west vs. east divide; for women, a north-south gradient.Conclusions:The analysis could identify for each gender clusters representing both separate and shared drinking patterns as well as distinctive geographical placements. This new knowledge can contribute to a new understanding of the dynamics of drinking cultures and could indicate new approaches to prevention efforts and policy initiatives.
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9.
  • Bollella, Paolo, et al. (author)
  • A Glucose/Oxygen Enzymatic Fuel Cell based on Gold Nanoparticles modified Graphene Screen-Printed Electrode. Proof-of-Concept in Human Saliva
  • 2018
  • In: Sensors and Actuators B: Chemical. - : Elsevier BV. - 0925-4005. ; 256, s. 921-930
  • Journal article (peer-reviewed)abstract
    • This paper presents a new direct electron transfer based-miniaturized glucose/oxygen enzymatic fuel cell (EFC) whose operating ability has been tested in real saliva samples. The bioanode and biocathode are a graphene working electrode and a graphite counter electrode localized on the same screen printed electrode (SPE) modified with poly(vinyl alcohol) N-methyl-4(4'-formylstyryl)pyridinium methosulfate acetal (PVA-SbQ)/cellobiose dehydrogenase from Corynascus Thermophilus (CtCDH) C291Y/AuNPs and with Trametes Hirsuta laccase (ThLac)/AuNPs, respectively.In order to optimize the bioanode, several CDH immobilization procedures were adopted, such as drop-casting, use of Nafion membrane or PVA-SbQ photopolymer. The photopolymer showed the best performance in terms of stability and reliability. As biocathode a partially optimized laccase electrode was employed with the variant that the used nanomaterials allowed to reduce the overpotential of O2/H2O redox reaction catalyzed by Trametes Hirsuta Laccase (ThLac), drop-casted onto the gold nanoparticles (AuNPs) modified SPE.The performances of bioanode and biocathode were tested separately, initially immobilizing the two enzymes onto separated graphene SPEs. An efficient direct electron transfer was achieved for both elements, obtaining an apparent heterogeneous electron transfer rate constant (ks ) of 0.99±0.05s-1 for CtCDH C291Y and 5.60±0.05s-1 for ThLac. Both electrodes were then assembled in a two compartment EFC obtaining a maximal power output of 5.16±0.15μWcm-2 at a cell voltage of 0.58V and an open circuit voltage (OCV) of 0.74V. Successively, the bioanode and biocathode were assembled in a non-compartmentalized EFC and a remarkable 50% decrease of the maximum power output at the value of 2.15±0.12μWcm-2 at cell voltage of 0.48V and an OCV of 0.62V at pH 6.5 was registered. In order to reduce the cell dimensions in view of its possible integration in biomedical devices, the bioanode and biocaythode were realized by immobilization of both enzymes onto the same SPE. The so miniaturized EFC delivered a maximal power output of 1.57±0.07μWcm2 and 1.10±0.12μWcm-2 with an OCV of 0.58V and 0.41V in a 100μM glucose solution and in human saliva, respectively.
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10.
  • Braun, Barbara, et al. (author)
  • Therapie alkoholbezogener Störungen im Alter : Ergebnisse der deutschen Stichprobe der randomisiert-kontrollierten ELDERLY-Studie bis zum 12-Monats-Follow-up
  • 2019
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 65:2, s. 101-114
  • Journal article (peer-reviewed)abstract
    • Zielsetzung: Der demographische Wandel lässt eine höhere Anzahl älterer Personen mit Alkoholproblemen erwarten, deren therapeutische Versorgung bislang unzureichend ist. Mit der internationalen, randomisiert-kontrollierten ELDERLY-Studie wurden zwei Varianten einer ambulanten psychotherapeutischen Behandlung für Personen ab 60 Jahren mit einer Alkoholkonsumstörung nach DSM-5 (AS) in drei Ländern erprobt. Methodik: Nach der Baseline-Befragung wurden die zufällig zugeordneten Behandlungsgruppen nach 1, 3, 6 und 12 Monaten erneut untersucht. Erfasst wurden Veränderungen (Zeit und Gruppe) hinsichtlich Trinkmenge, Anzahl abstinenter Tage, Anzahl Tage Rauschtrinken und Tage risikoarmen Konsums sowie Anzahl zutreffender DSM-5-Kriterien für AS. Complete-Case- und Intention-to-treat-Analysen werden für die deutsche Teilstichprobe vorgestellt (n=203). Ergebnisse: Für beide Behandlungsgruppen ergaben sich stabil bis zu 12 Monate nach Baseline ein Anstieg der Abstinenzrate (18 %; t0: 4 %), des Anteils der Personen ohne einen Tag mit riskantem Konsum (45 %, t0: 4 %) sowie ohne Rauschtrinken (68 %, t0: 15 %). Auch zeigte sich eine Verringerung der Trinkmenge (Median bei 27 g Reinalkohol pro Trinktag; t0: 58 g) und Anzahl erfüllter AS-Kriterien (Median bei 2; t0: 5). Schlussfolgerungen:Die Verbesserungen des Trinkverhaltens und der AS-Symptome waren trotz relativ kurzer Behandlungsdauer stabil. Motivierende Interventionen, insbesondere die persönliche Rückmeldung zum Trinkverhalten, bewirken auch bei älteren Personen mit alkoholbezogenen Störungen Verhaltensänderungen. Ein therapeutischer Nihilismus ist unangebracht; vielmehr sollten spezifische Bedürfnisse der Zielgruppe beachtet und in passenden Versorgungsangeboten umgesetzt werden.
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11.
  • Buchholz, Angela, et al. (author)
  • Patient-Centered Placement Matching of Alcohol-Dependent Patients Based on a Standardized Intake Assessment : Primary Outcomes of an Exploratory Randomized Controlled Trial
  • 2020
  • In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 26:3, s. 109-121
  • Journal article (peer-reviewed)abstract
    • Background: Placement matching guidelines are promising means to optimize patient-centered care and to match patients' treatment needs. Despite considerable research regarding placement matching approaches to optimize alcohol abuse treatment, findings are inconclusive. Objectives: To investigate whether the use of patient-centered placement matching (PCPM) guidelines is more effective in reducing heavy drinking and costs 6 months after discharge from an inpatient alcohol withdrawal treatment compared to usual referral to aftercare. Secondary aims were to investigate whether age, gender, trial site or level of care (LOC) are moderators of efficacy and whether patients who were actually referred to the recommended LOC had better treatment outcomes compared to patients who were treated under- or overmatched. Methods: Design. Exploratory randomized controlled trial with measurements during withdrawal treatment and 6 months after initial assessment. Setting. Four German psychiatric clinics offering a 7-21 day inpatient qualified withdrawal program for patients suffering from alcohol dependence. Participants. From 1,927 patients who had a primary diagnosis of alcohol dependence and did not have organized aftercare when entering withdrawal treatment, 299 were invited to participate. Of those, 250 were randomized to the intervention group (IG, n = 123) or the control group (CG, n = 127). Intervention. The PCPM were applied to patients of the IG by feeding back a recommendation to a LOC for aftercare that was calculated from the Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff of the treatment unit. Patients of the CG received a general feedback regarding their MATE interview on request. Measurements. The MATE, the Client Socio-Demographic and Service Receipt Inventory--European Version and the MATE-Outcomes were administered. Data were analyzed using generalized linear models. Results: In the intention-to-treat analysis, there were no significant differences between IG and CG regarding days of heavy drinking (incident risk ratio [IRR] 1.09; p = 0.640), direct (IRR 1.06; p = 0.779), indirect (IRR 0.77; p = 0.392) and total costs (IRR 0.89; p = 0.496). Furthermore, none of the investigated moderator variables affected statistically significant drinking or cost-related primary outcomes. Regardless of group allocation, patients who received matched aftercare reported significantly fewer days of heavy drinking than undermatched patients (IRR 2.09; p = 0.004). For patients who were overmatched, direct costs were significantly higher (IRR 1.79; p = 0.024), but with no additional effects on alcohol consumption compared to matched patients. Conclusions: While the use of PCPM failed to affect the actual referral to aftercare, our findings suggest that treating patients on the recommended LOC may have the potential to reduce days of heavy drinking compared to undertreatment and costs compared to overtreatment.
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12.
  • Buchholz, Angela, et al. (author)
  • Patient-centered placement matching of alcohol-dependent patients based on a standardized intake assessment : process evaluation within an exploratory randomized controlled trial
  • 2022
  • In: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 22:1
  • Journal article (peer-reviewed)abstract
    • Background: In the implementation of placement matching guidelines, feasibility has been concerned in previous research. Objectives of this process evaluation were to investigate whether the patient-centered matching guidelines (PCPM) are consistently applied in referral decision-making from an inpatient qualified withdrawal program to a level of care in aftercare, which factors affect whether patients actually receive matched aftercare according to PCPM, and whether its use is feasible and accepted by clinic staff.Methods: The study was conducted as process evaluation within an exploratory randomized controlled trial in four German psychiatric clinics offering a 7-to-21 day qualified withdrawal program for patients suffering from alcohol dependence, and with measurements taken during detoxification treatment and six months after the initial assessment. PCPM were used with patients in the intervention group by feeding back to them a recommendation for a level of care in aftercare that had been calculated from Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff on the treatment unit. As measurements, The MATE, the Client Socio-Demographic and Service Receipt Inventory—European Version, a documentation form, the Control Preference Scale, and the Motivation for Treatment Scale were administered. A workshop for the staff at the participating trial sites was conducted after data collection was finished.Results: Among 250 patients participating in the study, 165 were interviewed at follow-up, and 125 had received aftercare. Although consistency in the application of PCPM was moderate to substantial within the qualified withdrawal program (Cohen’s kappa ≥ .41), it was fair from discharge to follow-up. In multifactorial multinomial regression, the number of foregoing substance abuse treatments predicted whether patients received more likely undermatched (Odds Ratio=1.27; p=.018) or overmatched (Odds Ratio=0.78; p=.054) treatment. While the implementation process during the study was evaluated critically by the staff, they stated a potential of quality assurance, more transparency and patient-centeredness in the use of PCPM.Conclusions: While the use of PCPM has the potential to enhance the quality of referral decision making within treatment, it may not be sufficient to determine referral decisions for aftercare.Trial Registration: German Clinical Trials Register DRKS00005035. Registered 03/06/2013.
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13.
  • Buchholz, Angela, et al. (author)
  • Placement matching of alcohol-dependent patients based on a standardized intake assessment : rationale and design of a randomized controlled trial
  • 2014
  • In: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 14, s. 286-
  • Journal article (peer-reviewed)abstract
    • Background: Despite considerable research on substance-abuse placement matching, evidence is still inconclusive. The aims of this exploratory trial are to evaluate (a) the effects of following matching guidelines on health-care costs and heavy drinking, and (b) factors affecting the implementation of matching guidelines in the treatment of alcohol-dependent patients. Methods: A total of 286 alcohol-dependent patients entering one of four participating detoxification units and having no arrangements for further treatment will be recruited. During the first week of treatment, all patients will be administered Measurements in the Addictions for Triage and Evaluation (MATE), European Quality of Life-Five Dimensions health status questionnaire (EQ-5D), and the Client Socio-Demographic and Service Receipt Inventory-European Version (CSSRI-EU). Patients who are randomly allocated to the intervention group will receive feedback regarding their assessment results, including clear recommendations for subsequent treatment. Patients of the control group will receive treatment as usual and, if requested, global feedback regarding their assessment results, but no recommendations for subsequent treatment. At discharge, treatment outcome and referral decisions will be recorded. Six months after discharge, patients will be administered MATE-Outcome, EQ-5D, and CSSRI-EU during a telephone interview. Discussion: This trial will provide evidence on the effects and costs of using placement-matching guidelines based on a standardized assessment with structured feedback in the treatment of alcohol-dependent patients. A process evaluation will be conducted to facilitate better understanding of the relationship between the use of guidelines, outcomes, and potential mediating variables.
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14.
  • Datta-Chaudhuri, Timir, et al. (author)
  • The Fourth Bioelectronic Medicine Summit "Technology Targeting Molecular Mechanisms" : current progress, challenges, and charting the future
  • 2021
  • In: Bioelectronic medicine. - : BioMed Central. - 2332-8886. ; 7:1
  • Journal article (other academic/artistic)abstract
    • There is a broad and growing interest in Bioelectronic Medicine, a dynamic field that continues to generate new approaches in disease treatment. The fourth bioelectronic medicine summit "Technology targeting molecular mechanisms" took place on September 23 and 24, 2020. This virtual meeting was hosted by the Feinstein Institutes for Medical Research, Northwell Health. The summit called international attention to Bioelectronic Medicine as a platform for new developments in science, technology, and healthcare. The meeting was an arena for exchanging new ideas and seeding potential collaborations involving teams in academia and industry. The summit provided a forum for leaders in the field to discuss current progress, challenges, and future developments in Bioelectronic Medicine. The main topics discussed at the summit are outlined here.
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15.
  • Demichev, Vadim, et al. (author)
  • A time-resolved proteomic and prognostic map of COVID-19
  • 2021
  • In: Cell Systems. - : Elsevier BV. - 2405-4712 .- 2405-4720. ; 12:8, s. 780-794.e7
  • Journal article (peer-reviewed)abstract
    • COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. We characterized the time-dependent progression of the disease in 139 COVID-19 inpatients by measuring 86 accredited diagnostic parameters, such as blood cell counts and enzyme activities, as well as untargeted plasma proteomes at 687 sampling points. We report an initial spike in a systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution, and immunomodulation. We identify prognostic marker signatures for devising risk-adapted treatment strategies and use machine learning to classify therapeutic needs. We show that the machine learning models based on the proteome are transferable to an independent cohort. Our study presents a map linking routinely used clinical diagnostic parameters to plasma proteomes and their dynamics in an infectious disease.
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17.
  • Fehlmann, Tobias, et al. (author)
  • Common diseases alter the physiological age-related blood microRNA profile
  • 2020
  • In: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1
  • Journal article (peer-reviewed)abstract
    • Aging is a key risk factor for chronic diseases of the elderly. MicroRNAs regulate post-transcriptional gene silencing through base-pair binding on their target mRNAs. We identified nonlinear changes in age-related microRNAs by analyzing whole blood from 1334 healthy individuals. We observed a larger influence of the age as compared to the sex and provide evidence for a shift to the 5’ mature form of miRNAs in healthy aging. The addition of 3059 diseased patients uncovered pan-disease and disease-specific alterations in aging profiles. Disease biomarker sets for all diseases were different between young and old patients. Computational deconvolution of whole-blood miRNAs into blood cell types suggests that cell intrinsic gene expression changes may impart greater significance than cell abundance changes to the whole blood miRNA profile. Altogether, these data provide a foundation for understanding the relationship between healthy aging and disease, and for the development of age-specific disease biomarkers.
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18.
  • Friedrichs, Anke, et al. (author)
  • Role preferences of patients with alcohol use disorders
  • 2018
  • In: Addictive Behaviours. - : Elsevier BV. - 0306-4603 .- 1873-6327. ; 84, s. 248-254
  • Journal article (peer-reviewed)abstract
    • AimsShared decision making (SDM) is increasingly demanded in medical decision making. SDM acknowledges patients' role preferences in decision making processes. There has been limited research on SDM and role preferences in substance use disorders; results are promising. Aim of this study was to investigate role preferences of patients with alcohol use disorders (AUD), and to identify predictors of these preferences.MethodCross-sectional data collected from June 2013 to May 2014 in four detoxification wards in Germany during a randomised controlled trial (RCT, Registration Code O1GY1114) was analysed. Of the 250 patients with AUD who were included in the RCT, data from 242 patients [65% male; mean age = 45.2 years (sd = 10.3)] were analysed. Participants' role preferences were assessed with the Control Preference Scale. Potential correlates were drawn from instruments used in the RCT; multinomial logistic regression was used.Results90% (n = 217) of the AUD patients preferred an active or shared role in decision-making, 10% (n = 25) preferred a passive role. Patients' desire for help was associated with their role preference (OR = 3.087, p = .05). The model's goodness of fit was Nagelkerke's R-2 = 0.153 [chi(2) (24) = 25.206, p = .395].ConclusionsPatients' preference for an active role in decision-making underscores the importance of involving patients in their treatment planning. Patients' desire for help seems to be an important determinant of paternalistic decision making. However, further research is needed to determine whether patients' role preferences are related to their behavior during their treatment referral and recovery.
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19.
  • Gomes de Matos, Elena, et al. (author)
  • Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use
  • 2017
  • In: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 36:6, s. 797-804
  • Journal article (peer-reviewed)abstract
    • Introduction and Aims. This study estimates cross-country variation in socioeconomic disparities in adolescent alcohol use and identifies country-level characteristics associated with these disparities. Design and Methods. The association between socioeconomic status (family wealth and parental education) and alcohol use (lifetime use and episodic heavy drinking) of 15- to 16-year-olds from 32 European countries was investigated. Country-level characteristics were national income, income inequality and per capita alcohol consumption. Multilevel modelling was applied. Results. Across countries, lifetime use was lower in wealthy than in less wealthy families (odds ratio [OR]((girls))=0.95, OR(boys)=0.94). The risk of episodic heavy drinking, in contrast, was higher for children from wealthier families (OR(girls)=1.04, OR(boys)=1.08) and lower when parents were highly educated (ORs=0.95-0.98). Socioeconomic disparities varied substantially between countries. National wealth and income inequality were associated with cross-country variation of disparities in lifetime use in few comparisons, such that among girls, the (negative) effect of family wealth was greatest in countries with unequally distributed income (OR=0.86). Among boys, the (negative) effect of family wealth was greatest in low-income countries (OR=1.00), and the (positive) effect of mothers' education was greatest in countries with high income inequality (OR=1.11). Discussion and Conclusions. Socioeconomic disparities in adolescent alcohol use vary across European countries. Broad country-level indicators can explain this variation only to a limited extent, but results point towards slightly greater socioeconomic disparities in drinking in countries of low national income and countries with a high income inequality. [Gomes de Matos E, Kraus L, Hannemann T-V, Soellner R, Piontek D. Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use.
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20.
  • Gomes de Matos, Elena, et al. (author)
  • Does a Change Over All Equal a Change in All? Testing for Polarized Alcohol Use Within and Across Socio-Economic Groups in Germany
  • 2015
  • In: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 50:6, s. 700-707
  • Journal article (peer-reviewed)abstract
    • This study aimed at testing whether drinking volume and episodic heavy drinking (EHD) frequency in Germany are polarizing between consumption levels over time. Polarization is defined as a reduction in alcohol use among the majority of the population, while a subpopulation with a high intake level maintains or increases its drinking or its EHD frequency. The polarization hypothesis was tested across and within socio-economic subgroups. Analyses were based on seven cross-sectional waves of the Epidemiological Survey of Substance Abuse (ESA) conducted between 1995 and 2012 (n = 7833-9084). Overall polarization was estimated based on regression models with time by consumption level interactions; the three-way interaction with socio-economic status (SES) was consecutively introduced to test the stability of effects over socio-economic strata. Interactions were interpreted by graphical inspection. For both alcohol use indicators, declines over time were largest in the highest consumption level. This was found within all SES groups, but was most pronounced at low and least pronounced at medium SES. The results indicate no polarization but convergence between consumption levels. Socio-economic status groups differ in the magnitude of convergence which was lowest in medium SES. The overall decline was strongest for the highest consumption level of low SES.
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21.
  • Gomes de Matos, Elena, et al. (author)
  • Problembewusstsein und Inanspruchnahme von Hilfe bei substanzbezogenen Problemen
  • 2013
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 59:6, s. 355-366
  • Journal article (peer-reviewed)abstract
    • Aims: It was aimed to estimate 12-months prevalences of i) perception of substance-related problems among alcohol, illicit drugs and prescription drug users; ii) use of several formal and informal sources of care by individuals perceiving substance-related problems; and iii) use of professional help among individuals with a substance use disorder. Factors associated with help-seeking were assessed. Methods: Data come from the 2012 Epidemiological Survey of Substance Abuse (ESA; n = 9084; 18 to 64 years; response rate 53.6 %). DSM-IV diagnoses were assessed using the M-CIDI. Regression analyses were used to assess predictors of help-seeking. Results: Between 6 % (alcohol) and 19 % (illicit drugs) of substance users reported having experienced substance related problems. Of those, 14 % (alcohol), 33 % (illicit drugs) and 59 % (prescription drugs) sought help. With the exception of income, socio-demographic variables were not associated with help-seeking. Conclusions: Results show a clear under-treatment in individuals with substance related problems. Help-seeking seems to be mainly influenced by the severity of the substance-related disorder.
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22.
  • Gomes de Matos, Elena, et al. (author)
  • Substanzkonsum in der Allgemeinbevölkerung in Deutschland. Ergebnisse des Epidemiologischen Suchtsurveys 2015
  • 2016
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 62:5, s. 271-281
  • Journal article (peer-reviewed)abstract
    • Ziel: Die Verbreitung des Substanzkonsums in der erwachsenen Allgemeinbevölkerung Deutschlands soll anhand aktueller Daten dargestellt werden. Methodik: Datengrundlage bildete der Epidemiologische Suchtsurvey 2015, eine bundesweite Befragung in der Wohnbevölkerung von 18 bis 64 Jahren (n = 9,204; Rücklaufquote: 52.2 %). Probanden wurden zum Gebrauch von Tabak, Alkohol, illegalen Drogen und Medikamenten befragt. Ergebnisse: In den letzten 30 Tagen hatten 28.7 % der Befragten Tabakprodukte genutzt. Den Konsum von Alkohol in diesem Zeitraum berichteten 72.8 %. Hinweise auf klinisch relevanten Konsum in den letzten 12 Monaten wiesen 28.3 % (Männer) bzw. 9.6 % (Frauen) auf. Die 12-Monats-Prävalenz illegaler Drogen lag bei 6.1 % für Cannabis und bei maximal 1 % für alle anderen Substanzen. Unter Medikamenten hatten Schmerzmittel die höchste Gebrauchsprävalenz (47.1 %) sowie die geringste Prävalenz täglichen Gebrauchs unter Nutzern (8.6 %). Schlussfolgerungen: Die Ergebnisse belegen die nach wie vor hohe Verbreitung des Substanzkonsums in der Allgemeinbevölkerung. Konsumprävalenz sowie Hinweise auf klinisch relevanten Konsum sind in Bezug auf legale Substanzen, die eine hohe Verfügbarkeit charakterisiert, am häufigsten. Hinweise auf klinisch relevanten Konsum illegaler Drogen bestanden bei deutlich weniger Personen. Da es sich dabei jedoch um eine besondere Risikogruppe handelt, ist deren Erreichung durch adäquate Angebote sicherzustellen.
  •  
23.
  • Gomes de Matos, Elena, et al. (author)
  • The Consumption of New Psychoactive Substances and Methamphetamine Analysis of Data From 6 German Federal States
  • 2018
  • In: Deutsches Ärzteblatt International. - : Deutscher Arzte-Verlag GmbH. - 1866-0452. ; 115:4, s. 49-55
  • Journal article (peer-reviewed)abstract
    • Background: The abuse of new psychoactive substances (NPS) and methamphet amine has severe adverse effects. Here we provide the first report of regional patterns in NPS and methamphetamine consumption in Germany, on the basis of epidemiologic data from six federal states (Bavaria, Hamburg, Hesse, North Rhine-Westphalia, Saxony, and Thuringia).Methods: Data were derived from the 2015 Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey) and supplemented with additional cases from the federal states that were studied. The numbers of persons included in the representative samples of persons aged 18 to 64 in each state were 1916 (Bavaria), 1125 (Hamburg), 1151 (Hesse), 2008 (North Rhine-Westphalia), 1897 (Saxony), and 1543 (Thuringia). Potential risk factors for the lifetime prevalence of consumption were studied by logistic regression.Results: The lifetime prevalence of methamphetamine consumption in the individual states ranged from 0.3% (North Rhine-Westphalia) to 2.0% (Saxony). Thuringia and Saxony displayed values that were significantly higher than average. For NPS, the figures ranged from 2.2% (Bavaria) to 3.9% (Hamburg), but multivariate analysis revealed no statistically significant differences between the states. Higher age and higher educational level were associated with lower consumption of NPS and methamphetamine, while smoking and cannabis use were each associated with higher consumption.Conclusion: NPS consumption is equally widespread in all of the federal states studied. Methamphetamine is rarely consumed; its consumption appears to be higher in Saxony and Thuringia. The risk factor analysis reported here should be interpreted cautiously in view of the low case numbers with respect to consumption.
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24.
  • Gomes de Matos, Elena, et al. (author)
  • Trends im Substanzkonsum Jugendlicher : gibt es regionale Unterschiede?
  • 2014
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 60:3, s. 163-172
  • Journal article (peer-reviewed)abstract
    • Fragestellung: Es wurde untersucht, ob auf Bundeslandebene Unterschiede im Alkohol-, Tabak- und Cannabiskonsum Jugendlicher und seiner Zeitverläufe bestehen. Methodik: Daten von 23.997 Jugendlichen aus drei Erhebungswellen (2003; 2007; 2011) der Europäischen Schülerstudie zu Alkohol und anderen Drogen (ESPAD) der 9. und 10. Klasse aus fünf Bundesländern (Bayern, Berlin, Brandenburg, Mecklenburg-Vorpommern, Thüringen) wurden deskriptiv und regressionsanalytisch ausgewertet. Ergebnisse: Länderübergreifend zeigen sich für alle drei Substanzen sinkende Konsumwerte über die Zeit. Für den Cannabiskonsum ist dieser Trend nur bis 2007 zu beobachten. Berlin weist den geringsten Alkohol- und höchsten Cannabiskonsum auf. Der Tabakkonsum ist in Brandenburg und Mecklenburg-Vorpommern am höchsten und zeigt den stärksten Rückgang in Thüringen. Schlussfolgerungen: Trotz einiger Unterschiede in den Konsumprofilen der Bundesländer sind die Trends sehr homogen. Insgesamt betrachtet sind die beobachteten Konsumparameter, die sich im europäischen Vergleich auf hohem bis mittlerem Niveau befinden, rückläufig.
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25.
  • Gross, Cornelius, et al. (author)
  • Long-term outcomes after adolescent in-patient treatment due to alcohol intoxication : A control group study
  • 2016
  • In: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 162, s. 116-123
  • Journal article (peer-reviewed)abstract
    • Background: The long-term psychosocial development of adolescents admitted to in-patient treatment with alcohol intoxication (AIA) is largely unknown. Methods: We invited all 1603 AIAs and 641 age- and sex-matched controls, who had been hospitalized in one of five pediatric departments between 2000 and 2007, to participate in a telephone interview. 277 cases of AIA and 116 controls (mean age 24.2 years (SD 2.2); 46% female) could be studied 5-13 years (mean 8.3, SD 2.3) after the event. The control group consisted of subjects who were admitted due to conditions other than alcohol intoxication. Blood alcohol concentration on admission was systematically measured in the AIA but, owing to the retrospective study design, not in the control group. Subtle alcohol intoxication could therefore not be entirely ruled out in the control group. Long-term outcome measures included current DSM-5 alcohol use disorders (AUD), drinking patterns, illicit substance use, regular smoking, general life satisfaction, use of mental health treatment, and delinquency. Results: AIA had a significantly elevated risk to engage in problematic habitual alcohol use, to exhibit delinquent behaviors, and to use illicit substances in young adulthood compared to the control group. Severe AUD also occurred considerably more often in the AIA than the control group. Conclusions: In the majority of AIAs, further development until their mid-twenties appears to be unremarkable. However, their risk to develop severe AUD and other problematic outcomes is significantly increased. This finding calls for a diagnostic instrument distinguishing between high- and low-risk AIAs already in the emergency room.
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26.
  • Groß, Cornelius, et al. (author)
  • Prediction of long-term outcomes in young adults with a history of adolescent alcohol-related hospitalization
  • 2016
  • In: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 51:1, s. 47-53
  • Journal article (peer-reviewed)abstract
    • Aims: Empirical data concerning the long-term psychosocial development of adolescents admitted to inpatient treatment with alcohol intoxication (AIA) are lacking. The aim of this study was to identify the factors that, at the time of admission, predict future substance use, alcohol use disorders (AUD), mental health treatment, delinquency and life satisfaction.Methods: We identified 1603 cases of AIA treated between 2000 and 2007 in one of five pediatric departments in Germany. These former patients were invited to participate in a telephone interview. Medical records were retrospectively analyzed extracting potential variables predicting long-term outcomes.Results: Interviews were conducted with 277 individuals, 5–13 [mean 8.3 (SD 2.3)] years after treatment, with a response rate of 22.7%; of these, 44.8% were female. Mean age at the interview was 24.4 (SD 2.2) years. Logistic and linear regression models revealed that being male, using illicit substances and truancy or runaway behavior in adolescence predicted binge drinking, alcohol dependence, use of illicit substances and poor general life satisfaction in young adulthood, explaining between 13 and 24% of the variance for the different outcome variables.Conclusions: This naturalistic study confirms that known risk factors for the development of AUD also apply to AIA. This finding facilitates targeted prevention efforts for those cases of AIA who need more than the standard brief intervention for aftercare.
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27.
  • Grüne, Bettina, et al. (author)
  • Acute alcohol intoxication among adolescents - the role of the context of drinking
  • 2017
  • In: European Journal of Pediatrics. - : Springer Science and Business Media LLC. - 0340-6199 .- 1432-1076. ; 176:1, s. 31-39
  • Journal article (peer-reviewed)abstract
    • This study aims (1) to describe the context of drinking among adolescents with acute alcohol intoxication (AAI) by gender, (2) to explore temporal changes in the context of drinking and (3) to analyse the association between the context of drinking and blood alcohol concentration (BAC). A retrospective chart review of 12- to 17-year-old inpatients with AAI (n = 1441) of the years 2000 to 2006 has been conducted in five participating hospitals in Germany. Gender differences in the context of drinking were tested with t test and chi2 test. Differences over time were analysed using logistic regressions. Multivariate linear regression was used to predict BAC. Girls and boys differed in admission time, drinking situation, drinking occasion and admission context. No temporal changes in drinking situation and in admission to hospital from public locations or places were found. Higher BAC coincided with male gender and age. Moreover, BAC was higher among patients admitted to hospital from public places and lower among patients who drank for coping.Conclusion: The results suggest gender differences in the context of drinking. The context of drinking needs to be considered in the development and implementation of target group-specific prevention and intervention measures.
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28.
  • Grüne, Bettina, et al. (author)
  • Drinking Location and Drinking Culture and Their Association With Alcohol Use Among Girls and Boys in Europe
  • 2017
  • In: Journal of Studies on Alcohol and Drugs. - : Alcohol Research Documentation, Inc.. - 1937-1888 .- 1938-4114. ; 78:4, s. 549-557
  • Journal article (peer-reviewed)abstract
    • Objective: This study aimed to (a) investigate the relationship between drinking location and adolescent alcohol use, (b) analyze the association of drinking culture indicators with alcohol use, and (c) explore interaction effects of drinking location and drinking culture indicators. Method: Analyses were based on the 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD). The analytical sample consisted of 15-to 16-year-old students (N = 36,366; 51.6% female) from 11 countries. Alcohol volume and perceived drunkenness were used as outcomes. Drinking location was used as predictor variable. Per capita consumption and restrictions on public drinking were used as country-level predictors. Sex-stratified generalized linear models with cluster robust standard errors were applied. Results: Compared with drinking outdoors, the reported alcohol volume was lower when drinking at home and higher when drinking in multiple locations or at someone else's home. Drunkenness was highest among boys drinking at someone else's home and, compared with drinking outdoors, lower among girls drinking on premise. Per capita consumption was positively associated with alcohol volume. Among girls, the association between per capita consumption and both outcomes was stronger when drinking in multiple locations than when drinking outdoors. A ban on public drinking showed a negative effect on drinking volume and drunkenness among girls. Conclusions: The role of different drinking locations in alcohol use as well as sex differences should be considered in prevention and intervention of adolescent heavy drinking. Setting-specific prevention and intervention measures are of greater importance in medium-or high-consumption societies.
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29.
  • Gyepesi, Aron, et al. (author)
  • Psychometric Properties of the Cannabis Abuse Screening Test in Hungarian Samples of Adolescents and Young Adults
  • 2014
  • In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 20:3, s. 119-128
  • Journal article (peer-reviewed)abstract
    • Aim: The aim of our study was to analyze psychometric properties of the Cannabis Abuse Screening Test (CAST). Methods: Our sample comprised Hungarian high school (n = 476; male 56.3%; mean age 19.0 years, SD = 0.65 years) and college students (n = 439; male 65.1%; mean age 23.9 years, SD = 1.56 years) who reported cannabis use in the past year. The sample covered the five biggest universities of Hungary. Besides the CAST, participants responded to the Munich-Composite International Diagnostic Interview. Factor structure was analyzed by a confirmatory factor analysis. Receiver operating characteristic curve analysis was made to assess cut-off scores. Data collection took place in 2010. Results: CAST proved to be a reliable (Cronbach's alpha 0.71 and 0.76) one-dimensional measure. Regarding both cannabis dependence and cannabis use disorders, a cut-off of 2 points proved to be ideal in both samples, resulting in optimal specificity, negative predictive values and accuracy, but less than optimal positive predictive values (dependence) and low sensitivity (cannabis use disorder). Discussion and Conclusions: In line with former results, the CAST proved to be an adequate measure for the screening of cannabis-related problems among adolescents and young adults in an Eastern European country where this scale has not been studied before. (C) 2013 S. Karger AG, Basel
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30.
  • Hannemann, Tessa-Virginia, et al. (author)
  • Consumption Patterns of Nightlife Attendees in Munich : A Latent-Class Analysis
  • 2017
  • In: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 52:11, s. 1511-1521
  • Journal article (peer-reviewed)abstract
    • Background: The affinity for substance use among patrons of nightclubs has been well established. With novel psychoactive substances (NPS) quickly emerging on the European drug market, trends, and patterns of use are potentially changing. Objectives: (1) The detection of subgroups of consumers in the electronic dance music scene of a major German metropolitan city, (2) describing the consumption patterns of these subgroups, (3) exploring the prevalence and type of NPS consumption in this population at nightlife events in Munich. Methods: A total of 1571 patrons answered questions regarding their own substance use and the emergence of NPS as well as their experience with these substances. A latent class analysis was employed to detect consumption patterns within the sample. Results: A four class model was determined reflecting different consumption patterns: the conservative class (34.9%) whose substance was limited to cannabis; the traditional class (36.6%) which especially consumed traditional club drugs; the psychedelic class (17.5%) which, in addition to traditional club drugs also consumed psychedelic drugs; and an unselective class (10.9%) which displayed the greatest likelihood of consumption of all assessed drugs. Smoking mixtures and methylone were the new substances mentioned most often, the number of substances mentioned differed between latent classes. Conclusion: Specific strategies are needed to reduce harm in those displaying the riskiest substance use. Although NPS use is still a fringe phenomenon its prevalence is greater in this subpopulation than in the general population, especially among users in the high-risk unselective class.
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31.
  • Klionsky, Daniel J., et al. (author)
  • Guidelines for the use and interpretation of assays for monitoring autophagy
  • 2012
  • In: Autophagy. - : Informa UK Limited. - 1554-8635 .- 1554-8627. ; 8:4, s. 445-544
  • Research review (peer-reviewed)abstract
    • In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field.
  •  
32.
  • Kraus, Ludwig, et al. (author)
  • Age, Period and Cohort Effects on Time Trends in Alcohol Consumption in the Swedish Adult Population 1979-2011
  • 2015
  • In: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 50:3, s. 319-327
  • Journal article (peer-reviewed)abstract
    • Aims: In Sweden, alcohol abstention has increased over the last 20 years and consumption has recently decreased after a peak in 2004. To understand the dynamics of these trends the present study aims at estimating age, period and cohort (APC) effects on trends in alcohol use prevalence as well as overall and beverage-specific volume of drinking over the last three decades. Methods: APC analysis of seven cross-sectional surveys from 1979 to 2011 was conducted using cross-classified random effects models (CCREMs) by gender. The nationally representative samples comprised 77,598 respondents aged 16-80 years. Outcome measures were 30-day prevalence of alcohol use and overall as well as beverage-specific alcohol volume. Results: Trends in prevalence, overall and beverage-specific volume were significantly affected by APC. The period effects of prevalence and overall volume showa small decline after an increase up to the year 2005. Mean beer and wine volume levelled off after a peak in 2005 and volume of spirits drinking decreased constantly. Predicted alcohol prevalence rates in male cohorts (1945-1985) remained generally at the same level, while they declined in post-World War II female generations. Results point to high overall and beverage-specific consumption among cohorts born in the 1940s, 1950s and 1980s. Conclusions: High consuming cohorts of the 1940-1950s were key in rising consumption up to 2005. Progression through the life course of these cohorts, a decrease in prevalence and drinking volume in successive cohorts seem to have contributed to the recent downward trend in alcohol use in Sweden.
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33.
  • Kraus, Ludwig, et al. (author)
  • 'Are The Times A-Changin'? Trends in adolescent substance use in Europe
  • 2018
  • In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 113:7, s. 1317-1332
  • Journal article (peer-reviewed)abstract
    • Aims To estimate temporal trends in adolescents' current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence. Design and Setting Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions [northern (NE), southern (SE), western (WE), eastern Europe (EE) and the Balkans (BK)]. Participants A total of 223 814 male and 211 712 female 15-16-year-old students. Measurements Daily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED) and monthly cannabis use. Linear and quadratic trends were tested using multi-level mixed-effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion. Findings Daily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally somewhat stable over time. Conclusions Despite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities, with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.
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34.
  • Kraus, Ludwig, et al. (author)
  • Changes in mortality due to major alcohol-related diseases in four Nordic countries, France and Germany between 1980 and 2009 : a comparative age-period-cohort analysis
  • 2015
  • In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 110:9, s. 1443-1452
  • Journal article (peer-reviewed)abstract
    • Aims: To investigate age, period and cohort effects on time trends of alcohol-related mortality in countries with different drinking habits and alcohol policies.Design and setting: Age-period-cohort (APC) analyses on alcohol-related mortality were conducted in Denmark, Finland, Norway, Sweden, France and Germany.Participants: Cases included alcohol-related deaths in the age range 20-84 years between 1980 and 2009.Measurements: Mortality data were taken from national causes of death registries and covered the ICD codes alcoholic psychosis, alcohol use disorders, alcoholic liver disease and toxic effect of alcohol.Findings: In all countries changes across age, period and cohort were found to be significant for both genders [effect value with confidence interval (CI) shown in Supporting information, Table S1]. Period effects pointed to an increase in alcohol-related mortality in Denmark, Finland and Germany and a slightly decreasing trend in Sweden, while in Norway an inverse U-shaped curve and in France a U-shaped curve was found. Compared with the cohorts born before 1960, the risk of alcohol-related mortality declined substantially in cohorts born in the 1960s and later. Pairwise between-country comparisons revealed more statistically significant differences for period (P<0.001 for all 15 comparisons by gender) than for age [P<0.001 in seven (men) and four (women) of 15 comparisons] or cohort [P<0.01 in two (men) and three (women) of 15 comparisons].Conclusions: Strong period effects suggest that temporal changes in alcohol-related mortality in Denmark, Finland, Norway, Sweden, France and Germany between 1980 and 2009 were related to secular differences affecting the whole population and that these effects differed across countries.
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35.
  • Kraus, Ludwig, et al. (author)
  • Effects of community-based prevention on alcohol consumption in adolescents
  • 2013
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 59:5, s. 269-277
  • Journal article (peer-reviewed)abstract
    • Aims: The present paper aims at evaluating the effectiveness of the community-based substance use prevention program “Wegschauen ist keine Lösung”. Methods: Communities of the district of Karlsruhe were divided into a group with high (HIG) and low (LIG) program implementation fidelity. In 2011, a school survey was conducted among 892 adolescents in grades 9 and 10 of regular schools in the district of Karlsruhe. The Bavarian sample of the 2011 European School Survey Project on Alcohol and other Drugs (ESPAD) was used as external comparison group (n=1635). Results: Only few differences were found between HIG and LIG with regard to alcohol consumption and negative consequences. Compared to the external ESPAD comparison group, students in Karlsruhe showed lower 30-day prevalence of alcohol use (66.0 vs. 80.5 %), lower consumption quantity (17.17 vs. 34.91 grams of ethanol per drinking day) and lower frequency of use (0.75 vs. 1.21 days within the last week). Conclusions: Considering restrictions of the limited study design there are indications of possible positive effects of the project “Wegschauen ist keine Lösung”. However, for methodological sound evaluations of community-based prevention programs pre-post studies with clearly defined control conditions are needed.
  •  
36.
  • Kraus, Ludwig, et al. (author)
  • Estimating high‐risk cannabis and opiate use in Ankara, Istanbul and Izmir
  • 2017
  • In: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 36:5, s. 626-632
  • Journal article (peer-reviewed)abstract
    • Introduction and Aims. Information on high-risk drug use in Turkey, particularly at the regional level, is lacking. The present analysis aims at estimating high-risk cannabis use (HRCU) and high-risk opiate use (HROU) in the cities of Ankara, Istanbul and Izmir. Design and Methods. Capture–recapture and multiplier methods were applied based on treatment and police data stratified by age and gender in the years 2009 and 2010. Case definitions refer to ICD-10 cannabis (F.12) and opiate (F.11) disorder diagnoses from outpatient and inpatient treatment records and illegal possession of these drugs as recorded by the police. Results. High-risk cannabis use was estimated at 28 500 (8.5 per 1000; 95% confidence interval 7.3–10.3) and 33 400 (11.9 per 1000; 95% confidence interval 10.7–13.5) in Ankara and Izmir, respectively. Using multipliers based on capture–recapture estimates for Izmir, HRCU in Istanbul was estimated up to 166 000 (18.0 per 1000; range: 2.8–18.0). Capture–recapture estimates of HROU resulted in 4800 (1.4 per 1000; 95% confidence interval 0.9–1.9) in Ankara and multipliers based on these gave estimates up to 20 000 (2.2 per 1000; range: 0.9-2.2) in Istanbul. HROU in Izmir was not estimated due to the low absolute numbers of opiate users. Discussion and Conclusions. While HRCU prevalence in both Ankara and Izmir was considerably lower in comparison to an estimate for Berlin, the rate for Istanbul was only slightly lower. Compared with the majority of European cities, HROU in these three Turkish cities may be considered rather low. [Kraus L, Hay G, Richardson C, Yargic I, Ilhan N M, Ay P, Karasahin F, Pinarci M, Tuncoglu T, Piontek D, Schulte B Estimating high-risk cannabis and opiate use in Ankara, Istanbul and Izmir Drug Alcohol Rev 2016;00:000-000]
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37.
  • Kraus, Ludwig, et al. (author)
  • Inanspruchnahme gesundheitlicher Versorgung durch Alkoholabhängige [Health care utilization of perople with alcohol dependence]
  • 2015
  • In: Suchttherapie. - : Georg Thieme Verlag KG. - 1439-9903 .- 1439-989X. ; 16:1, s. 18-26
  • Journal article (peer-reviewed)abstract
    • Aims: The study aims at estimating health care utilization of alcohol dependents. Estimates will be provided for the number of people with dependence in the general population, the number of people that have received the diagnosis "dependence" by a general practitioner, and number of people treated in addiction care. Methods: Estimates are based on the most recent data on health care utilization. The estimation methods are described in detail. Results: In Germany, the prevalence of alcohol dependence in the general population aged 18 years and above is estimated at 2.8 % or 1.86 million individuals in 2012. Approximately 649 000 individuals were diagnosed as, alcohol dependent" by a general practitioner indicating that about one third of the people with dependence (35.0%) were registered in the health care system (2009 data). In the same year approximately 297 000 individuals with alcohol dependence (16 %) were utilizing specialized addiction services (in-or outpatient treatment, general hospital). The rate of addicts in rehabilitation treatment was estimated at 1.8%. Conclusions: For reducing the burden of morbidity and mortality associated with alcohol dependence considerable improvements in health care utilization by addicts are required. Utilization may be increased by improving excess to early intervention, diversification of treatment offers and challenging the paradigm of abstinence-oriented treatment.
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38.
  •  
39.
  • Kraus, Ludwig, et al. (author)
  • Studiendesign und Methodik des Epidemiologischen Suchtsurveys 2012
  • 2013
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 59:6, s. 309-320
  • Journal article (peer-reviewed)abstract
    • Aims: The paper gives an overview on design and sample selection, measures, realization and analyses of the 2012 Epidemiological Survey of Substance Abuse (ESA). Methods: A disproportional sample was drawn from population registers using a two-stage probability design oversampling younger birth cohorts. Different modes of administration were used (paper-and-pencil questionnaire, telephone interview, online questionnaire). Results: A total of 9 084 individuals aged 18 to 64 years participated in the survey (response rate 53.6 %). The redressement weight had an effectiveness of 67.6 %. Non-responders showed a lower prevalence of alcohol and cannabis use, but a higher prevalence of episodic heavy drinking and hypnotics use as well as a higher tobacco use quantity. Respondents in the telephone and internet mode had a lower rate of substance use than those in the paper-and-pencil mode. Conclusions: Contrary to the general trend of decreasing response rates, the ESA achieves increasing response rates over the past years due to the application of a mixed mode design. Selectivity effects are possible because of the exclusion of specific population subgroups and non-response effects.
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40.
  • Kraus, Ludwig, et al. (author)
  • Temporal Changes in Alcohol-Related Morbidity and Mortality in Germany
  • 2015
  • In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 21:5, s. 262-272
  • Journal article (peer-reviewed)abstract
    • Aims: Trends in morbidity and mortality, fully or partially attributable to alcohol, for adults aged 18-64 were assessed for Germany. Methods: The underestimation of population exposure was corrected by triangulating survey data with per capita consumption. Alcohol-attributable fractions by sex and two age groups were estimated for major disease categories causally linked to alcohol. Absolute numbers, population rates and proportions relative to all hospitalizations and deaths were calculated. Results: Trends of 100% alcohol-attributable morbidity and mortality over thirteen and eighteen years, respectively, show an increase in rates of hospitalizations and a decrease in mortality rates. Comparisons of alcohol-attributable morbidity including diseases partially caused by alcohol revealed an increase in hospitalization rates between 2006 and 2012. The proportion of alcohol-attributable hospitalizations remained constant. Rates of alcohol-attributable mortality and the proportion among all deaths decreased. Conclusions: The increasing trend in mortality due to alcohol until the mid-1990s has reversed. The constant proportion of all hospitalizations that were attributable to alcohol indicates that factors such as improved treatment and easier health care access may have influenced the general increase in all-cause morbidity. To further reduce alcohol-related mortality, efforts in reducing consumption and increasing treatment utilization are needed.
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41.
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42.
  • Kraus, Ludwig, et al. (author)
  • Zeitliche Entwicklungen im Substanzkonsum in der deutschen Allgemeinbevölkerung : Ein Rückblick auf zwei Dekaden
  • 2016
  • In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 62:5, s. 283-294
  • Journal article (peer-reviewed)abstract
    • Ziel: Ziel der Studie ist die Analyse von Trends des (klinisch relevanten) Konsums von Tabak, Alkohol, Cannabis und anderen illegalen Drogen sowie der Einnahme von Medikamenten zwischen 1995 und 2015. Methodik: Datengrundlage bilden acht Erhebungswellen des Epidemiologischen Suchtsurveys (ESA) aus den Jahren 1995 bis 2015. Die Befragungen erfolgten schriftlich, telefonisch oder online. Eine einheitliche Darstellung zeitlicher Trends ist für den Altersbereich 18 bis 59 Jahre möglich. Ergebnisse: Der Tabakkonsum hat in den letzten 20 Jahren abgenommen. Trenddaten des Alkoholkonsums zeigen sinkende Konsumwerte für Männer und stabile Werte für Frauen. Die Prävalenz des Rauschtrinkens ist bei Frauen seit dem Jahr 2009 angestiegen. Der Cannabiskonsum hat zwischen 2012 und 2015 bei beiden Geschlechtern zugenommen. Der wöchentliche Gebrauch von Schmerzmitteln ist angestiegen, während bei Schlaf-/Beruhigungsmitteln ein Rückgang zu verzeichnen ist. Indikatoren eines klinisch relevanten Konsums zeigen für Cannabis keine Änderungen, für Tabak einen Rückgang und für Medikamente einen Anstieg. Hinweise auf klinisch relevanten Alkoholkonsum sind bei Männern konstant geblieben und bei Frauen angestiegen. Schlussfolgerungen: Die weite Verbreitung insbesondere der legalen Substanzen legt einen dringenden Handlungsbedarf für Prävention und Intervention nahe. Als besondere Zielgruppe wurden Frauen identifiziert, bei denen der klinisch relevante Konsum von Alkohol und Medikamenten zugenommen hat.
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43.
  • Legleye, Stephane, et al. (author)
  • A validation of the Cannabis Abuse Screening Test (CAST) using a latent class analysis of the DSM-IV among adolescents
  • 2013
  • In: International Journal of Methods in Psychiatric Research. - : Wiley. - 1049-8931 .- 1557-0657. ; 22:1, s. 16-26
  • Journal article (peer-reviewed)abstract
    • This paper explored the latent class structure of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (assessed with the Munich Composite International Diagnostic Interview). Secondly, the screening properties of the Cannabis Abuse Screening Test (CAST) in adolescents were assessed with classical test theory using the latent class structure as empirical gold standard. The sample comprised 3266 French cannabis users aged 17 to 19 from the general population. Three latent classes of cannabis users were identified reflecting a continuum of problem severity: non-symptomatic, moderate and severe. Gender-specific analyses showed the best model fit, although results were almost identical in the total sample. The latent classes were good predictors of daily cannabis use, number of joints per day and age of first experimentation. The CAST showed good screening properties for the moderate/severe class (area under receiver operating characteristic curve>0.85) and very good for the severe class (0.90). It was more sensitive for boys, more specific for girls. Although structural equivalence across gender was rejected, results suggest small gender differences in the latent structure of the DSM-IV. The performance of the CAST in screening for the latent class structure was good and superior to those obtained with the classical DSM-IV diagnoses.
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44.
  • Legleye, Stephane, et al. (author)
  • Is there a cannabis epidemic model? Evidence from France, Germany and USA
  • 2014
  • In: International Journal of Drug Policy. - : Elsevier BV. - 0955-3959. ; 25:6, s. 1103-1112
  • Journal article (peer-reviewed)abstract
    • Background: Cannabis is the most popular illicit drug in the world, but the process of its diffusion throughthe population has rarely been studied. The unfolding of the tobacco epidemic was accompanied by ashift in the educational gradient of users across generations. As a consequence, cannabis may show thesame pattern of widening social inequalities. We test the diffusion hypotheses that a positive value inolder cohorts – the more educated experimenting more – shifts to a negative one in younger cohorts –the more educated experimenting less, first for males and then females. Methods: Three nationwide subsamples (18–64 years old) of representative surveys conducted in France(n = 21,818), Germany (n = 7887) and USA (n = 37,115) in 2009–2010 recorded age at cannabis experimen-tation (i.e., first use), educational level, gender, and age. Cumulative prevalence of experimentation wasplotted for three retrospective cohorts (50–64, 35–49, 18–34 years old at data collection) and multivariatetime-discrete logistic regression was computed by gender and generation to model age at experimen-tation adjusted on age at data collection and educational level. This latter was measured according tofour categories derived from the International Standard Classification of Education (ISCED) and a relative(rather than absolute) index of education. Results: The findings demonstrate a consistent pattern of evolution of the prevalence, gender ratio andeducational gradient across generations and countries that support the hypothesis of an “epidemic” ofcannabis experimentation that mimics the epidemic of tobacco. Conclusion: We provide evidence for a cannabis epidemic model similar to the tobacco epidemic model.In the absence of clues regarding the future of cannabis use, our findings demonstrate that the gender gapis decreasing and, based on the epidemic model, suggest that we may expect widening social inequalitiesin cannabis experimentation if cannabis use decreases in the future.
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45.
  • Legleye, Stephane, et al. (author)
  • Validation of the cannabis abuse screening test in a sample of cannabis inpatients
  • 2012
  • In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 18:4, s. 193-200
  • Journal article (peer-reviewed)abstract
    • The present study aims at validating the Cannabis Abuse Screening Test (CAST) in a clinical sample of adolescent and young adult cannabis users seeking treatment. Applying a classical test theory approach using DSM-IV diagnoses as gold standard, two versions of the CAST questionnaire are compared. The sample consisted of 140 subjects aged 15-26 years (mean 18.9) recruited from two cannabis treatment centers. Gold standard diagnoses were assessed using the Adolescent Diagnostic Interview-Light. Internal structure and consistency of the CAST were assessed by principal component analysis and Cronbach's alpha. Optimal thresholds were defined using receiver operating characteristic analysis. Both the binary and the full test version revealed unidimensional structures with moderate to satisfactory internal consistency (alpha = 0.66 and 0.73). Screening properties were unsatisfactory when the CAST was compared against cannabis dependence. With regard to cannabis use disorders, both test versions yielded comparable and good sensitivity and specificity at cut-off 3 (binary: 92.2%, 66.7%) and 6 (full: 93.0%, 66.7%). Overall, the full CAST may be used for screening cannabis use disorders in clinical settings. Further research may use validation methods that do without gold standard.
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46.
  • Maron, Julian, et al. (author)
  • Exploring socio-economic inequalities in the use of medicines : is the relation mediated by health status?
  • 2019
  • In: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 169, s. 1-9
  • Journal article (peer-reviewed)abstract
    • Objectives: This study evaluated mediating effects of the health status on the association between socio-economic status (SES) and medicine use. It was hypothesized that more privileged people show a reduced use of medicines, as compared with the underprivileged, because of their superior health status. It was further hypothesized that people may apply medication based on their type of health complaint (ill physical versus mental status).Study design: Data were taken from the 2012 German Epidemiological Survey of Substance Abuse, a nationally representative cross-sectional study of n = 9084 individuals of the German general population aged 18-64 years.Methods: Direct and indirect effects of SES on weekly use of analgesics and sedatives/hypnotics were examined by applying generalized structural equation modeling. Self-rated physical and mental health statuses were considered as potential mediators. SES was measured by using educational level as a proxy. All analyses were gender-stratified.Results: Among men, both physical and mental health mediated the path from SES to the use of analgesics and sedatives/hypnotics, respectively, with a stronger effect of physical health on analgesic use and mental health on sedative/hypnotic use. These effects were only partially found among women.Conclusions: Social inequalities in health seem to have substantial impact on the prevalence of medicine use. Identification and elimination of the reasons for poor health among people of low SES may, therefore, not only help to reduce health inequalities directly. A decline in the use of medicines would also result in less side-effects and a reduced number of people with medicine-related misuse and addiction.
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47.
  • Maron, Julian, et al. (author)
  • Occupational inequalities in psychoactive substance use : A question of conceptualization?
  • 2016
  • In: Addiction Research and Theory. - : Informa UK Limited. - 1058-6989 .- 1606-6359 .- 1476-7392. ; 24:3, s. 186-198
  • Journal article (peer-reviewed)abstract
    • Background: Three different conceptualizations of occupational prestige were contrasted by applying social stratification to four exemplarily selected psychoactive substances. Although these conceptualizations partly measure the same construct, it is hypothesized that the gradient of occupational inequality differs depending on the type of conceptualization. Method: Data were taken from the 2012 German Epidemiological Survey of Substance Abuse. The study sample comprised n = 9084 individuals of the general population aged 18–64 years. Use and heavy use of cigarettes, alcohol, cannabis and analgesics were stratified by (a) employment status (six groups: employed, marginally employed, apprenticeship, unemployed, retired and other), (b) occupational status (five groups: low to high) and (c) occupational social class (two groups: blue-collar and white-collar). Absolute and relative differences between occupational groups were calculated. All analyses were stratified by gender. Results: Risk for smoking was increased amongst unemployed males and blue-collar workers. Retired persons, people with low occupational status and female blue-collar workers had a diminished risk for alcohol consumption; apprentices had an increased risk. Amongst males, low occupational status and blue-collar work was associated with episodic heavy drinking. Unemployment and blue-collar work was related to cannabis use. Risk for heavy analgesics use was increased amongst unemployed women, men with low occupational status and male blue-collar workers, respectively. Conclusions: The results suggest that occupational inequality differs depending on the applied conceptualizations of occupational prestige. Consequently, they should not be used interchangeably.
  •  
48.
  • Messner, Christoph B., et al. (author)
  • Ultra-High-Throughput Clinical Proteomics Reveals Classifiers of COVID-19 Infection
  • 2020
  • In: Cell Systems. - : Elsevier BV. - 2405-4712 .- 2405-4720. ; 11:1, s. 11-24.E4
  • Journal article (peer-reviewed)abstract
    • The COVID-19 pandemic is an unprecedented global challenge, and point-of-care diagnostic classifiers are urgently required. Here, we present a platform for ultra-high-throughput serum and plasma proteomics that builds on ISO13485 standardization to facilitate simple implementation in regulated clinical laboratories. Our low-cost workflow handles up to 180 samples per day, enables high precision quantification, and reduces batch effects for large-scale and longitudinal studies. We use our platform on samples collected from a cohort of early hospitalized cases of the SARS-CoV-2 pandemic and identify 27 potential biomarkers that are differentially expressed depending on the WHO severity grade of COVID-19. They include complement factors, the coagulation system, inflammation modulators, and pro-inflammatory factors upstream and downstream of interleukin 6. All protocols and software for implementing our approach are freely available. In total, this work supports the development of routine proteomic assays to aid clinical decision making and generate hypotheses about potential COVID-19 therapeutic targets.
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49.
  • Pabst, Alexander, et al. (author)
  • Decomposing social inequalities in alcohol consumption in Germany 1995-2015 : an age-period-cohort analysis
  • 2019
  • In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 114:8, s. 1359-1368
  • Journal article (peer-reviewed)abstract
    • Background and aims Previous research indicates that compared with individuals with lower socio-economic status (SES), individuals in higher SES groups are more often drinkers but those who drink report drinking smaller amounts more frequently. We aimed to decompose trends in self-reported alcohol consumption in Germany into age, period and birth cohort effects and examine whether these effects varied by SES. Design Age-period-cohort (APC) analysis using data from eight waves of the cross-sectional German Epidemiological Survey of Substance Abuse (ESA) collected between 1995 and 2015. Setting Germany. Participants The analytical sample included n=65821 individuals aged 18-64years reporting alcohol use within the last 30days. Measurements Alcohol measures included drinking prevalence, alcohol volume and prevalence of episodic heavy drinking (EHD). Educational attainment was used as an indicator of SES. A series of generalized linear and logistic regression models, including both main and interaction effects of age, period and cohort with SES, were estimated. Findings Regression models revealed significant interactions between APC effects and SES on two alcohol consumption measures. Higher SES was consistently associated with drinking prevalence across age (P<0.001), period (P=0.016) and cohort (P=0.016), and with volume of drinking in younger cohorts (P=0.002) and 50+-year-olds (P=0.001). Model results were inconclusive as to whether or not APC effects on EHD prevalence differed by SES. Conclusions In Germany, there are positive associations between socio-economic status and alcohol consumption during the life-course, over time and among birth cohorts. Three groups appear vulnerable to risky drinking: high socio-economic status young birth cohorts who drink high average quantities, low socio-economic status young birth cohorts who show a risky drinking pattern and high socio-economic status adults in their 50s and older who increase their drinking volume beyond that age.
  •  
50.
  • Pabst, Alexander, et al. (author)
  • Direct and indirect effects of alcohol expectancies on alcohol-related problems
  • 2014
  • In: Psychology of Addictive Behaviors. - : American Psychological Association (APA). - 0893-164X .- 1939-1501. ; 28:1, s. 20-30
  • Journal article (peer-reviewed)abstract
    • This study investigates pathways from alcohol outcome expectancies to alcohol-related problems (ARPs), considering alcohol volume and episodic heavy drinking (EHD) as potential mediators. It is further examined whether these pathways vary by age. The population-based sample comprised 6,823 individuals aged 18 to 64 years reporting alcohol use in the past year. Direct and indirect effects of five alcohol expectancies (social assertiveness, tension reduction, sexual enhancement, cognitive impairment, aggression) and alcohol use (average daily intake, EHD) on a latent measure of ARPs (six items of the Alcohol Use Disorders Identification Test) were investigated. A multiple-group structural equation model with three age groups (18 to 24, 25 to 44, 45 to 64 years) was examined. In individuals aged 18 to 24 years, social assertiveness expectancies were positively associated with average intake and EHD, which in turn were associated with more ARPs. In addition, expectancies related to cognitive impairment and aggression were directly linked to more ARPs without mediation in this age group. In individuals aged 25 years and older, tension reduction expectancies were associated with more ARPs through increased average intake. In contrast, high scores on cognitive impairment were associated with lower average intake and in turn with fewer ARPs. Challenging expectancies of sociability in young and expectancies of relaxation in mid adulthood might help decrease high-risk drinking and subsequently ARPs. Considering negative alcohol expectancies may help to identify younger individuals at high risk for ARPs, even if they have not previously exhibited repeated excessive drinking.
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