| 21. |
- Bendtsen, Preben, et al.
(författare)
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Professional's Attitudes Do Not Influence Screening and Brief Interventions Rates for Hazardous and Harmful Drinkers: Results from ODHIN Study
- 2015
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 50:4, s. 430-437
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Tidskriftsartikel (refereegranskat)abstract
- To determine the relation between existing levels of alcohol screening and brief intervention rates in five European jurisdictions and role security and therapeutic commitment by the participating primary healthcare professionals. Health care professionals consisting of, 409 GPs, 282 nurses and 55 other staff including psychologists, social workers and nurse aids from 120 primary health care centres participated in a cross-sectional 4-week survey. The participants registered all screening and brief intervention activities as part of their normal routine. The participants also completed the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), which measure role security and therapeutic commitment. The only significant but small relationship was found between role security and screening rate in a multilevel logistic regression analysis adjusted for occupation of the provider, number of eligible patients and the random effects of jurisdictions and primary health care units (PHCU). No significant relationship was found between role security and brief intervention rate nor between therapeutic commitment and screening rate/brief intervention rate. The proportion of patients screened varied across jurisdictions between 2 and 10%. The findings show that the studied factors (role security and therapeutic commitment) are not of great importance for alcohol screening and BI rates. Given the fact that screening and brief intervention implementation rate has not changed much in the last decade in spite of increased policy emphasis, training initiatives and more research being published, this raises a question about what else is needed to enhance implementation.
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| 22. |
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| 23. |
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| 24. |
- Berg, Noora, et al.
(författare)
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A 26-year follow-up study of heavy drinking trajectories from adolescence to mid-adulthood and adult disadvantage
- 2013
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 48:4, s. 452-7
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood.METHODS: Finnish cohort study's participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42.RESULTS: Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage.CONCLUSION: Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.
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| 25. |
- Berggren, Ulf, 1948, et al.
(författare)
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Different effects of smoking or use of smokeless tobacco on platelet MAO-B activity in type 1 alcohol-dependent subjects.
- 2007
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Ingår i: Alcohol and alcoholism (Oxford, Oxfordshire). - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 42:3, s. 267-71
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Low platelet monoamine oxidase (MAO)-B activity has been proposed as a marker for alcohol-dependence. Findings are, however, contradictory and the influence of confounding factors have been thoroughly investigated. Thus, it is now well established that cigarette smoking reduces platelet MAO-activity. However, not much is known about the influence of smokeless tobacco, i.e. snuff or chewing tobacco, on platelet MAO-B activity. The aim of the present study was to compare platelet MAO-B activity in type 1 alcohol-dependent subjects with concomitant use of smokeless tobacco (i.e. snuff users), use of smoking tobacco (i.e. cigarette smokers), and in those without any tobacco use. METHODS: Platelet MAO-B activity was examined in three groups of alcohol-dependent subjects: snuff users (n = 14), cigarette smokers (n = 33), and non-tobacco users (N = 46). RESULTS: In the alcohol-dependent subjects concomitant cigarette smokers, but not snuff users, were found to have significantly lower platelet MAO-B activity as compared to non-tobacco users (platelet MAO-B activity 4.0 +/- 1.5, 5.1 +/- 1.5 and 5.0 +/- 1.9 microkat/kg protein, respectively). CONCLUSIONS: The findings in the present study suggests that in the alcohol-dependent subjects the concomitant use of smokeless tobacco, i.e. snuffing, does not have an inhibitory effect on platelet MAO-B activity. This may have implications for future research. Thus, alcohol-dependent subjects with concomitant tobacco use should be grouped separately according to the form of the tobacco used, i.e. smoking or smokeless tobacco.
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| 26. |
- Berggren, Ulf, 1948, et al.
(författare)
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Dopamine D2 Receptor Genotype Is Associated with Increased Mortality at a 10-Year Follow-up of Alcohol-Dependent Individuals.
- 2010
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Ingår i: Alcohol and alcoholism. - : Oxford University Press (OUP). - 1464-3502 .- 0735-0414. ; 45:1, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Because the TAQ1 A1 allele may be associated with alcohol-related medical illnesses, and medical illnesses in alcohol-dependent individuals are associated with increased mortality, we test the hypothesis that the TAQ1 A1 allele of the DRD2 gene is associated with increased mortality in alcohol-dependent individuals. METHODS: Following an index treatment episode, a 10-year follow-up study in 366 alcohol-dependent individuals was performed. The TAQ1 A1/A2 DRD2 genotype and allele frequencies were compared between those deceased and those still living at the 10-year point. In addition, the genotype and allele frequencies of these alcohol-dependent individuals were compared to that in 578 control subjects. RESULTS: The prevalence of the A1 allele differed between the deceased and living patients and the controls: 47% of the deceased were A1+, compared to 37% of the living patients and 32% of the controls. The frequency of the TAQ1 A1/A2 genotype also differed between the groups. Thus, 43% had the A1/A2 genotype in comparison with 32% in the living patients and 29% in the controls. The TAQ 1 A1 allele frequency differed between the groups. The frequency of A1 allele was 25% in the deceased patients compared to 21% in the living patients and 17% in the controls. CONCLUSION: The TAQ I A1 allele of the DRD2 gene (or DRD2 gene region) was associated with increased mortality over a 10-year period in alcohol-dependent individuals.
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| 27. |
- Berggren, Ulf, et al.
(författare)
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Subnormal alpha-2-adrenoceptor-mediated sedation during 6 months of sobriety in male type 1 alcohol-dependent subjects
- 2003
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 38, s. 321-326
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Tidskriftsartikel (refereegranskat)abstract
- Aims: In the present study, α2-adrenoceptor function was investigated over 6 months of sobriety in eight male alcohol-dependent subjects. Methods: Subjects were investigated with repeated clonidine (CLON, 2 μg/kg body weight intravenously) challenge tests at days 1 and 7, and months 2 and 6 after the end of a period of heavy alcohol intake. CLON-induced sedation was rated at challenge tests. Mental well-being was self-reported before all challenge tests. Three challenge tests were performed at 1-week intervals in six male healthy controls. Results: Sedation was significantly lower after CLON at all time-points for the challenge tests in alcohol-dependent subjects compared with mean values for three challenge tests in controls. Three dimensions of mental well-being were negatively correlated with scores of CLON-induced sedation at month 6. Conclusions: α2-Adrenoceptor function is subnormal, as assessed by CLON-induced sedation, for at least 6 months after termination of alcohol intake. Whether this subnormal receptor function is pre-existing and possibly genetically determined or is a consequence of long-term alcohol intake must be further investigated, as should this receptor status in alcohol-dependent subjects with longer time-periods of sobriety.
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| 28. |
- Berggren, Ulf, 1948, et al.
(författare)
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The taqI DRD2 A1 allele is associated with alcohol-dependence although its effect size is small
- 2006
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Ingår i: Alcohol. - : Oxford University Press (OUP). - 0735-0414. ; 41:5, s. 479-85
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Numerous studies of the relationship between the TaqIA DRD2 A1 allele and alcohol-dependence have been performed and many of these have shown an association whereas others have not (Noble, 2003). This has consequently generated some controversy as to whether such an association actually exists (Noble, 2003). In the two recent meta-analyses by Noble (2003) and Young et al. (2004) some very important methodological issues have been discussed, which need to be addressed in forthcoming studies. Thus, the sample size is of great importance. In case-control studies it has been estimated that to detect the role of genes with small effect size of approximately 2, which is in the range of the DRD2 A1 allele-alcoholism relationship, case-control sets of 300-400 subjects are necessary (Noble, 2003). METHODS: In the present study, we have consequently recruited a large number of subjects, 375 alcohol-dependent individuals, who were treated as inpatients for alcohol withdrawal symptoms and out of these 357 could be evaluated. As controls, 578 individuals screened and 254 individuals unscreened for alcohol consumption were used. Thus, the total number of subjects was 1217. RESULTS: In the present study, in which the TaqI A1/A2 DRD2 polymorphism was in Hardy-Weinberg equilibrium in the patient group and the two control groups, we found that the TaqI DRD2 A1/A2 genotype frequency differed significantly between the alcohol-dependent group and both the total and screened control groups. Furthermore, the TaqI DRD2 A1 allele frequency was significantly overrepresented in the alcohol-dependent subjects as compared with both the total and screened control groups. The odds ratio for alcohol-dependency being associated with the A1 allele was 1.34. CONCLUSIONS: Consequently, the findings in this study lend further support to the notion of an association between the DRD2 A1 allele and alcohol-dependence, although the effect size of the DRD2 A1 allele is small.
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| 29. |
- Berggren, Ulf, 1948, et al.
(författare)
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Thrombocytopenia in early alcohol withdrawal is associated with development of delirium tremens or seizures.
- 2009
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Ingår i: Alcohol and alcoholism (Oxford, Oxfordshire). - : Oxford University Press (OUP). - 1464-3502 .- 0735-0414. ; 44:4, s. 382-6
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: In several studies, possible risk factors/predictors for severe alcohol withdrawal syndrome (AWS), i.e. delirium tremens (DT) and/or seizures, have been investigated. We have recently observed that low blood platelet count could be such a risk factor/predictor. We therefore investigated whether such an association could be found using a large number of alcohol-dependent individuals (n = 334). METHODS: This study is a retrospectively conducted cohort study based on data from female and male patients (>20 years of age), consecutively admitted to an alcohol treatment unit. The individuals had to fulfil the discharge diagnoses alcohol dependence and alcohol withdrawal syndrome according to DSM-IV. RESULTS: During the treatment period, 3% of the patients developed DT, 2% seizures and none had co-occurrence of both conditions. Among those with DT, a higher proportion had thrombocytopenia. Those with seizures had lower blood platelet count and a higher proportion of them had thrombocytopenia. The sensitivity and specificity of thrombocytopenia for the development of DT during the treatment period was 70% and 69%, respectively. The positive predictive value (PPV) was 6% and the negative predictive value (NPV) was 99%. For the development of seizures, the figure for sensitivity was 75% and for specificity 69%. The figures for PPV and NPV were similar as those for the development of DT. CONCLUSIONS: Thrombocytopenia is more frequent in patients who develop severe AWS (DT or seizures). The findings, including the high NPV of thrombocytopenia, must be interpreted with caution due to the small number of patients who developed AWS. Further studies replicating the present finding are therefore needed before the clinical usefulness can be considered.
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| 30. |
- Berggren, Ulf, 1948, et al.
(författare)
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Tobacco use is associated with more severe alcohol dependence, as assessed by the number of DSM-IV criteria, in Swedish male type 1 alcoholics.
- 2007
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Ingår i: Alcohol and alcoholism (Oxford, Oxfordshire). - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 42:3, s. 247-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A high smoking prevalence has been reported in treatment-seeking alcohol-dependent individuals. It has also been suggested that alcohol-dependent individuals who smoke may have a more severe course and greater severity of their alcoholism. METHODS: This study evaluated the impact of tobacco use in 108 Swedish male type 1 alcohol-dependent individuals, recruited by advertisement in a local daily newspaper. They were sub-grouped into smokers (N = 50), snuffers (N = 12) and tobacco nonusers (N = 46). The number of criteria for the diagnosis of alcohol dependence was used to assess the severity of alcohol dependence. RESULTS: The smokers were significantly younger compared to the tobacco non-using group, and also younger at their onset of excessive alcohol consumption. Both smokers and snuffers fulfilled significantly more DSM-IV criteria for alcohol dependence than tobacco nonusers. Furthermore, significantly higher proportions of smokers and snuffers fulfilled the criteria no 2 (experiencing withdrawal syndrome) and no 7 (continuing to use alcohol despite problems). CONCLUSIONS: These findings indicate that not only smoking, but also snuffing, is associated with greater severity of alcohol dependence, as reflected by the greater number of DSM-IV criteria.
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