Abstract Background The aim of this study was to define optimal cut points for the Alcohol Use Disorders Identification Test (AUDIT) and its abbreviated versions (AUDIT-C, AUDIT-QF, and AUDIT-3), and ...to evaluate how effectively these questionnaires detect heavy drinking in the general population. Methods The study population consisted of a sub-sample of the National FINRISK Study. A stratified random sample of 3216 Finns, aged 25–64, was invited to a health check. Of these, 1851 (57.6%) completed the AUDIT and participated in person in the Timeline Followback (TLFB) interview regarding their alcohol consumption. The TLFB-based definition of heavy drinking was used as a primary gold standard (for males ≥16 standard drinks average in a week or ≥7 drinks at least once a month; for females, respectively, ≥10 and ≥5 drinks). Areas under receiving operating characteristics curves (AUROCs), sensitivities and specificities were used to compare the performance of the tests. Results and conclusions The AUDIT and its abbreviated versions are valid for detecting heavy drinking also in a general population sample. However, performance seems to vary between the different versions and accuracy of each test is achieved only by using tailored cut points according to gender. The AUDIT and AUDIT-C are effective for both males and females. The optimal cut points for males were found to be ≥7 or 8 for AUDIT and ≥6 for AUDIT-C. Among females the optimal cut points were found to be ≥5 for AUDIT and ≥4 for AUDIT-C. The study also indicates that AUDIT-QF among females and AUDIT-3 among males are relatively effective. The cut points for detecting all heavy drinkers (including binge drinkers without exceeding weekly thresholds) were lower than for detecting heavy drinkers excluding those who are only binge drinkers.
Abstract Aims To estimate the gender-specific prevalences of alcohol consumption levels and to investigate the association between heavy drinking and all-cause mortality among elderly males. Design A ...cohort derived from a nationally representative sample of Finns aged >65 years was followed for six years. Number of subjects was 1569 (72.7% of the original sample, 65.3% females, weighted n = 1357). Measurements Alcohol consumption was retrospectively measured by beverage-specific quantity and frequency over a 12-month period. Mortality data were obtained from the official Cause-of-Death Register. Cox proportional hazards models were used to analyse the relative risks (RRs) of death. Findings The prevalence of heavy drinking (>8 standard drinks per week) was 20.3% in males and 1.2% in females. Over one-tenth (11.4%) of males reported drinking ≥15 standard drinks per week. Relative death risks suggested a J-curved relationship between alcohol consumption levels and mortality. However, significant curvilinear relationship was not found, when using alcohol consumption as continuous variable. The multivariate adjusted RR of death among moderate drinkers (1–7 drinks per week) vs. abstinent subjects was 0.41 (95% CI = .23–.72). Males drinking ≥15 standard drinks per week had a two-fold multivariate adjusted risk of death (RR = 2.11, 95% CI = 1.19–3.75) compared with abstinent males. The level of alcohol consumption by females was too low for analysis. Conclusions Heavy drinking is common among Finnish elderly males but not among females. The present study shows an increased all-cause mortality risk for males drinking, on average, more than two standard drinks per day.
Background: Hazardous drinking, defined as consuming alcohol on a risky level and not meeting the diagnostic criteria of alcohol use disorders (AUDs), has been suggested for a new complementary ...nondependence diagnosis. This study aimed to investigate the prevalence and associations of hazardous drinking in comparison to AUDs, moderate drinking, and abstinence.
Methods: A national representative sample of Finns was examined in the Health 2000 Survey. For 4477 subjects aged 30 to 64 years (76%, 2341 females), both the quantity frequency data about alcohol consumption and Composite International Diagnostic Interview (CIDI) data concerning AUD diagnoses were available. The nationally recommended limits for hazardous dinking were used (males: 24 drinks, females: 16 drinks/wk). Logistic regression models were used to analyze associations.
Results: The prevalence of hazardous drinking was 5.8%. Hazardous drinking was more prevalent among males than females (8.5% vs. 3.1%). It was most prevalent among the subjects aged 40 to 49 years (7.3%), divorced or separated (8.3%), unemployed (8.2%) and subjects living in the southern (Helsinki) region (7.5%). AUDs versus hazardous drinking were more likely to be in males versus females and in the unemployed versus employed. Subjects aged 40 and over had higher odds for hazardous drinking versus AUDs. The odds for hazardous versus moderate drinking were higher for males versus females (adjusted odds ratio = 3.24), for subjects aged over 40 years, unemployed versus employed and cohabiting, divorced/separated or unmarried subjects versus married subjects.
Conclusion: The high prevalence of hazardous drinking makes it an important public health concern. Hazardous drinkers have different sociodemographic characteristics as compared to people in other alcohol use categories.
AIMS - Internet gambling has been associated with increased risk of problem gambling. In this study different clusters of gambling activities and behavioral measures of gambling were used in ...analyses, which aimed at investigating prevalence of problem gambling in Internet poker gamblers and in other gamblers. DATA AND METHODS - The study consisted of secondary analyses of a Finnish population data set collected in 2007 (telephone survey, reaching 5,008 Finns aged 15 years and over). Bivariate statistics and logistic regression models were used in the analyses. RESULTS - When only age and sex were added to logistic regressions, overseas Internet poker (IP) gamblers were almost three times more likely to be problem gamblers than other gamblers. However, when also behavioral measures of gambling were added to equations, no difference in problem gambling between IP and other gambling was found. In the slot machine (SM) cluster an opposite phenomena occurred: when behavioral variables were added to analyses, subjects in SM cluster were more likely to be problem gamblers than other gamblers. When IP and SM were compared in the same multivariate analysis, subjects in both of these gambling clusters were more likely to be problem gamblers than other gamblers. CONCLUSIONS - The present study shows the importance of behavioral measures in gambling research. The level of involvement in gambling should be one of the primary interests in studies and interventions.
The inclusion of a battery system for a diesel mechanical short sea ship was investigated. The main benefits of the battery were assumed to emerge from shaving thruster generated power peaks, rather ...than starting additional generating sets to accommodate the power demand and additionally from replacing a diesel engine as a reserve power source. To support the analysis, an auxiliary engine power output dataset of a roll-on/roll-off passenger ferry operating in the Baltic Sea was acquired. Required capacity for the battery system was derived by considering power availability requirements and battery safety margins for performance deterioration. A multi-period mixed-integer linear programming model was developed to derive a globally optimal power management strategy for the auxiliary engines and the battery, with the goal of minimizing the battery installation total cost. The battery system was found to reduce fuel oil consumption by 257.5 tons annually due to improved auxiliary engine efficiency alone. Furthermore, the battery system total cost advantage was found to vary from -€0.61 to €2.82 million during the ten-year investment period, depending on fuel oil and battery system costs applied in the modeling. For the studied case ship, the hybrid electric topology was concluded to be economically feasible.
•Optimization model for designing and operating a hybrid ship.•Application in retrofitting of a lithium-ion battery to a passenger ferry.•Case ship operating profile and engine model based on measurements.•257 tons of fuel oil savings attributed to the hybrid system.•Higher fuel oil costs increase the attractiveness of battery investment.
This letter presents two broadband ball grid array-via transition structures applicable in reliable radio frequency/microwave low-temperature co-fired ceramic system-in-package (LTCC-SiP) module ...packaging from dc up to the K-band. The first transition provides better electromagnetic shielding, while the second one exhibits 40% wider bandwidth by including an air-cavity in the LTCC module. To specifically address board-level reliability, novel plastic-core solder balls as large as 1100 mum were employed. The measured 1-dB cutoff frequencies of the transition structures, all the way from the printed circuit board up to the top surface of the module package, were 19 and 27 GHz. In addition, equivalent circuit models for the transitions were developed.
Aims: To investigate the effectiveness of buprenorphine maintenance treatment (BMT) among opioid dependents who are mainly misusing buprenorphine intravenously. Methods: The study was a prospective ...naturalistic follow-up with a non-randomized control group. In Finland, 30 opioid dependents reporting previous misuse of buprenorphine and participating in the outpatient BMT and 30 matched controls participating in a syringe exchange program (SEP) were followed. Based on the evidence for the superiority of maintenance treatment, randomization was not done. The effectiveness was evaluated by retention rate, European Addiction Severity Index (EuropASI) interviews, Beck Depression Inventory (BDI), visual analogue scale for quality of life (VAS) during the 2-year follow-up and mortality rates during the 3-year follow-up. Because of drop-outs in the SEP group, only the BMT group was interviewed at 24 months. Results: At 3 months, the retention rate of the BMT group was 100% and of the SEP group 47%. At 12 months, the corresponding percentages were 83% and 37%. The total EuropASI composite score improved significantly only in the BMT group. In the BMT group, the BDI total score and VAS scales for quality of life improved significantly more than they did in the SEP group. During 3-year follow-up, four patients in the SEP died and none in the BMT. Conclusions: BMT appears to be an effective treatment for opioid dependents using mainly buprenorphine intravenously. On the other hand, bare SEP appears to result in high drop-out, not significant improvements and deaths.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Internationally, and also in Europe, adolescent gambling is increasingly recognized as an important public health issue. Most research on adolescent gambling, however, is prevalence-focused and ...population-based studies are scarce. Few studies have examined gambling-related harms among adolescents. In a national sample, we examined self-experienced harms related to gambling and the relationship between reported harms and gambling behavior among Finnish adolescents. A national survey of 12–18-year-olds was conducted in Finland in 2011 (
N
= 4,566). Main measures were frequency of gambling and gambling-related harms reported during the past 6 months. The relationship between reported harms and gambling behavior was assessed using logistic regression analysis. Overall, 44% had gambled during the past 6 months. Of the sample, 12% were frequent gamblers (at least weekly) and 32% were occasional gamblers (monthly or less often). Compared to occasional gamblers, frequent gamblers were more likely to experience harms. The most commonly reported harms among frequent gamblers were “felt guilty or shameful due to gambling” (17%) followed by “problems with relationships” (13%) and “disruptions of daily rhythm” (10%). In age and gender-adjusted analysis, daily gamblers were significantly more likely to report all different types of harms when compared to other groups. These findings suggest that when planning and targeting youth gambling prevention and harm reduction strategies the nature and extent to which gambling may contribute to the different types of harms are important to consider.
The epidemiology of independent use of sedatives or alcohol is well reported in previous research. However, the epidemiology of concurrent use of sedatives and alcohol is vastly understudied despite ...the unpredictable interactions associated with it.
Our aim was to study the prevalence of concurrent use of alcohol and sedatives and further examine the use of sedatives in some subgroups of people with alcohol use.
A mailed questionnaire was sent to a randomly chosen representative sample of a Finnish population (n = 5000). The main outcome measure was the prevalence of the use of sedatives in five subgroups of people with alcohol use in the previous week.
Of the participants, 7.8% (142/1818) reported use of both alcohol and sedatives in the previous week. Among the people with sedative use, 67.0% (142/212) reported at least some alcohol use, and 9.9. % (21/212) reported high use of at least 21 units of alcohol in the previous 7 days. The prevalence of sedative use was highest among those who had used at least 21 units of alcohol in the previous 7 days (19.4%).
The use of sedatives was especially common among those who reported having used large amounts of alcohol.
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