Objectives
To determine the relationship between alcohol consumption and cognitive decline, and to further explore the potential regulatory role of education, socio‐economic status (SES), and social ...or intellectual activity in this relationship.
Methods
6197 participants aged 45–75 years with four repeated measures data from 2011 to 2018 were included. A mixed‐effect model was used to explore the relationship between alcohol consumption and the rate of change in cognitive decline, a latent class growth mixed model (LCGMM) was applied to determine the potential trajectory of cognitive decline, and finally, the mediating and moderating analyses were used to determine the regulatory effect of all four variables on the relationship between alcohol consumption and potential trajectory.
Results
Compared to never‐drinkers, moderate alcohol consumption was a protective factor for overall cognitive function (β = 0.13, 95% CI: 0.04–0.20, p < 0.001), but there was no statistical correlation with the decline rate of cognitive function. And this protective effect was no longer significant after additional adjustments for education, SES, social and intellectual activity. The LCGMM model divided participants into two trajectories, a high‐level‐to‐decline group including 79.75% of participants (quadratic: β SE: −0.90 0.07, p < 0.001), and a low‐level‐to‐decline group including 20.25% participants (linear: β SE: −3.05 0.49, p < 0.001). With the latter as the reference, SES played a reverse regulation role in the harmful effect of heavy drinking on cognitive trajectories (odd ratio OR = 0.46, 95% CI: 0.23–0.93, p < 0.05). Social and intellectual activities played a negative mediating role in the harmful effect of alcohol consumption on cognitive trajectories (light: OR = 0.96, p < 0.001; moderate: OR = 0.96, p < 0.001; heavy: OR = 0.97, p < 0.01).
Conclusions
Alcohol itself has no protective effect on the decline of longitudinal cognitive trajectory. But the regulatory effect of SES, social and intellectual activities slows down the harm of alcohol consumption on the decline of cognitive function.
Clinical Trial Registration
The data used in this study are from publicly available databases. They are retrospective cohort studies without any intervention. Therefore, no clinical trial registration has been conducted.
Key points
Previous results on the association between alcohol consumption and cognitive function are inconsistent, and the role of socio‐economic status (SES), social and intellectual activities in this association has not been explored.
In this study of 6197 Chinese people aged 45–75, it was observed that drinking is a risk factor for the decline of the longitudinal cognitive trajectory, and the negative regulatory effects of SES, social and intellectual activities slows down the harm of alcohol consumption on the decline of cognitive function.
Aims
To estimate the probability of transitioning between different categories of alcohol use (drinking states) among a nationally representative cohort of United States (US) adults and to identify ...the effects of socio‐demographic characteristics on those transitions.
Design, setting and participants
Secondary analysis of data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a prospective cohort study conducted in 2001–02 and 2004–05; a US nation‐wide, population‐based study. Participants included 34 165 adults (mean age = 45.1 years, standard deviation = 17.3; 52% women).
Measurements
Alcohol use was self‐reported and categorized based on the grams consumed per day: (1) non‐drinker (no drinks in past 12 months), (2) category I (women = ≤ 20; men = ≤ 40), (3) category II (women = 21–40; men = 41–60) and (4) category III (women = ≥ 41; men = ≥ 61). Multi‐state Markov models estimated the probability of transitioning between drinking states, conditioned on age, sex, race/ethnicity and educational attainment. Analyses were repeated with alcohol use categorized based on the frequency of heavy episodic drinking.
Findings
The highest transition probabilities were observed for staying in the same state; after 1 year, the probability of remaining in the same state was 90.1% 95% confidence interval (CI) = 89.7%, 90.5% for non‐drinkers, 90.2% (95% CI = 89.9%, 90.5%) for category I, 31.8% (95% CI = 29.7, 33.9%) category II and 52.2% (95% CI = 46.0, 58.5%) for category III. Women, older adults, and non‐Hispanic Other adults were less likely to transition between drinking states, including transitions to lower use. Adults with lower educational attainment were more likely to transition between drinking states; however, they were also less likely to transition out of the ‘weekly HED’ category. Black adults were more likely to transition into or stay in higher use categories, whereas Hispanic/Latinx adults were largely similar to White adults.
Conclusions
In this study of alcohol transition probabilities, some demographic subgroups appeared more likely to transition into or persist in higher alcohol consumption states.
This is a novel investigation of whether, and how, a single close supportive friendship may facilitate psychological resilience in socio‐economically vulnerable British adolescents. A total of 409 ...adolescents (160 boys, 245 girls, four unknown), aged between 11 and 19 years, completed self‐report measures of close friendship quality, psychological resilience, social support, and other resources. Findings revealed a significant positive association between perceived friendship quality and resilience. This relationship was facilitated through inter‐related mechanisms of developing a constructive coping style (comprised of support‐seeking and active coping), effort, a supportive friendship network, and reduced disengaged and externalising coping. While protective processes were encouragingly significantly present across genders, boys were more vulnerable to the deleterious effects of disengaged and externalizing coping than girls. We suggest that individual close friendships are an important potential protective mechanism accessible to most adolescents. We discuss implications of the resulting Adolescent Friendship and Resilience Model for resilience theories and integration into practice.
Aim
To assess the quality of evidence and determine the effect of patient‐related and economic outcomes of self‐management support interventions in chronically ill patients with a low socio‐economic ...status.
Background
Integrated evidence on self‐management support interventions in chronically ill people with low socio‐economic status is lacking.
Design
Systematic literature review.
Data sources
Cochrane database of trials, PubMed, CINAHL, Web of Science, PsycINFO and Joanna Briggs Institute Library were searched (2000–2013). Randomized controlled trials addressing self‐management support interventions for patients with cardiovascular disease, stroke, cancer, diabetes and/or chronic respiratory disease were included.
Review methods
Data extraction and quality assessment were performed by independent researchers using a data extraction form.
Results
Studies (n = 27) focused mainly on diabetes. Fourteen studies cited an underlying theoretical basis. Most frequently used self‐management support components were lifestyle advice, information provision and symptom management. Problem‐solving and goal‐setting strategies were frequently integrated. Eleven studies adapted interventions to the needs of patients with a low socio‐economic status. No differences were found for interventions developed based on health behaviour theoretical models.
Conclusion
Limited evidence was found for self‐management support interventions in chronically ill patients with low socio‐economic status. Essential characteristics and component(s) of effective self‐management support interventions for these patients could not be detected. Rigorous reporting on development and underlying theories in the intervention is recommended.
Objective (s): In recent years decreasing fertility in Iran has become one of the demographic problems which has attracted the attention of policymakers. The purpose of this study was to identify the ...association between socio-economic factors with childbearing tendency. Methods: This was a cross sectional study. A sub-sample of data from the “2017 Iran Fertility Transition Survey” was used. The sample comprised of 374 ever married men and women aged 15-49 in Kermanshah, Iran. They were selected through the clustered sampling and the data was analyzed via SPSS 22 software using linear regression, Pearson correlation, independent t-test, and one-way analysis of variance Results: The results obtained from data analysis indicated no significant relationships between residency, housing, home size, employment, education and social class and attitudes toward childbearing (p>0.05). However, significant relationships between sex preference, gender, spouse age, birth interval, Internet consumption, birth space and attitudes toward childbearing was observed (p<0.05). Overall the result indicated that independent variables could explain 23% of variance of dependent variables. Conclusion: The findings suggest that the ideal number of children of young couples is affected by their living conditions. So, the success of any potential population polices depends on the improvement of coupleschr('39') living conditions.
Family history (FH) of autism and ADHD is not often considered during the recruitment process of developmental studies, despite high recurrence rates. We looked at the rate of autism or ADHD amongst ...family members of young children (9 to 46 months) in three UK‐based samples (N = 1055) recruited using different methods. The rate of FH‐autism or FH‐ADHD was 3%–9% for diagnosed cases. The rate was highest in the sample recruited through an online participant pool, which also consisted of the most socio‐economically diverse families. Lower parental education and family income were associated with higher rates of FH‐ADHD and lower parental education with increased FH‐autism. Thus, recruitment strategies have a meaningful impact on neurodiversity and the conclusions and generalizations that can be drawn. Specifically, recruitment using crowdsourcing websites could create a sample that is more representative of the wider population, compared to those recruited through university‐related volunteer databases and social media.
This study investigates ethnic differences in self‐assessed health in Scotland and their determinants, focusing on socio‐economic status and migrant generations. We use the Scottish Health and ...Ethnicity Linkage Study (SHELS) and apply regression analysis to data for 4.6 million people. The analysis shows that the White British, Other White and Chinese groups reported better health than the White Scottish population, whereas Pakistani and Indian populations had worse health outcomes. For the latter two groups, this contrasts with previous findings of mortality advantage and thus highlights a morbidity–mortality paradox in these South Asian populations. Our findings imply that socio‐economic deprivation, health selection and acculturation explain health inequalities for some ethnic groups, but for other groups, especially those of Pakistani origin, other mechanisms deserve further exploration.
Background
Ethnic and socio‐economic inequalities have been reported in the uptake of colorectal cancer (CRC) screening. This study aimed to explore the factors affecting CRC screening participation ...in an ethnically and socio‐economically diverse inner city population.
Methods
Semi‐structured interviews were undertaken with 50 people aged 55–74 years, recruited from GP practices in south‐east London. Participants were from Black African (n=13), Black Caribbean (n=15), White British (n=17), Black other (n=2) and White other (n=3) backgrounds. Participants' socio‐economic status (SES) was assessed using a combined measure of educational attainment, housing tenure and car ownership. Participants' SES varied although there were more participants from less deprived backgrounds than those from more deprived backgrounds. The interview topic guide was informed by the Theoretical Domains Framework. Interviews were recorded, transcribed and analysed using framework analysis.
Findings
Lack of awareness of CRC screening was a barrier for all participants. There were also some notable group differences by ethnicity and SES. Cancer fear was a barrier for White British participants of varying SES. Misunderstanding instructions for completing the guaiac faecal occult blood test (gFOBt) was a barrier for people of low SES regardless of ethnicity. For Black African and Black Caribbean participants, of any SES, religious faith and a perceived civic duty to participate in screening encouraged participation.
Discussion and conclusions
This is the first study to provide detailed information on the separate views of Black African and Black Caribbean participants about screening. Consideration of ethnicity and SES together also allowed us to identify pertinent barriers for particular groups that can be targeted to improve access to screening for those who wish to take part.
Aim
Predicting neurodevelopmental outcomes in hypoxic‐ischaemic encephalopathy (HIE) remains imprecise, despite advanced imaging and neurophysiological tests. We explored the predictive value of ...socio‐economic status (SES).
Methods
The cohort comprised 93 infants (59% male) with HIE, who had received therapeutic hypothermia. Patients underwent magnetic resonance imaging, and brain injuries were quantified using the Barkovich scoring system. Family SES was self‐reported using a questionnaire. Adverse outcomes were defined as mild to severely delayed development with a score of ≤85 in any domain at 2 years of age, based on the Bayley Scales of Infant Development, Second Edition. Data are presented as odds ratios (OR) with 95% confidence intervals (95% CI).
Results
Multiple regression modelling revealed that higher parental education was strongly associated with good cognitive development, when adjusted for gestational age, serum lactate and brain injuries (OR 2.20, 95% CI 1.16–4.36). The effect size of parental education (β = 0.786) was higher than one score for any brain injury using the Barkovich scoring system (β = −0.356). The literacy environment had a significant effect on cognitive development in the 21 infants who had brain injuries (OR 40, 95% CI 3.70–1352).
Conclusion
Parental education and the literacy environment influenced cognitive outcomes in patients with HIE.
Background and aims
No previous studies have examined the prospective association between disposable income and binge‐drinking initiation among adolescents. We aimed to examine whether there is such ...an association and, if so, whether it is robust to confounders, uniform across individual characteristics and linear versus non‐linear.
Design
Prospective study of adolescents from 32 middle schools, stratified according to geographic location, urban and rural locations and standard of living. Adolescents were assessed in 2017 (T1) and 1 year later (T2).
Setting
Norway.
Participants
A nation‐wide sample of 1845 adolescents (mean age 13.5 years, 44% boys) with no binge‐drinking experience at T1.
Measurements
Data were collected on binge drinking at T1 and T2. Data on disposable income and on a range of demographic, individual and family factors were collected at T1.
Findings
Overall, 7.2% initiated binge drinking between T1 and T2. Logistic regression showed that the crude linear effect of disposable income on binge drinking initiation was substantial, and only slightly attenuated in the fully adjusted model including all putative confounders odds ratio (OR) = 1.19, 95% confidence interval (CI) = 1.08, 1.31, P < 0.001. However, interaction analyses showed disposable income to be negatively related to binge drinking initiation for adolescents who had experienced light drinking at T1 (OR = 0.66, 95% CI = 0.49, 0.89, P = 0.006) or who had seen their mothers intoxicated OR = 0.62, 95% CI = 0.39, 0.99, P = 0.043).
Conclusion
Norwegian adolescents with higher disposable income have a greater risk of subsequent binge drinking initiation than those with lower disposable income. Each additional 100 NOK (≈ €10) of weekly income increased the risk of binge drinking initiation in the following year by approximately 20%.
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