Australian Guidelines to Reduce Health Risks from Drinking Alcohol The National Health and Medical Research council (NHMRC) released revised guidelines which aim to reduce the risks associated with alcohol consumption. The Guidelines can be found on the National and Medical Research Council website — http://www.nhrrirc.dov.au/publications/synobses/ds10s_yn.htnn It provides universal guidance for healthy adults aged 18 years and over and guidelines specific to children and young people and to pregnant and breastfeeding women. The guidelines do not represent a 'safe" or "no-risk" level. Rather, it is an advisory drinking level that enables healthy adults to maintain a low risk of alcohol-related accidents, injuries, diseases and death. What is a standard drink? The term "standard drink" should not be confused with a serving of alcohol, which is often much larger. For example, with wine, a standard drink corresponds to 100mL of wine, whereas a typical serve is at least 150mL. Australian law requires that all cans, bottles and casks containing alcoholic beverages be labelled with the approximate amount of standard drinks it contains. However, it can sometimes be difficult to translate standard drinks into real-life scenarios. There are no common glass sizes used across all drinking environments and people often underestimate how much they are drinking. This is compounded where large containers such as jugs and casks, are shared, where glasses are topped up by others, where the composition of mixed drinks is not known eg. cocktails or punch, and when pre-mixed spirit drinks contain a variable amount of alcohol per bottle or can.

/pdf/australian-guidelines-to-reduce-health-risks-from-drinking-3wlzbbwjn6.pdf

Australian guidelines to reduce health risks from drinking alcohol

Although alcohol intake and hepatitis C virus (HCV) infection are the major determinants of liver cirrhosis (LC) in Western countries, the joint effect of these two factors on LC risk has not yet been adequately studied. We used data from two hospital-based case-control studies performed in Italy. Cases were 285 cirrhotic patients admitted for the first time to district hospitals for liver decompensation. Controls were 417 patients admitted during the same period, and in the same hospitals as the cases, for acute diseases unrelated to alcohol. Alcohol consumption was expressed as lifetime daily alcohol intake (LDAI). Serum HCV antibodies (anti-HCV) were detected using a second-generation test and recombinant immunoblotting assay. We found a dose-effect relationship between LDAI and the risk of LC in both anti-HCV-negative and -positive subjects. Considering the extreme LDAI categories (LDAI = 0 g, lifetime teetotalers, and LDAI = 175 g), the LC odds ratios increased from 1.0 (reference category) to 15.0 (95% CI, 7.1-31.7) and from 9.2 (95% CI, 2.0-43.2) to 147.2 (95% CI, 42.1-514.3) in anti-HCV-negative and -positive patients respectively. The interaction between LDAI and HCV showed an additive structure for LDAI 125 g/day. Alcohol intake and HCV infection are independent risk factors for symptomatic liver cirrhosis, each being sufficient to induce the disease. In subjects with high alcohol intake, the coexistence of HCV infection multiplies the alcohol-associated risk of cirrhosis. In subjects with low alcohol intake, other factors could be involved.

Independent and combined action of hepatitis C virus infection and alcohol consumption on the risk of symptomatic liver cirrhosis

Rising Incidence of Hepatocellular Carcinoma in the United States

Underage drinking in the UK: changing trends, impact and interventions. A rapid evidence synthesis.

The interaction between temperament and the family environment in adolescent substance use and externalizing behaviors : support for diathesis–stress or differential susceptibility?

This review of reviews relating to the impact of alcohol consumption on young people was undertaken between May and October 2008 by a research team based at the Institute of Health and Society at Newcastle University.

The aim of the study was to undertake a systematic review of the published review literature and summarise the evidence on the harms and benefits of alcohol consumption for children and young people. In this process we assessed the quality of the evidence in this field and its relevance to a UK population.

Impact of alcohol consumption on young people a systematic review of published reviews.

/pdf/a-rapid-review-of-liver-disease-epidemiology-treatment-and-3dft717155.pdf

A rapid review of liver disease epidemiology, treatment and service provision in England [Report Commissioned by Department of Health and the British Liver Trust]

Background: Shared medical appointments (SMAs) have the potential to address interlinked challenges of limited capacity in primary healthcare and rising prevalence of patients with multiple long-term conditions (LTCs). This review aimed to examine the effectiveness of SMAs compared to one-to-one appointments in primary care at improving health outcomes and reducing demand on healthcare services. Methods: We searched for randomised controlled trials (RCTs) of SMAs involving patients with LTCs in primary care across six databases from 2013 and added eligible papers identified from previous relevant reviews. Data were extracted and outcomes narratively synthesised, meta-analysis was undertaken where possible. Results: Twenty-three unique trials were included. SMA models varied in terms of components, mode of delivery and target population. Most trials recruited patients with a single LTC, mostly commonly diabetes (n=13), although eight trials selected patients with multiple LTCs. There was substantial heterogeneity in outcome measures which we categorised into health outcomes (biomedical indicators, psychological and well-being measures), behavioural outcomes, and resource use. Meta-analysis showed that participants in SMA groups had lower diastolic blood pressure than those in usual care (d=-0.123, 95%CI = -0.22, -0.03, k=8). No statistically significant differences were found across other outcomes. Where individual studies showed significant differences (patient self-efficacy), these trended in favour of SMAs. Compared with usual care, SMAs had no significant effect on healthcare service use. Conclusions: SMAs were at least as effective as usual care in terms of health outcomes and did not lead to increased healthcare service use in the short-term. They show some potential in improving self-efficacy which may boost self-care. To strengthen the evidence base, future studies should target standardised behavioural and health outcomes and clearly report SMA components so key behavioural ingredients can be identified. Similarly, transparent approaches to measuring costs would improve comparability between studies.

http://medrxiv.org/cgi/content/short/2022.03.24.22272866v1?rss=1

Effectiveness of shared medical appointments delivered in primary care for improving health outcomes in patients with long-term conditions: a systematic review of randomised controlled trials

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Papers

Impact of alcohol consumption on young people a systematic review of published reviews.

A rapid review of liver disease epidemiology, treatment and service provision in England [Report Commissioned by Department of Health and the British Liver Trust]

Effectiveness of shared medical appointments delivered in primary care for improving health outcomes in patients with long-term conditions: a systematic review of randomised controlled trials