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INTRODUCTION Unhealthy alcohol use is common among persons with HIV (PWH) [1]. Sub‐Saharan Africa (SSA) is home to 68% of the 34 million PWH worldwide [2] and has the highest [...], : Introduction: Unhealthy alcohol use significantly contributes to viral non‐suppression among persons with HIV (PWH). It is unknown whether brief behavioural interventions to reduce alcohol use can improve viral suppression among PWH with unhealthy alcohol use in sub‐Saharan Africa (SSA). Methods: As part of the SEARCH study (NCT04810650), we conducted an individually randomized trial in Kenya and Uganda of a brief, skills‐based alcohol intervention among PWH with self‐reported unhealthy alcohol use (Alcohol Use Disorders Identification Test–Consumption [AUDIT‐C], prior 3 months, ≥3/female; ≥4/male) and at risk of viral non‐suppression, defined as either recent HIV viral non‐suppression (≥400 copies/ml), missed visits, out of care or new diagnosis. The intervention included baseline and 3‐month in‐person counselling sessions with interim booster phone calls every 3 weeks. The primary outcome was HIV viral suppression ( Results: Between April and September 2021, 401 persons (198 intervention, 203 control) were enrolled from HIV clinics in Uganda (58%) and Kenya (27%) and alcohol‐serving venues in Kenya (15%). At baseline, 60% were virally suppressed. Viral suppression did not differ between arms at 24 weeks: suppression was 83% in intervention and 82% in control arms (RR: 1.01, 95% CI: 0.93–1.1). Among PWH with baseline viral non‐suppression, 24‐week suppression was 73% in intervention and 64% in control arms (RR 1.15, 95% CI: 0.93–1.43). Unhealthy alcohol use declined from 98% at baseline to 73% in intervention and 84% in control arms at 24 weeks (RR: 0.86, 95% CI: 0.79–0.94). Effects on unhealthy alcohol use were stronger among women (RR 0.70, 95% CI: 0.56–0.88) than men (RR 0.93, 95% CI: 0.85–1.01) and among participants with a baseline PEth⩽200 ng/ml (RR 0.68, 95% CI: 0.53–0.87) versus >200 ng/ml (RR 0.97, 95% CI: 0.92–1.02). Conclusions: In a randomized trial of 401 PWH with unhealthy alcohol use and risk for viral non‐suppression, a brief alcohol intervention reduced unhealthy alcohol use but did not affect viral suppression at 24 weeks. Brief alcohol interventions have the potential to improve the health of PWH in SSA by reducing alcohol use, a significant driver of HIV‐associated co‐morbidities.

Patients impart their highest trust in the health care professionals from whom they might seek services, to provide the best quality care regardless of biases, predispositions worldview, and personal values. [...], Healthcare professionals from whom clients might seek services should provide the best quality care regardless of biases, predispositions, worldview, and personal values. The purpose of this study was to explore how the perceived cause of spinal cord injury (SCI) affected service delivery recommendations from bachelor-level rehabilitation services trainees. Specifically, causal attribution of disability was the dependent variable in two case vignettes, one where the person was personally responsible for the cause of the SCI (i.e., driving under the influence, leading to a motor vehicle accident) and one with an external cause (i.e., motor vehicle accident caused by another driver). The impact on acute care, lifelong care, and specific specialist recommendations was assessed. There was a significant difference in the scores for external cause (M = 1.85, SD = .89) and internal cause (M = 1.4, SD = .60) of SCI and recommendation for life-long care, t(245) = 4.62, p = .000. Acute care and specialist recommendations revealed no differences. Implications for training to address attitudes are discussed.. Keywords: Causal Attribution, Attitudes toward Disability, Rehabilitation Services, Spinal Cord Injury

Author(s): Cen Xie [1]; Tomoki Yagai [1]; Yuhong Luo [1]; Xianyi Liang [2, 3]; Tao Chen [4]; Qiong Wang [1]; Dongxue Sun [1]; Jie Zhao [1]; Sadeesh K Ramakrishnan [5]; [...], Nonalcoholic fatty liver disease is becoming the most common chronic liver disease in Western countries, and limited therapeutic options are available. Here we uncovered a role for intestinal hypoxia-inducible factor (HIF) in hepatic steatosis. Human-intestine biopsies from individuals with or without obesity revealed that intestinal HIF-2[alpha] signaling was positively correlated with body-mass index and hepatic toxicity. The causality of this correlation was verified in mice with an intestine-specific disruption of Hif2a, in which high-fat-diet-induced hepatic steatosis and obesity were substantially lower as compared to control mice. PT2385, a HIF-2[alpha]-specific inhibitor, had preventive and therapeutic effects on metabolic disorders that were dependent on intestine HIF-2[alpha]. Intestine HIF-2[alpha] inhibition markedly reduced intestine and serum ceramide levels. Mechanistically, intestine HIF-2[alpha] regulates ceramide metabolism mainly from the salvage pathway, by positively regulating the expression of Neu3, the gene encoding neuraminidase 3. These results suggest that intestinal HIF-2[alpha] could be a viable target for hepatic steatosis therapy.

Alcohol and nutrition have the potential to interact at multiple levels. For example, heavy alcohol consumption can interfere with normal nutrition, resulting in overall malnutrition or in deficiencies of important [...]

Alcohol consumption during pregnancy is the most common preventable cause of birth defects in the Western world, producing a range of physical, neurological, and behavioral alterations known as fetal alcohol [...]

INDIVIDUALS WHO COME TO BE described as alcoholics show great variability in the chronicity and extent of their problematic alcohol involvement, an observation that can be traced to Jellinek's seminal [...], Objective: Although it has been recognized that the course of alcoholism may differ across individuals, little work has characterized drinking trajectories from drinking onset to midlife. Method: The current study examined trajectories of alcohol dependence from adolescence to the mid-50s in a sample of 420 men with a lifetime diagnosis of alcohol dependence. Men from the Vietnam Era Twin Registry were given the Lifetime Drinking History, which assesses the patterns of alcohol consumption and diagnostic symptoms for self-defined drinking phases. Phase data were converted into person-year data, with alcohol-dependence diagnosis coded as present or absent for each of 13 age groupings, starting with up to age 20 and ending with ages 54-56. Results: Latent growth mixture modeling was used to define four drinking trajectories: young-adult, late-onset, severe-nonchronic, and severe-chronic alcoholics. Further analyses with other diagnostic variables, other drinking variables, alcohol expectancies, personality scales, and religiousness scores were completed to differentiate men best categorized by each trajectory. Conclusions: Extension of Latent Growth Mixture Modeling (LGMM) into the mid-50s revealed that, although some individuals remain chronic alcohol users, others decline in alcohol problem use. Differences seen among these groups may help in the treatment of alcohol dependence, such that more energy can be spent treating those likely to be in the more severe trajectories.

PRESENTATION S.E., a 53-year-old Caucasian woman, was referred to the endocrinology clinic for management of type 2 diabetes. She was diagnosed 2 years ago and failed to achieve acceptable glycemic [...]

Table 1: Association between clinical and demographical variables and risky alcohol consumption Coef. Std.Err. z p 95% Conf. interval Ethnicity 1.757 0.639 2.75 0.006 0.503?3.011 Sex ?1.811 0.767 ?2.36 0.018 [...], Introduction: The prevalence of risky alcohol consumption, associated factors and its impact on the brain is not well established in clinically stable HIV patients. Materials and Methods: Within the PIVOT neurocognitive sub?study, effectively suppressed HIV?infected adults on either standard cART or ritonavir?boosted PI monotherapy completed the Alcohol Use Disorders Identification Test (AUDIT) designed to detect risky alcohol consumption. They also completed a brief neuropsychological assessment (NPZ 5) composed by five measures. For this cross?sectional analysis, we calculated rates of hazardous (AUDIT=8?15) or harmful (AUDIT=16?19) consumption and likely dependence (AUDIT>20). We explored the association between risky alcohol intakes (AUDIT>8) and clinical/demographical variables, conducting logistic regressions when significant association was found (p Results: Of the 146 included participants, the majority were male (86.3%), white (81.5%) and educated (mean years on formal education=15, SD=3.9). Average age was 47.6 years (SD=8.7), and 36.3% had risky consumption (29.5% hazardous, 6.2% harmful, 0.7% likely dependence). White ethnicity and male sex were positively associated with risky consumption (Table 1). After adjustments, white ethnicity remained significantly associated with risky consumption (1.64 [95% CI 0.34?2.95]; p=0.013). Better cognitive performance was associated with risky alcohol consumption in the univariate analysis (p Conclusions: Despite the substantially high prevalence of risky alcohol consumption, it was not associated with worse adherence, immunological or quality of life measures in this cohort of effectively suppressed patients but prevalence of likely alcohol dependency was extremely low. White patients were more vulnerable to risky consumption. Moreover, positive association between cognitive performance and risky alcohol consumption remained after adjustment. In our study, the association we found between cognitive function and alcohol consumption does not reflect the effect of alcohol dependency on cognition.

Alcohol consumption is associated with markers of inflammation in patients with rheumatoid arthritis (RA) before symptoms occur. This association suggests that the anti-inflammatory effect of alcohol might be the link [...]

In our society, athletics and alcohol go hand in hand. Observe athletes drinking beer post-exercise, tailgaters at football games, champions getting showered with champaign. Athletics and alcohol also mesh together [...]