Biomedical subjects

Thomas H Nochajski

Publications and source records attributed to Thomas H Nochajski.

11 recordsLinked to original sources

PubMed2006

Alcohol drinking pattern and subjective health in a population-based study.

AIMS: Some patterns of alcohol consumption (e.g. binge drinking, drinking outside of meals) have been associated with detrimental effects on health outcomes. Subjective health provides a global assessment of health status and is a strong predictor of total mortality; however, little is known about its relationship with alcohol drinking pattern. The association between several drinking patterns (i.e. drinking intensity and frequency, frequency of intoxication, drinking outside of meals, and beverage type) and subjective health was examined in a random sample of 3586 women and men. DESIGN: A population-based cross-sectional study. METHODS: Subjective health was assessed using the physical and mental health component summaries of the Short Form-36 health survey questionnaire. Alcohol consumption refers to the 30 days before the interview. Analysis of covariance compared gender-specific mean scores across alcohol drinking patterns. FINDINGS: Overall, non-current drinkers reported poorer physical and mental health than life-time abstainers and current drinkers, while no consistent differences were found between life-time abstainers and current drinkers. In female current drinkers, daily drinking, beer and mixed beverage consumption were associated with better mental health. In male current drinkers, moderate alcohol consumption (2-2.9 drinks per day), wine and mixed beverage consumption were associated with better physical health. Intoxication and liquor consumption were associated with poorer mental health in women and poorer physical health in men. No consistent associations were found for drinking outside meals. CONCLUSIONS: Aspects of drinking pattern may affect subjective health differentially in women and men. Overall, intoxication and liquor drinking are associated with poorer self-perceived health status than regular, moderate consumption of other alcoholic beverages.

Adult↗

PubMed2006

More than a set of teeth: assessing and enhancing dental students' perceptions of older adults.

Dental professionals play a key role in maintaining the well-being of older adults by identifying problems that disturb systemic health. A 3-part instrument was used to assess dental students' knowledge of aging, comfort with patient diversity and patient care strategies (Years 1-4; N = 321). Collaborative education and services were developed by the Schools of Dental Medicine and Social Work. Results indicate that dental students' knowledge of aging was low (Palmore's FAQ 1 Range = 58%-64%), comfort with geriatric issues improved after the first year of intervention, and strategies for patient care changed with experience. Group differences suggest the importance of utilizing educational "turning points" as teachable moments.

Adult↗

PubMed2005

Relapse to driving under the influence (DUI): a review.

Driving under the influence (DUI) is a major public health problem. In 2003, there were 17,401 alcohol-related crash fatalities. Although there has been a large decrease in the fatality rates over the past two decades, further progress has stalled in recent years. This plateau in the injury and death rates resulting from impaired driving has been attributed, in part, to the persistent or repeat DUI offender. Broadly defined, repeat offenders are those individuals who, following an initial DUI arrest, relapse to driving under the influence of alcohol and other drugs. In this paper, we first provide a brief overview of several models of DUI relapse. We then review the empirical literature on DUI relapse, the data describing characteristics of first-time and repeat DUI offenders, and, especially, studies that have evaluated the impact of legal sanctions and rehabilitation programs on subsequent DUI behavior. The data reveal that DUI offenders are a heterogeneous group, and that simple models relying on only one or two behavioral domains (e.g., driving characteristics, demographics) to explain DUI relapse are insufficient to account for the DUI behavior of offenders. To advance our understanding of DUI relapse, we argue for development and testing of multifactorial models focusing on the interplay of legal, social and psychological factors that describe and explain relapse among DUI offenders. By recognizing the heterogeneity within the offender population it will be easier for researchers and clinicians to identify subgroups that are at high-risk for relapse and which should be targeted by prevention and intervention programs.

Accidents, Traffic↗

PubMed2005

Understanding dental students' knowledge and perceptions of older people: toward a new model of geriatric dental education.

Increasing numbers of older people and the decreasing rates of edentulism highlight the importance of dental education that focuses on oral health and aging. This evaluation study assessed dental students' knowledge and beliefs about older people as well as their awareness of the biopsychosocial concerns that are potential barriers to oral health care. Dental students' (N=202) knowledge and perceptions of older people were evaluated before and after the first year of a new educational program. Students completed the Palmore Facts on Aging Quiz II (FAQ II) and answered questions about health problems and social concerns that may influence patient care. The intervention was twofold: 1) the CARES (Counseling, Advocacy, Referral, Education, and Service) Program, a clinical collaboration between the schools of Dental Medicine and Social Work, was initiated; and 2) all students were exposed to geriatric educational interventions. FAQ II scores did not significantly change, but dental students' awareness of mental health, independence, and social concerns increased between Times 1 and 2. The results of the study suggest that positive interactions with older adults by health care providers may depend more on positive perceptions toward older people than increased knowledge about aging. Future research will focus on positive experiences with older adults and attitudes of dental students toward the elderly.

Adult↗

PubMed2004

Relationship of alcohol drinking pattern to risk of hypertension: a population-based study.

Epidemiological studies have demonstrated a positive relationship between heavy alcohol use and hypertension, but few studies have directly addressed the role of drinking pattern. This study was designed to investigate the association of current alcohol consumption and aspects of drinking pattern with hypertension risk in a sample of 2609 white men and women from western New York, aged 35 to 80 years, and free from other cardiovascular diseases. Hypertension was defined by systolic blood pressure > or =140 mm Hg or diastolic blood pressure > or =90 mm Hg or use of antihypertensive medication. Odds ratios (95% confidence intervals) were computed after adjustment for several covariates. Compared with lifetime abstainers, participants reporting drinking on a daily basis (1.75 [1.13 to 2.72]) or mostly without food (1.64 [1.08 to 2.51]) exhibited significantly higher risk of hypertension. When analyses were restricted to current drinkers, daily drinkers and participants consuming alcohol without food exhibited a significantly higher risk of hypertension compared with those drinking less than weekly (1.65 [1.18 to 2.30]) and those drinking mostly with food (1.49 [1.10 to 2.00]), respectively. After additional adjustment for the amount of alcohol consumed in the past 30 days, the results were follows: 0.90 (0.58 to 1.41) for daily drinkers and 1.41 (1.04 to 1.91) for drinkers without food. For predominant beverage preference, no consistent association with hypertension risk was found across the various types of beverages considered (beer, wine, and liquor). In conclusion, drinking outside meals appears to have a significant effect on hypertension risk independent of the amount of alcohol consumed.

Adult↗

PubMed2004

Body fat distribution, relative weight, and liver enzyme levels: a population-based study.

Regional body fat distribution may represent an independent risk factor for several conditions, especially metabolic and cardiovascular diseases; recent findings have shown that abdominal fat accumulation can be an independent predictor of hepatic steatosis. Very few studies, mostly using selected clinical samples, have focused on the relationship between indices of abdominal visceral fat accumulation and the most commonly used biochemical liver tests, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT). The aim of the present study was to evaluate the relation between central fat accumulation, as assessed by abdominal height, relative weight, as determined by body mass index (BMI), and liver function tests (ALT, AST, and GGT) in a random sample of 2,704 residents of Erie and Niagara Counties in New York State, 35-80 years of age and free from known hepatic disease. Multiple linear regression models were used, with liver enzymes as dependent variables with abdominal height and BMI as independent variables, and the inclusion of several covariates (age, race, education, smoking status, pack-years of smoking, drinking status, and total ounces of ethanol in the past 30 days). Abdominal height was consistently a better correlate of ALT and GGT levels than BMI in both sexes. In addition, abdominal height was the most powerful independent predictor of ALT in both sexes as well as of GGT among women. In conclusion, these findings support a role for central adiposity independent from BMI in predicting increased levels of hepatic enzymes, likely as a result of unrecognized fatty liver.

Abdomen↗

PubMed2004

Differential effects of alcohol drinking pattern on liver enzymes in men and women.

BACKGROUND: Increasing evidence suggests that drinking pattern may have powerful implications for health; however, very few studies have focused on the association between drinking pattern and risk of alcoholic liver damage. This study was aimed at examining the association of gamma-glutamyltransferase (GGT), aspartate aminotransferase, and alanine aminotransferase with current alcohol consumption and with some aspects of drinking pattern (e.g., drinking frequency during the week and in relation to food consumption). METHODS: A cross-sectional analysis was conducted of a random sample of 2943 white residents of Erie and Niagara Counties in New York State who were 35 to 80 years of age and free from known hepatic disease. RESULTS: The most significant associations were found for GGT; in both sexes, average levels were significantly higher in current and former drinkers compared with lifetime abstainers. In analyses based on quartiles of alcohol consumption, only participants in the two top quartiles showed significantly elevated enzymes compared with both lifetime abstainers and participants in other quartiles. For drinking pattern, there was evidence of sex-specific associations. In men, daily drinkers showed the highest levels of GGT, whereas in women, the highest level of GGT was observed in weekend drinkers. Women (but not men) who consumed alcohol without food exhibited higher levels of GGT compared with women who consumed alcoholic beverages in relation to food. CONCLUSIONS: These findings support the hypothesis that, in addition to amount, drinking pattern may affect liver function and that differences exist between sexes with regard to the effect of drinking pattern on liver function and potential liver damage.

Adult↗

PubMed2004

Greater hepatic vulnerability after alcohol intake in African Americans compared with Caucasians: a population-based study.

AIMS OF THE STUDY: In the last 40 years, African Americans have experienced higher age-adjusted liver cirrhosis mortality rates than whites. Alcohol use has been hypothesized to be the likely determinant of this disparity in liver disease mortality. This study was aimed at evaluating racial variations in common biomarkers of liver injury, such as gamma-glutamyltransferase (GGT), aspartate amino transferase (AST) and alanine amino transferase (ALT), by categories of drinking status and levels of current alcohol use. METHODS: A cross-sectional analysis of a general population sample of 3304 residents of Erie and Niagara counties in New York State, 35-80 years of age and free from known hepatic disease, stratified by racial group (African-American and white). RESULTS: Concentrations of GGT were higher for African-Americans than for whites in all categories of drinking status (lifetime abstainers, former and current drinkers) after adjustment for potential confounders (age, sex, education, smoking, and body mass index). However, differences in enzyme mean values between the two racial groups were consistently larger among current drinkers than for either lifetime abstainers or former drinkers. In analyses based on tertiles of alcohol consumption in the last 30 days, differences in GGT mean values between the two races tended to amplify with increasing amounts of consumption. CONCLUSIONS: These findings seem to support the hypothesis of greater sensitivity to alcohol-induced hepatotoxicity among African-Americans than for whites.

Adult↗

PubMed2003

Lung cancer in humans is not associated with lifetime total alcohol consumption or with genetic variation in alcohol dehydrogenase 3 (ADH3).

Although there is clear evidence that smoking is the primary risk factor for lung cancer, not all variation in disease risk is understood. There is some evidence that alcohol may contribute to risk. We examined lifetime and recent (12-24 mo previous) alcohol consumption in relation to risk of lung cancer in a case-control study in western New York. In addition we examined the alcohol dehydrogenase 3 (ADH3) genotype in relation to lung cancer risk; ADH3 is rate limiting in alcohol metabolism and has a functional polymorphism. We interviewed incident, primary, histologically confirmed lung cancer cases (n = 111) in two counties. Controls were randomly selected from among those residing in the counties, frequency-matched to cases for age and race (n = 1546). Lifetime and recent total alcohol and beverage-specific alcohol consumption as well as relevant confounders were assessed by interview. ADH3 genotype was evaluated by a PCR-restriction fragment length polymorphism assay. Because of the small sample size, power was limited and CI were wide. Residual confounding by smoking remains a concern. Although we found a significant trend for increased risk for beer consumption in the recent period (odds ratio 1.67, 95% CI 0.96-2.92, P for trend = 0.05), chance cannot be ruled out as an explanation. We found no evidence of risk related to lifetime alcohol consumption nor evidence that alcohol dehydrogenase genotype modifies risk related to alcohol and lung cancer.

Alcohol Drinking↗

PubMed2003

Alcohol drinking patterns differentially affect central adiposity as measured by abdominal height in women and men.

Alcohol drinking in light-to-moderate amounts has been associated with reduced coronary heart disease (CHD) risk. However, there is evidence that the way people consume alcohol (drinking pattern) may affect risk. Central adiposity, a known CHD risk factor may be one mechanism in the pathway between alcohol consumption and CHD risk. Our study examined whether various drinking patterns differentially affect fat distribution, particularly abdominal fat in women and men. In a randomly selected population-based cohort (n = 2343), 35-79 y old, we assessed drinking pattern as reported for the past 30 d, including beverage type and amount, frequency of consumption, percentage of time drinking while eating and number of drinks consumed/drinking day. Central adiposity was determined using an abdominal caliper to measure supine height of the abdomen. Current drinkers tended to have smaller abdominal heights than nondrinkers (women, P < 0.0001; men, P = 0.0559). For drinking pattern, frequency was inversely associated, but drinking intensity (drinks/drinking day) was positively associated with central adiposity in women (P trend for frequency, 0.0007; intensity, 0.0010) and men (P trend for frequency, 0.0005; intensity, 0.0004), even when age, education, physical activity, smoking status and amount of alcohol (g) were included in the models. When frequency and intensity were considered together, daily drinkers of <1 drink/drinking day had the smallest mean abdominal height measures with the largest measures in less than weekly drinkers who consumed 4 or more drinks/drinking day. These results support the hypothesis that drinking pattern affects the distribution of body fat, an important CHD risk factor.

Abdomen↗

PubMed2002

One drink to a lifetime of drinking: temporal structures of drinking patterns.

This article presents the proceedings of a symposium at the 2001 Research Society on Alcoholism Meeting in Montreal, Canada. The cochairs were Paul J. Gruenewald and Marcia Russell. The focus of the symposium was on mathematical, methodological, and statistical approaches to the assessment of drinking patterns from short (daily and monthly) to very long periods (the life course) of time. The research presented in the symposium argues that (1) model-based approaches to analyzing drinking patterns can provide comprehensive bases for assessing drinking risks, (2) data acquisition technologies that track daily drinking over long periods of time can illuminate unique features of drinking associated with abuse and dependence, and (3) retrospective data can be used to assess life-course trajectories of drinking associated with chronic problem outcomes. Each of the presentations points toward an integrated approach to understanding acute and chronic risks related to alcohol use. The presentations were (1) Mathematical models of current drinking, by Paul J. Gruenewald and Fred Johnson; (2) Mathematical models of drinking problems, by John Light and Rob Lipton; (3) Patterns of drinking ascertained from daily data aggregated across 24 months, by John Searles; and (4) Cognitive lifetime drinking histories and natural histories of drinking, by Marcia Russell, Paul J. Gruenewald, Fred Johnson, Maurizio Trevisan, Jo Freudenheim, Paola Muti, Ann Marie Carosella, and Thomas H. Nochajski.

Alcohol Drinking↗