Biomedical subjects

U John

Publications and source records attributed to U John.

118 records · Page 7Linked to original sources

PubMedDate not supplied

Motivation to change drinking behavior: comparison of alcohol-dependent individuals in a general hospital and a general population sample.

The general hospital would be especially suited to initiate interventions if hospitalized alcohol-dependent individuals were particularly motivated to change their drinking behavior. This study compares the readiness to change of alcohol-dependent persons in the general hospital and the general population. Stages of change according to the model of Prochaska and DiClemente [6] are assessed using the Readiness to Change Questionnaire (RCQ) in two representative samples: 118 alcohol-dependent subjects admitted to a general hospital (sample 1) and 50 alcohol-dependent individuals in the general population (sample 2). In sample 1, alcohol-dependent persons were identified in 1167 consecutive admissions using screening questionnaires and a diagnostic interview (SCAN). In sample 2, alcohol dependence was assessed in 4075 individuals using a German version of CIDI. The distribution of stages of change differed significantly (p < 0.0001) between the groups, revealing a shift towards higher stages in the hospital subjects. Logistic regression analysis revealed that the stages of readiness to change and age contributed in predicting whether subjects belonged to the general hospital or the general population sample. Findings suggest that the general hospital is a suitable site to initiate interventions for alcohol-dependent individuals.

Adult↗

PubMedDate not supplied

[Promoting the intention to quit smoking among patients in family medicine practice].

BACKGROUND: General practitioners can reach large number of smokers. Their good interpersonal relationship with patients promises successful guidance with regard to smoking. However, little is known about the accessibility of smokers to intervention in general practice and about the motivation to abandon smoking. There is a lack of information concerning the GPs' perceived responsibility for smoking counselling. The goal of the study is to examine to what extent smokers can be advised in general practice and how GPs' assess the practicability of such counselling. METHODS: The sample consisted of consecutive general practices patients. A random sample of 39 GPs was drawn and 34 took part in the study. Of 3434 patients, 99.7 % participated in the screening procedure. Inclusion criteria (age 18 to 70 years, admitted smokers), were met by 551 subjects. The participation rate was 81.4 % (n = 449). All GPs received a single training session. Counselling was tailored to the motivation to quit. More than 60 % of the patients were not motivated to stop smoking. RESULTS: Following the study design, 87.8 % of all smoking patients were counselled by GPs. A total of 79.3 % among the GPs considered the intervention to be practicable. CONCLUSIONS: Despite a low motivation to quit smoking in the general practice, 80 % of the smoking patients can be reached by interventions. Furthermore, since the agreement of the GPs concerning practicability was almost 80 %, measures should be initiated to promote counselling for all smokers within the scope of medical consultation.

Adolescent↗

PubMedDate not supplied

[Smoking behavior in adolescents: a comparison of population-representative, regional or selectively assessed data and implications for prevention].

INTRODUCTION: The prevalence of adolescent smoking underlines the necessity of preventive measures, which goals are based on representative data. It is not known whether schools participate in prevention interventions, where smoking constitutes a relatively big or minor problem. OBJECTIVE: This study examines a population of adolescents on (a) different smoking variables and (b) compares them with representative, population based data. METHODS: Survey of n = 324 adolescents of grade 7-10 in 3 schools in Greifswald and surroundings that were ready to participate in a prevention curriculum. RESULTS: In total, 80% of the students under examination indicated to have at least tried smoking in their lifetime. Daily smokers were 31%, 18% were occasional smokers, 39% have indicated that they hat tried to quit without success. These figures vary across age, grade and sex. Smoking prevalence is comparable between schools ready to participate in prevention and regionally assessed data, but much higher than population based data would have estimated. CONCLUSION: The goal of preventive measures can not be solely grounded on representative, population-based data, but needs (a) to be regionally defined and (b) to consider the population actually participating in such prevention interventions. The readiness to participate is not higher in schools where smoking constitutes a comparable minor problem. Preventive measures are applied in schools where the problem is perceived.

Adolescent↗

PubMedDate not supplied

Drinking pattern and alcohol-related medical disorders.

Although heavy alcohol intake is known to be one of the most common causative factors of liver disease, pancreatitis, upper gastrointestinal and neurological disorders, the influence of the drinking pattern is largely unknown. The study investigated the relationship of alcohol-related medical disorders in alcoholics and their drinking pattern. Two hundred and forty-one chronic alcoholics were referred consecutively for detoxification and their drinking pattern was sufficient for them to be included in this study. History of alcohol abuse as well as drinking behaviour in the last 6 months were assessed by a semi-structured interview. Findings included intensive clinical examination with abdominal ultrasound in most subjects. Heavy drinking with frequent inebriation was most often found in our sample (44.4%), whereas continuous heavy alcohol consumption without intoxication (33.6%), and an episodic drinking style (22.0%) were less frequent. The heavy drinkers suffered more often from pancreatitis, oesophageal varices, polyneuropathy or erectile dysfunction than episodic drinkers. They also showed more upper gastrointestinal disorders, although the estimated life-time alcohol intake was comparable to continuous drinkers. No difference relating to withdrawal delirium or seizures could be found between the groups of alcoholics. Frequent heavy drinkers showed a trend to more alcohol-related medical disorders than alcoholics with a different drinking pattern, although they were younger and their estimated life-time alcohol intake was comparable to that of continuous drinkers. Thus, the drinking pattern, particularly frequent inebriation, has an influence on the occurrence of alcohol-related disorders.

Adult↗

PubMedDate not supplied

Estimating prevalence of alcohol abuse and dependence in one general hospital: an approach to reduce sample selection bias.

Prevalence estimates of alcohol abuse or dependence in general hospitals are often limited to single wards, small data collecting periods or insufficient diagnostic procedures. Therefore, the present study aimed to ascertain alcohol abuse or dependence in one general hospital, to compare prevalence data for all the 11 wards and 6 intake months, to establish if screening is sufficient or if a two-step diagnostic procedure is needed, and to determine whether information for an alcohol diagnosis on suspicion is available. A sample of 1309 medical or surgical in-patients were screened by questionnaires or medication for withdrawal, and, if screening-positive, were interviewed with the alcohol section of a standardized psychiatric interview. In screening-negative patients, a diagnosis on suspicion was given if medication to treat withdrawal had been used, or if there was evidence of single criteria of alcohol dependence, somatic disorders from alcohol drinking, raised laboratory parameters on grounds of alcohol drinking or of self-reported high alcohol consumption. Of the medical and surgical in-patients, 20.7 and 16.0% respectively were alcohol abusers or dependents, with a range of prevalence rates of alcohol abuse or dependence among wards of 11.1-32.9% and among intake months between 11.3 and 28.7%. Of the medical department in-patients, 1.9%, and of the surgical in-patients, 2.1%, were screened as false-positive cases. In addition, 5.5% of the medical and 12.0% of the surgical patients were given a diagnosis on suspicion. It is concluded that all general wards and different intake months should be taken into account when estimating prevalence of alcohol abuse or dependence in a general hospital.

Adolescent↗

PubMedDate not supplied

Motivational intervention: an individual counselling vs a group treatment approach for alcohol-dependent in-patients.

AIMS: The present study aimed to evaluate whether individual counselling for alcohol-dependent patients in three sessions is as effective as a 2-week group treatment programme as part of an in-patient stay in a psychiatric hospital which was to foster motivation to seek further help and to strengthen the motivation to stay sober. Of particular importance was the external validity of the results, i.e. a 'normal' intake load of in-patients in detoxification and a wide variety of motivation to stop drinking were to be investigated. METHODS: Subjects eligible for the study were all patients with alcohol problems admitted to a psychiatric hospital, but without psychosis, as the main diagnosis, and with a maximum of 10 detoxification treatments in the past. A randomized-controlled trial was conducted with 161 alcohol-dependent in-patients who received three individual counselling sessions on their ward in addition to detoxification treatment and 161 in-patients who received 2 weeks of in-patient treatment and four out-patient group sessions in addition to detoxification. Both interventions followed the principles and strategies of motivational interviewing. RESULTS: Six months after intervention, group-treatment patients showed a higher rate of participation in self-help groups; however, this difference had disappeared 12 months after treatment. The abstinence rate among the former patients did not differ between the two intervention groups. CONCLUSION: Group treatment may lead to a higher rate of participation in self-help groups, but does not increase the abstinence rate 6 months after treatment.

Alcoholism↗

PubMedDate not supplied

Alcohol-related diseases in general hospital patients.

To determine the prevalence and spectrum of alcohol-related diseases in a general hospital inpatient population, data of 1288 patients newly admitted to a city general hospital, who had been examined with regards to alcoholism, were surveyed. The sample consisted of 625 medical and 663 surgical patients aged 18-64 years. In 21% (29.3% of the men and 9.4% of the women), inpatient treatment was due to an alcohol-related disorder. The highest occurrence was found in the 35-55 year-olds. Frequently diagnosed disorders in alcohol-dependent patients included delirium tremens (12.8%), seizures (11.4%), head injuries (9.4%) and cirrhosis of the liver (8.1%), whereas alcohol abusers had often been injured. Excluding patients with alcohol-related diseases decreases the proportion of men in the sample by 6.2%. The prevalence of physically-damaged alcoholic patients in general hospitals suggests that preventative measures, such as consultation services, could be applied efficiently in this setting.

Adolescent↗

PubMedDate not supplied

A new rating scale for the assessment of the alcohol-withdrawal syndrome (AWS scale).

A new rating scale for the quantitative assessment of the alcohol-withdrawal syndrome (AWS) was developed from the CIWA-A scale by item analysis based on the data from 132 alcoholic patients. The clinical evaluation of this AWS scale in a second sample of 256 alcoholic patients showed that it adequately assessed the course and severity of the AWS. The AWS scale provides data for a rational strategy of therapy for the AWS by rating mental and somatic symptoms on different scales. In particular, the mental subscale allows prediction of a complicated AWS. Subjects with an AWS score > or = 10 at admission have a higher risk of becoming delirious than those with a lower score (46.6% vs 2.8%; P < 0.001). In order to minimize the prescription of drugs with abuse potential, such as diazepam and clomethiazole, a structured treatment programme of in-patient alcohol detoxification based on the AWS score was also developed. The comparison revealed that, in the second sample, which was treated following this protocol, the number of cases given medication was lower and the amount of clomethiazole prescribed per patient was less.

Adult↗

PubMedDate not supplied

Prevalence and distribution of root caries in Pomerania, North-East Germany.

The aim of this study was to assess the prevalence and distribution of root caries in the adult population of Pomerania, Germany. The study sample comprised 6,267 randomly selected subjects who were scheduled for examination from 1997 to 2001 (population-based cross-sectional study, response rate: 69%, age range 20-79 years). 499 edentulous persons were excluded from the dental examination (12%) performed according to WHO guidelines (1997). In the statistical analysis, frequency distributions, means and median values were calculated and subdivided for different age groups. The percentage of exposed and affected root surfaces increased with age (root caries index 4.6-10.6%). The mean number of carious/filled root surfaces (RDFS) rose from 0.4 per person (25-34 years) to 2.3 (55-64 years) and dropped for seniors due to the low number of retained teeth. Fillings comprised the largest proportion of the RDFS (69.5%). Most caries/fillings were found on buccal surfaces, the highest rate in mandibular premolars. With about half of over-45-year-olds having at least one carious/filled root surface and increasing number of retained teeth in seniors, root caries is a relevant and probably growing disease in Pomerania and East Germany.

Adult↗

PubMedDate not supplied

[Regional differences in the prevalence of high-risk alcohol drinking: secondary analysis of the East-West health survey].

Basing on a reanalysis of the public use file "Health Survey East and West Germany", the regional distribution of at risk alcohol consumption in Germany was examined in a representative sample of 7,466 adults. Substantial differences were seen in the prevalence rates between the German Federal Lands (provincial states), also if the social class, number of inhabitants of the community, unemployment as well as age and sex are statistically controlled. Besides a higher prevalence in the Eastern parts of Germany with the newly formed Federal Lands, there is a decrease in prevalence from south to north, mainly caused by the frequency of beer consumption. The results underline the importance of specific regional epidemiological data for public health-related interventions.

Adult↗