A Preliminary Evaluation of Mobile Phone Apps to Curb Alcohol Consumption

Mobile apps have become increasingly prevalent in modern society, and persuasive technology has a broader market than ever. Mobile-based alcohol cessation apps can promote positive behaviour change in users and improve the overall health of our society. This research aimed to understand the various features users respond to and make design recommendations for alcohol cessation apps. This paper reports on three sources of feedback (user ratings, user reviews, MARS App Quality score) provided on 20 alcohol cessation apps in the Google Play Store. Our findings suggest that self-control type apps received much greater positive user reviews than motivational apps. In addition, this trend was not observed through numeric user ratings. We also speculate on design recommendations for apps that are meant to inhibit alcohol intake.

Use of YouTube as a Source of Information for Quitting or Cutting Down Alcohol

Background: Although research has been done on considering YouTube for dissuading and encouraging unhealthy behaviours such as smoking, less focus has been placed on its role in quitting or cutting down alcohol. This study aims to analyse the alcohol cessation videos available and accessible on YouTube to gain a more in-depth insight into the ways that YouTube as a platform is being used to persuade with relation to alcohol cessation.Methods: We systematically searched for content on YouTube related to alcohol cessation and these videos were analysed and evaluated for the format, themes, specific alcohol cessation advice, and uploader.Results: The results demonstrated that the collected alcohol cessation videos included a fairly even presence of the themes of discussing the negative impacts of alcohol and the benefits of quitting or staying away from it. At the same time, however, we found the videos were not sourced from professional institutions, such as government or anti-alcohol misuse non-government organisations.Conclusion: More research is needed to investigate utilising YouTube to support those looking to quit or cut down alcohol.

Adolescent ethanol drinking promotes hyperalgesia, neuroinflammation and serotonergic deficits in mice that persist into adulthood

Adolescent alcohol use can permanently alter brain function and lead to poor health outcomes in adulthood. Emerging evidence suggests that alcohol use predispose to pain disorders or exacerbate existing pain conditions, but the neural mechanisms are currently unknown. Here we report that mice exposed to adolescent intermittent access to ethanol (AIE) exhibit increased pain sensitivity and depressive-like behaviors that persist after alcohol cessation and are accompanied by elevated CD68 expression in microglia and reduced numbers of serotonin (5-HT)-expressing neurons in the dorsal raphe nucleus (DRN). 5-HT expression was also reduced in the thalamus, anterior cingulate cortex (ACC) and amygdala as well as the lumbar dorsal horn of the spinal cord. We then found that chronic minocycline administration after AIE alleviated hyperalgesia and social deficits, while chemogenetic activation of microglia in the DRN of Cx3cr1-cre-GFP mice reproduced the effects of AIE on pain and social interaction. Taken together, these results indicate that microglial activation in the DRN may be a primary driver of pain and negative affect after AIE.

Associations of education and work status with alcohol use and cessation among pregnant women in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Background There is inconsistent evidence on the associations of education and work status with alcohol use during pregnancy. Our aim was to examine the associations of education and work status with alcohol use and alcohol cessation during pregnancy in Japan. Methods Data were analyzed from 11,839 pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017 in Japan. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Alcohol cessation was defined as alcohol use in early pregnancy, but not in middle pregnancy. Multivariable log-binomial regression analyses were conducted to examine associations of education and work status with alcohol use in early and middle pregnancy and alcohol cessation, adjusted for age and income. The prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated by work status and education. Results The prevalence of alcohol use in early and middle pregnancy was 20.9 and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy both among working and non-working women; the PRs of university education or higher compared with high school education or lower were 1.62 (95% CI, 1.34–1.96) and 1.29 (95% CI, 1.16–1.45), respectively. Higher education was associated with alcohol cessation during pregnancy among working women; the corresponding PR was 1.09 (95% CI, 1.01–1.17). Working was associated with alcohol use in early and middle pregnancy. Working was associated with a decreased probability of alcohol cessation among women with lower education but with an increased probability of alcohol cessation among women with higher education; the PRs of working compared with not working were 0.91 (95% CI, 0.82–1.00) and 1.10 (95% CI, 1.00–1.20), respectively. Conclusions Women with higher education were more likely to consume alcohol in early pregnancy and to cease alcohol use between early and middle pregnancy, especially working women. Working women were more likely to consume alcohol throughout pregnancy. Working women with lower education were less likely to cease alcohol use, whereas working women with higher education were more likely to cease alcohol use between early and middle pregnancy.

855 Sexsomnia: A Case Series Looking at a Rare Parasomnia

Introduction Sexsomnia is a male predominant, rare subset of NREM parasomnia involving sleep-related sexual activity. Symptoms can range from individual sexual acts, such as masturbation, to acts involving bed partners, often without recollection. Sexsomnia results in profound personal, social, and legal ramifications. Though typically treated with benzodiazepines, here we present three patients that were managed nontraditionally. Report of case(s) Case 1 A 34-year-old man with a history of optimized obstructive sleep apnea (OSA), alcohol abuse, and bipolar disorder reported eight-years of parasomnia characterized by fondling, sexual intercourse, and aggressive sexual acts, despite treatment with benzodiazepines. His fiancé noted that his advances when sleeping were atypical for their normal intimate interactions. He was observed to have frequent arousals from N3 sleep during PSG. The patient denied current substance use, but did report bilateral foot discomfort leading to sleep disturbance. His ferritin was 38 ng/mL, and he was started on oral iron and vitamin C. Case 2 A 41-year-old woman with a history of anxiety, psoriatic arthritis, insomnia and childhood somnambulism presented with parasomnia ranging from fondling to sexual intercourse. Her husband noted that during the episodes, her mannerisms and speech pattern were vastly different from normal. She endorsed difficulty initiating sleep, with a sleep latency of one hour and frequent arousals despite using trazodone nightly. She consumed two to five glasses of whiskey in the evenings several nights a week. Parasomnia events were more prevalent on nights that she partook in alcohol and improved with alcohol cessation. Case 3 A 44-year-old man with a history of optimized mild OSA presented with parasomnias characterized by somnambulism with goal-directed behavior and sexual activity, with a family history of violent parasomnias. Given the atypical nature of his events, he was referred to the epilepsy monitoring unit, which was ultimately nondiagnostic. Benzodiazepine therapy was ineffective. He chose to defer further medical management, leading the patient to pursue cognitive behavioral therapy, with moderate benefit. He reports infrequent parasomnias off medications. Conclusion Sexsomnia remains a rare, and likely under reported phenomenon. In each of the highlighted cases, the patients responded to treatment without the use of standard benzodiazepine therapy. Support (if any):

Incidence and management patterns of alcohol-related liver disease in Korea: a nationwide standard cohort study

The recent incidence and management patterns of alcohol-related liver disease (ARLD) are not well defined in Korea. We sought to evaluate the epidemiology of ARLD with regard to disease severity and alcohol cessation management after diagnosis. We performed an observational cohort study of standardized Common Data Model data from the Health Insurance Review and Assessment-National Patient Samples database between 2012 and 2016. The incidence and demographic properties of ARLD were extracted and divided into non-cirrhotic alcoholic liver disease (ALD) and alcoholic liver cirrhosis (ALC). ALC was compared with non-alcoholic cirrhosis by severity at diagnosis. The management patterns were captured by the initiation of pharmaco- and behavioral therapy for alcohol cessation. We analyzed data from 72,556 ALD to 7295 ALC patients. The ALD incidence was stable from 990 to 1025 per 100,000 people. In ALD, the proportion of patients who were ≥ 65 years old, the proportion of female patients, and the comorbidity index increased significantly during the study period (all P values < 0.001). ALC accounted for > 20% of all cirrhosis, with decompensation occurring twice as often as in non-alcoholic cirrhosis. The initiation of alcoholism management was stationary in ARLD, remaining at < 10% for both pharmacotherapy and behavioral therapy, regardless of severity or the site of diagnosis. The incidence of ARLD did not decrease during the study period. Moreover, an increasing trend in the proportion of people vulnerable to drinking was observed. Unfortunately, management for the cessation of alcohol use remains very low. The best way to manage ARLD should be evaluated in further study.