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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Binge drinking is considered harmful, regardless of a person's age, and there have been calls for healthcare professionals to give increased attention to their patients drinking habits, especially binge drinking. Some researchers believe that raising the legal drinking age and screening brief interventions by healthcare providers are the most effective means of reducing morbidity and mortality rates associated with binge drinking. Programs in the United States have thought of numerous ways to help prevent binge drinking. The Centers for Disease Control and Prevention suggests increasing the cost of alcohol or the excise taxes, restricting the number of stores who may obtain a license to sell liquor (reducing "outlet density"), and implementing stricter law enforcement of underage drinking laws. There are also a number of individual counseling approaches, such as motivational interviewing and cognitive behavioral approaches, that have been shown to reduce drinking among heavy drinking college students. In 2006, the Wisconsin Initiative to Promote Healthy Lifestyles implemented a program that helps primary care physicians identify and address binge drinking problems in patients. In August 2008, a group of college presidents calling itself the Amethyst Initiative asserted that lowering the legal drinking age to 18 (presumably) was one way to curb the "culture of dangerous binge drinking" among college students. This idea is currently the subject of controversy. Proponents argue that the 21 law forces drinking underground and makes it more dangerous than it has to be, while opponents have claimed that lowering the age would only make the situation worse. Despite health warnings, most Australian women drink at least one night a week. But experts are warning they are not only damaging their bodies but are also at risk of attracting sexual predators.
Research shows ways to reduce binge drinking or engage in dangerous driving. Some computer-based intervention appear to reduce binge drinking, an example of which is "rethinking drinking".
Understanding consumer personality and how people view others is important. People were shown ads talking of the harmful effects of binge drinking. People who valued close friends as a sense of who they are were less likely to want to binge drink after seeing an ad featuring them and a close friend. People who were loners or who did not see close friends important to their sense of who they were reacted better to ads featuring an individual. A similar pattern was shown for ads showing a person driving at dangerous speeds. This suggests ads showing potential harm to citizens from binge drinking or dangerous driving are less effective than ads highlighting a person’s close friends.
In 2009 the Australian Government Department of Health and Ageing spent $53.5 million Australian Dollars on National Binge Drinking Strategy to target young Australians. This campaign titled "Don't Turn a Night Out Into a Nightmare" was delivered to the public over many mass media platforms to show the harms and consequences of risky single occasion drinking (RSOD) as binge drinking is defined in Australia. Evidence as to the effectiveness of these types of campaigns is mixed. Research needs to be completed to ensure that the effectiveness of the messages are resulting in a positive shift in the behaviours of the target audience.
Drunkorexia is not a medically diagnosed disorder therefore there is no specific treatment. However, as drunkorexia is a combination of two different disorders, binge drinking and eating disorders such as anorexia and bulimia the treatment will need to address both.
Drunkorexia consists of 3 major aspects: alcohol use/abuse, food intake restriction, and excessive physical activity. It is commonly summarised in the following activities:
- Counting daily calorie intake (commonly known as "calorie counting") to ensure no weight will be gained when consuming alcohol.
- Missing or skipping meals to conserve calories for consumption of alcoholic beverages.
- Over exercising to counterweigh for calories consumed from alcoholic beverages.
- Consuming an extreme amount of alcohol to vomit previously digested food.
There are two main types of treatment given to those suffering with bulimia nervosa; psychopharmacological and psychosocial treatments.
Some researchers have also claimed positive outcomes in hypnotherapy.
Counselling and certain medication, such as lisdexamfetamine and selective serotonin reuptake inhibitor (SSRIs), may help. Some recommend a multidisciplinary approach in the treatment of the disorder.
Cognitive behavioral therapy (CBT) treatment has been demonstrated as a more effective form of treatment for BED than behavioral weight loss programs. 50 percent of BED individuals achieve complete remission from binge eating. CBT has also been shown to be an effective method to address self-image issues and psychiatric comorbidities (e.g., depression) associated with the disorder. Recent reviews have concluded that psychological interventions such as psychotherapy and behavioral interventions are more effective than pharmacological interventions for the treatment of binge eating disorder. There is the 12-step Overeaters Anonymous or Food Addicts in Recovery Anonymous.
Prevention aims to promote a healthy development before the occurrence of eating disorders. It also intends early identification of an eating disorder before it is too late to treat. Children as young as ages 5–7 are aware of the cultural messages regarding body image and dieting. Prevention comes in bringing these issues to the light. The following topics can be discussed with young children (as well as teens and young adults).
- Emotional Bites: a simple way to discuss emotional eating is to ask children about why they might eat besides being hungry. Talk about more effective ways to cope with emotions, emphasizing the value of sharing feelings with a trusted adult.
- Say No to Teasing: another concept is to emphasize that it is wrong to say hurtful things about other people's body sizes.
- Body Talk: emphasize the importance of listening to one's body. That is, eating when you are hungry (not starving) and stopping when you are satisfied (not stuffed). Children intuitively grasp these concepts.
- Fitness Comes in All Sizes: educate children about the genetics of body size and the normal changes occurring in the body. Discuss their fears and hopes about growing bigger. Focus on fitness and a balanced diet.
Internet and modern technologies provide new opportunities for prevention. On-line programs have the potential to increase the use of prevention programs. The development and practice of prevention programs via on-line sources make it possible to reach a wide range of people at minimal cost. Such an approach can also make prevention programs to be sustainable.
Diet is the most essential factor to work on in people with anorexia nervosa, and must be tailored to each person's needs. Food variety is important when establishing meal plans as well as foods that are higher in energy density. People must consume adequate calories, starting slowly, and increasing at a measured pace. Evidence of a role for zinc supplementation during refeeding is unclear.
Compulsive overeating is treatable with nutritional assistance and medication. Psychotherapy may also be required, but recent research has proven this to be useful only as a complementary resource, with short-term effectiveness in middle to severe cases.
Lisdexamfetamine is an FDA-approved appetite suppressant drug that is indicated for the treatment of binge eating disorder. The antidepressant fluoxetine is a medication that is approved by the Food and Drug Administration (FDA) for the treatment of an eating disorder, specifically bulimia nervosa. This medication has been prescribed off-label for the treatment of binge eating disorder (BED). Off-label medications, such as other selective serotonin reuptake inhibitors (SSRIs), have shown some efficacy, as have several atypical agents, such as mianserin, trazodone and bupropion. Anti-obesity medications have also proven very effective. Studies suggest that anti-obesity drugs, or moderate appetite suppressants, may be key to controlling binge eating.
Many eating disorders are thought to be behavioral patterns that stem from emotional struggles; for the individual to develop lasting improvement and a healthy relationship with food, these affective obstacles need to be resolved. Individuals can overcome compulsive overeating through treatment, which should include talk therapy and medical and nutritional counseling. Such counseling has been recently sanctioned by the American Dental Association in their journal article cover-story for the first time in history in 2012: Given "the continued increase in obesity in the United States and the willingness of dentists to assist in prevention and interventional effort, experts in obesity intervention in conjunction with dental educators should develop models of intervention within the scope of dental practice". Moreover, dental appliances such as conventional jaw wiring and orthodontic wiring for controlling compulsive overeating have been shown to be “efficient ways in terms of weight control in properly selected obese patients and usually no serious complications could be encountered through the treatment course.
As well, several twelve-step programs exist to help members recover from compulsive overeating and food addiction, such as Overeaters Anonymous and others.
The rate of refeeding can be difficult to establish, because the fear of refeeding syndrome (RFS) can lead to underfeeding. It is thought that RFS, with falling phosphate and potassium levels, is more likely to occur when BMI is very low, and when medical comorbidities such as infection or cardiac failure, are present. In those circumstances, it is recommended to start refeeding slowly but to build up rapidly as long as RFS does not occur. Recommendations on energy requirements vary, from 5–10 kCal/Kg/day in the most medically compromised patients, who appear to have the highest risk of RFS to 1900 Kcal/day
Preventing or reducing the harm has been called for via increased taxation of alcohol, stricter regulation of alcohol advertising and the provision of brief Interventions. Brief Interventions for alcohol abuse reduce the incidence of unsafe sex, sexual violence, unplanned pregnancy and, likely, STD transmission. Information and education on social norms and the harms associated with alcohol abuse delivered via the internet or face-to-face has not been found to result in any meaningful benefit in changing harmful drinking behaviours in young people.
According to European law, individuals who are suffering from alcohol abuse or other related problems cannot be given a license, or if in possession of a license cannot get it renewed. This is a way to prevent individuals driving under the influence of alcohol, but does not prevent alcohol abuse per se.
An individual's need for alcohol can depend on their family's alcohol use history. For instance, if it is discovered that their family history with alcohol has a strong pattern, there might be a need for education to be set in place to reduce the likelihood of reoccurrence (Powers, 2007). However, studies have established that those with alcohol abuse tend to have family members who try to provide help. In many of these occasions the family members would try to help the individual to change or to help improve the individual's lifestyle.
Social isolation has been shown to have a deleterious effect on an individual's physical and emotional well-being. Those that are socially isolated have a higher mortality rate in general as compared to individuals that have established social relationships. This effect on mortality is markedly increased in those with pre-existing medical or psychiatric conditions, and has been especially noted in cases of coronary heart disease. "The magnitude of risk associated with social isolation is comparable with that of cigarette smoking and other major biomedical and psychosocial risk factors." (Brummett "et al.")
Social isolation can be inherently stressful, depressing and anxiety-provoking. In an attempt to ameliorate these distressful feelings an individual may engage in emotional eating in which food serves as a source of comfort. The loneliness of social isolation and the inherent stressors thus associated have been implicated as triggering factors in binge eating as well.
Waller, Kennerley and Ohanian (2007) argued that both bingeing–vomiting and restriction are emotion suppression strategies, but they are just utilized at different times. For example, restriction is used to pre-empt any emotion activation, while bingeing–vomiting is used after an emotion has been activated.
A review on behavioral addictions listed the estimated the lifetime prevalence rate (i.e., the proportion of individuals in the population that developed the disorder during their lifetime) for food addiction in the United States as 2.8%.
While little detailed genetic research has been done, it has been shown that alcoholism tends to run in families with possible involvement of differences in alcohol metabolism and the genotype of alcohol-metabolizing enzymes.
Youth treatment and intervention should focus on eliminating or reducing the effects of adverse childhood experiences, like childhood maltreatment, since these are common risk factors contributing to the early development of alcohol abuse. Approaches like contingency management and motivational interviewing have shown to be effective means of treating substance abuse in impulsive adolescents by focusing on positive rewards and redirecting them towards healthier goals. Educating youth about what is considered heavy drinking along with helping them focus on their own drinking behaviors has been shown to effectively change their perceptions of drinking and could potentially help them to avoid alcohol abuse.
Completely stopping the use of alcohol, or "abstinence," is the ideal goal of treatment. A strong social network and family support maybe important in achieving this goal.
Some people who abuse alcohol may be able to reduce the amount they drink, also called "drinking in moderation." If this method does not work, the person may need to try abstinence. Abstinence has been regularly achieved by many alcoholics in Alcoholics Anonymous.
Mindfulness-based intervention programs (that encourage people to be aware of their own experiences in the present moment and of emotions that arise from thoughts) can reduce the consumption of alcohol.
Cognitive behavioural therapy, individual therapy, and group therapy are often beneficial in helping people keep track of their eating habits and changing the way they cope with difficult situations.
There are several 12-step programs that helps overeaters, such as Overeaters Anonymous or Food Addicts in Recovery Anonymous and others.
It is quite clear through research, and various studies that overeating causes addictive behaviors.
In some instances, overeating has been linked to the use of medications known as dopamine agonists, such as pramipexole.
Injury is defined as damage or harm that is done or sustained. The potential of injuring oneself or others can be increased after consuming alcohol due to the certain short term effects related to the substance such as lack of coordination, blurred vision, and slower reflexes to name a few. Due to these effects the most common injuries include head, fall, and vehicle related injuries. These include a range of soft tissue damage and fractures. A study was conducted between November 1, 2001 and June 30, 2002 of patients admitted to The Ulster Hospital in Northern Ireland with fall related injuries. They found that 113 of those patients admitted to that hospital during that had consumed alcohol recently and that the injury severity was higher for those that had consumed alcohol compared to those that hadn't. Another study showed that 21% of patients admitted to the Emergency Department of the Bristol Royal Infirmary had either direct or indirect alcohol related injuries. If these figures are extrapolated it shows that the estimated number of patients with alcohol related injuries are over 7000 during the year at this ED alone.
In the United States alcohol resulted in about 88,000 deaths in 2010.
There are a number of ways to preventing alcoholism throughout
adolescents. One of the main ways to do this is to "Promote an
understanding of underage alcohol consumption in the context of human
development and maturation that takes into account individual adolescent
characteristics as well as environmental, ethic, cultural and gender
differences". Another way in preventing underage drinking would be by reducing the cultural forces which are encouraging and
supporting underage drinking will also contribute to preventing adolescents from
consuming alcohol as a culture in which adolescents feel that it is acceptable,
will allow them to think that it is appropriate. Another important
component to preventing alcoholism throughout adolescence is the responsibility
of the government, to send a message to
underage drinkers informing them how themselves and the rest of society
strongly disapprove underage alcohol use because of the severe consequences it
can cause and also informing that it will not be tolerated.
There are many health hazards that are caused from drinking. When students drink too much, the alcohol affects one's brain and ability to comprehend what is going on. One such problem is alcohol poisoning. After drinking too much, the alcohol and toxins in alcoholic drinks cause complications in one's brain and respiratory system. This causes mental and physical issues in one's body and could be very dangerous for one's health. Other hazardous health issues could arise from a drug called Rohypnol, nicknamed roofies. This is a toxic drug that could potentially be slipped into one’s drink which cause one to lose sight of what one thinks and does. This will also cause complications within one's body.
Alcohol consumption by youth in the United States of America is an umbrella term for alcohol consumption by individuals under the age of 21 in the country.
Although the minimum legal age to purchase alcohol is 21 in all states (see National Minimum Drinking Age Act), the legal details vary greatly. While a few states completely ban alcohol usage for people under 21, the majority have exceptions that permit consumption.
Underage drinking has become an activity primarily done behind closed doors. Typically, underage drinkers hide their alcohol consumption by drinking quickly before they go out, which is often referred to as pregaming or pre-partying. Brittany Levine explained in her article "Pre-Gaming" in USA Today that "of all drinking events involving pre-partying, 80% involved additional drinking afterward." Those who oppose a complete ban on underage drinking argue that it is important that minors be introduced to alcohol in a controlled environment, so that supervision and guidance might occur instead of experimentation. Some parents are willing to provide alcohol for their children if they drink it in a controlled environment. Furnishing alcohol to one's own children is permitted in 31 states, while it's illegal to do so for other people's children in all fifty states. Social host ordinances have been enacted in a number of jurisdictions to attempt to limit the parties where adults may permit minors to drink. Social host laws or ordinances have proliferated in the last ten years because it has been too difficult for law enforcement to prove which adults furnished or served alcohol to minors in their own home, so it permits them to cite or arrest the adult who has control of the premises.
In the United States there are four approved medications for alcoholism: disulfiram, two forms of naltrexone, and acamprosate. Several other drugs are also used and many are under investigation.
- Benzodiazepines, while useful in the management of acute alcohol withdrawal, if used long-term can cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate of achieving abstinence from alcohol than those not taking benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or anxiety management. Initiating prescriptions of benzodiazepines or sedative-hypnotics in individuals in recovery has a high rate of relapse with one author reporting more than a quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and panic may develop, which are known risk factors for relapse into alcohol abuse. Taper regimes of 6–12 months have been found to be the most successful, with reduced intensity of withdrawal.
- Acamprosate may stabilise the brain chemistry that is altered due to alcohol dependence via antagonising the actions of glutamate, a neurotransmitter which is hyperactive in the post-withdrawal phase. By reducing excessive NMDA activity which occurs at the onset of alcohol withdrawal, acamprosate can reduce or prevent alcohol withdrawal related neurotoxicity. Acamprosate reduces the risk of relapse amongst alcohol dependent persons.
- Disulfiram (Antabuse) prevents the elimination of acetaldehyde, a chemical the body produces when breaking down ethanol. Acetaldehyde itself is the cause of many hangover symptoms from alcohol use. The overall effect is severe discomfort when alcohol is ingested: an extremely fast-acting and long-lasting uncomfortable hangover. This discourages an alcoholic from drinking in significant amounts while they take the medicine.
- Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects of endorphins and opioids. Naltrexone is used to decrease cravings for alcohol and encourage abstinence. Alcohol causes the body to release endorphins, which in turn release dopamine and activate the reward pathways; hence when naltrexone is in the body there is a reduction in the pleasurable effects from consuming alcohol. Evidence supports a reduced risk of relapse among alcohol dependent persons and a decrease in excessive drinking. Nalmefene also appears effective and works by a similar manner.
- Calcium carbimide works in the same way as disulfiram; it has an advantage in that the occasional adverse effects of disulfiram, hepatotoxicity and drowsiness, do not occur with calcium carbimide.
The Sinclair method is a method of using naltrexone or another opioid antagonists to treat alcoholism by having the person take the medication about an hour before they drink alcohol, and only then. The medication blocks the positive reinforcement effects of ethanol and hopefully allows the person to stop drinking or drink less.
Evidence does not support the use of selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), antipsychotics, or gabapentin.
A legal minimum age for the buying or consuming of alcohol is in place in many of the world's countries, typically with the intent to protect the young from alcohol-related harm. This age varies between countries; for example, the minimum legal drinking age for Australia is 18, whereas the MLDA in the United States is 21.
Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable eating. It is sometimes a symptom of binge eating disorder or compulsive overeating disorder. During such binges, a person rapidly consumes an excessive quantity of food. A diagnosis of binge eating is associated with feelings of loss of control.