Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

BACKGROUND: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING: Bill & Melinda Gates Foundation

Readiness for Self-Directed Learning Among Students of Bachelor of Science in Nursing Program of Selected Colleges in Kathmandu, Nepal

Self-Directed Learning (SDL) is a process in which the learner takes self-initiation for assessing own learning needs and work accordingly with the help of available resources for achievement of required learning, The objective of this study is to identify the readiness for self-directed learning among the Bachelor of Science in Nursing (BSN) students. A descriptive cross sectional study was conducted among BSN students of Yeti Health Science Academy and Kantipur Academy of Health Science, Kathmandu, Nepal. Complete enumerative sampling technique was used in this study where 107 students were involved. Questionnaire method with SDL scale was used for data collection. Most of the respondents 74(69.2%) had high level of readiness for self-directed learning and 33(30.8%) of respondents had low level of readiness for self-directed learning. The association between academic year with the level of readiness for self-directed learning were statistically significant (p=0.045) whereas the association between other variables (age, ethnicity, religion, marital status, family type and residence) with the level of readiness for self-directed learning were statistically insignificant (p&gt;0.05).It is concluded that depending upon the academic year, seniors are more ready towards self-directed learning than junior nursing students.</jats:p