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Rehm J, Shield K, Hassan AS, Franklin A. The role of alcohol control policies in the reversal of alcohol consumption levels and resulting attributable harms in China. Alcohol 2024; 121:19-25. [PMID: 39009173 DOI: 10.1016/j.alcohol.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/05/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Abstract
Yearly adult per capita consumption of alcohol in China between 2016 and 2019 decreased by 2.4 L of pure alcohol, or 33%. According to the World Health Organization, this decrease in consumption was accompanied by reductions in alcohol-attributable mortality of 23% between 2015 and 2019. This paper examines the contribution of alcohol control policies in China to these public health gains. A systematic search of the literature was conducted on alcohol control policies and their effectiveness in China as part of a larger search of all countries in WHO Western Pacific Region. In addition to articles on empirical evidence on the impact of such alcohol control policies, we also searched for reviews. The plausibility of changes of traditional alcohol control policies (taxation increases, availability restrictions, restriction on advertisement and marketing, drink-driving laws, screening and brief interventions) in explaining reductions of consumption levels and attributable mortality rates was explored. There was some progress in the successful implementation of strict drink-driving policies, which could explain reductions in traffic injuries, including fatalities. Other traditional alcohol control policies seem to have played a minimal role in reducing alcohol consumption and attributable harms during the time period 2016-2019. However, an anti-corruption campaign was extensive enough to have substantially contributed to these reductions. The campaign prohibited the consumption of alcoholic beverages in everyday life of government officials and thus contributed to a de-normalization of alcohol. While this anti-corruption campaign was the only policy to potentially explain marked decreases in levels of alcohol consumption and attributable mortality, more detailed research is required to determine exactly how the campaign achieved these decreases.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at the Public Health Institute of Catalonia, Roc Boronat Street 81 - 95, 08005, Barcelona, Catalonia, Spain; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Program on Substance Abuse & WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Roc Boronat Street 81 - 95, 08005, Barcelona, Catalonia, Spain.
| | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at the Public Health Institute of Catalonia, Roc Boronat Street 81 - 95, 08005, Barcelona, Catalonia, Spain; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada
| | - Ahmed S Hassan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada
| | - Ari Franklin
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
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Tangcharoensathien V, Adulyanon S, Supaka N, Munkong R, Viriyathorn S, Sirithienthong S, Kanhachon S, Marten R. The Thai Health Promotion Foundation: Two Decades of Joint Contributions to Addressing Noncommunicable Diseases and Creating Healthy Populations. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:e2300311. [PMID: 38448166 PMCID: PMC11057797 DOI: 10.9745/ghsp-d-23-00311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Globally, the current investment in preventive care is inadequate and ineffective for addressing noncommunicable diseases and their causes. The Thai Health Promotion Foundation, with its sustainable funding from 2% levies on tobacco and alcohol, together with partners, has been used to address noncommunicable diseases effectively.
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Affiliation(s)
| | | | | | | | - Shaheda Viriyathorn
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Siriya Sirithienthong
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Siriyaporn Kanhachon
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
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Liu R, Zhao B, Zhao J, Zhang M. Ethanol causes non-communicable disease through activation of NLRP3 inflammasome: a review on mechanism of action and potential interventions. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:139-149. [PMID: 38237017 DOI: 10.1080/00952990.2023.2297349] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/16/2023] [Indexed: 04/28/2024]
Abstract
Background: Ethanol exposure has been suggested to be implicated in the initiation and progression of several non-communicable diseases (NCD), including neurological disorders, diabetes mellitus, alcoholic liver disease, gastric injury, pancreatitis, and atherosclerosis. Recent findings show that the NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome is involved in the progression of ethanol-induced NCDs.Objective: The aim of this review was to summarize the research progress on NCDs associated with the action of the NLRP3 inflammasome by ethanol and potential interventions, with a specific focus on preclinical literature.Methods: A literature search was conducted on PubMed using the keywords "[ethanol] and [NLRP3]" up until January 2023. Articles describing cases of NCDs caused by ethanol and associated with the NLRP3 inflammasome were included.Results: After removing duplicates, 35 articles were included in this review. These studies, mostly conducted in animals or in vitro, provide evidence that ethanol can contribute to the development of NCDs, such as neurological disorders, alcoholic liver disease, gastric injury, pancreatitis, and atherosclerosis, by activating the NLRP3 inflammasome. Ethanol exposure primarily triggers NLRP3 inflammasome activation by influencing the TRL/NF-κB, ROS-TXNIP-NLRP3 and P2X7 receptor (P2X7R) signaling pathways. Several natural extracts and compounds have been found to alleviate NCDs caused by ethanol consumption by inhibiting the activation of the NLRP3 inflammasome.Conclusion: Preclinical research supports a role for ethanol-induced NLRP3 inflammasome in the development of NCDs. However, the clinical relevance remains uncertain in the relative absence of clinical studies.
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Affiliation(s)
- Ruizi Liu
- School of Clinical Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Bin Zhao
- Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Jie Zhao
- Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Meng Zhang
- School of Clinical Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
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Akselrod S, Collins TE, Berlina D, De Pinho Campos K, Fones G, de Sousa Neves D, Bashir F, Allen LN. Multisectoral action to address noncommunicable diseases: lessons from three country case studies. Front Public Health 2024; 12:1303786. [PMID: 38450149 PMCID: PMC10915276 DOI: 10.3389/fpubh.2024.1303786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/22/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Multisectoral action is a central component of the global response to the rising prevalence of non-communicable diseases (NCDs). In this paper we aimed to unpack the definition of multisectoral action and provide an overview of the historical context, challenges, and recommendations alongside three country case studies: salt reduction in the UK, tobacco legislation in Nigeria, and regulation of edible oils in Iran. Methods We used an iterative review process to select three country case studies from a list of 20 potential cases previously identified by WHO. At our third round of review we unanimously agreed to focus on salt reduction in the UK, tobacco regulation in Nigeria, and edible oil regulation in Iran as these represented rich cases on diverse risk factors from three different world regions that we felt offered important lessons. We conducted literature reviews to identify further data for each case study. Results Across the three studies a number of important themes emerged. We found that multisectoral approaches demand the often difficult reconciliation of competing and conflicting values and priorities. Across our three chosen cases, commercial interests and free trade agreements were the most common obstacles to successful multisectoral strategies. We found that early consultative stakeholder engagement and strong political and bureaucratic leadership were necessary for success. Discussion The complex multi-rooted nature of NCDs requires a multisectoral approach, but the inevitable conflicts that this entails requires careful navigation.
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Affiliation(s)
| | | | | | | | - Guy Fones
- World Health Organization, Geneva, Switzerland
| | | | | | - Luke N. Allen
- Healthier Systems Ltd., Streatley, United Kingdom
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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Haley SJ, Peddireddy S, El-Harakeh A, Akasreku B, Riibe D. Qualitative study of states' capacity to support alcohol prevention policies during the COVID-19 pandemic in the USA. Drug Alcohol Rev 2023; 42:1358-1374. [PMID: 37452762 PMCID: PMC11002955 DOI: 10.1111/dar.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The onset of the COVID-19 pandemic accelerated rates of alcohol purchasing and related harms in the USA. The increases followed governors' emergency orders that increased alcohol availability, including the allowance of alcohol home delivery, alcohol to-go from restaurants and bars, and curbside pickup from retailers. METHODS Semi-structured interviews were conducted with 53 participants involved in state-level alcohol prevention policy across 48 states. Interviewees' perspectives on changes to alcohol prevention policies during the COVID-19 pandemic, including capacity to respond to alcohol-focused executive and legislative changes to alcohol availability, were explored. Initial codes were developed collectively and refined through successive readings of transcripts using a phenomenological, action-oriented research approach. Themes were identified semantically after all transcripts were coded and reviewed. RESULTS Four themes were developed including: (i) alcohol prevention policies and capacity during COVID-19; (ii) industry-related challenges during COVID-19; (iii) limited pre-COVID-19 alcohol prevention capacity; and (iv) needs to strengthen alcohol prevention capacity. DISCUSSION AND CONCLUSIONS The pandemic exacerbated states' capacity limitations for alcohol prevention efforts and created additional impediments to public health messaging about alcohol health risks related to greater alcohol availability. Participants offered a myriad of strategies to improve alcohol prevention and to reduce alcohol-related harms. Recommendations included dedicated federal and state prioritisation, more funding for community organisations, greater coordination, consistent high-quality trainings, stronger surveillance and widespread prevention messaging. States' alcohol prevention efforts require dedicated leadership, additional funding and support to strengthen population-based strategies to reduce sustained alcohol-related harms associated with increases in alcohol availability.
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Affiliation(s)
- Sean J. Haley
- Department of Health Policy and Management, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
| | - Snigdha Peddireddy
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, USA
| | - Amena El-Harakeh
- Departments of Health Policy and Management and Community Health and Social Sciences, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
| | - Bridget Akasreku
- Departments of Health Policy and Management and Community Health and Social Sciences, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
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Room R, Rehm J. "Harm per litre" as a concept and a measure in studying determinants of relations between alcohol consumption and harm. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104006. [PMID: 36965304 DOI: 10.1016/j.drugpo.2023.104006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/27/2023]
Abstract
The term "harm per litre" has been increasingly used in alcohol research in recent years as a concept and a comparative measure of alcohol-attributable harm in comparisons between environments, circumstances, and patterns of drinking. This essay discusses the origins of the term in connection with analyses in terms of patterns as well as levels of drinking and with concerns about differential harms from drinking different beverage types. Also discussed is the term's current primary usage, in the context of epidemiological concerns about differentially severe harms for poorer persons who drink. It is noted that these same concerns have been discussed, particularly in Britain, using the phrase "alcohol harm paradox". "Harm per litre" was initially most often used in comparisons between rates of alcohol-attributable harm by beverage type. After 2010, the expression was applied more broadly, particularly after its use in various World Health Organization-related discussions and documents. In addition, and especially from 2018 onwards when most of the papers using this term were published, it has been used in comparisons by socioeconomic status at the individual level, and by level of socioeconomic development at the country level. Almost all the findings indicate that people with lower socioeconomic status, and countries with lower average income, e.g., low income and lower-middle income countries, incur considerably higher harm per litre (with harm being expressed in disease burden and mortality) than upper middle-income and high-income countries. "Harm per litre" is a practicable and easy-to-understand concept to compare groups of individuals or countries, and to quantify health inequalities. The next important step will need to be elucidating a better causal understanding of the processes underlying these inequalities, with an emphasis on factors which can be most easily changed by interventions.
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Affiliation(s)
- Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health & Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Babor TF, Casswell S, Graham K, Huckle T, Livingston M, Rehm J, Room R, Rossow I, Sornpaisarn B. Alcohol: No Ordinary Commodity-a summary of the third edition. Addiction 2022; 117:3024-3036. [PMID: 36321607 DOI: 10.1111/add.16003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND AIMS This article summarizes the findings and conclusions of the third edition of Alcohol: No Ordinary Commodity. The latest revision of this book is part of a series of monographs designed to provide a critical review of the scientific evidence related to alcohol control policy from a public health perspective. DESIGN A narrative summary of the contents of the book according to five major issues. FINDINGS An extensive amount of epidemiological evidence shows that alcohol is a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. Trends in alcohol products and marketing are described, indicating that a large part of the global industry has been consolidated into a small number of transnational corporations that are expanding their operations in Asia, Africa and Latin America. The main part of the book is devoted to a review of strategies and interventions designed to prevent or minimize alcohol-related harm. Overall, the most effective strategies to protect public health are taxation that decreases affordability and restrictions on the physical availability of alcohol. A total ban on alcohol marketing is also an effective strategy to reduce consumption. In addition, drink-driving counter-measures, brief interventions with at-risk drinkers and treatment of drinkers with alcohol dependence are effective in preventing harm in high-risk contexts and groups of hazardous drinkers. CONCLUSION Alcohol policy is often the product of competing interests, values and ideologies, with the evidence suggesting that the conflicting interests between profit and health mean that working in partnership with the alcohol industry is likely to lead to ineffective policy. Opportunities for implementation of evidence-based alcohol policies that better serve the public good are clearer than ever before as a result of accumulating knowledge on which strategies work best.
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Affiliation(s)
- Thomas F Babor
- Department of Public Health Sciences, University of Connecticut School of Medicine, CT, USA
| | - Sally Casswell
- College of Health, SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
| | - Kathryn Graham
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto/London, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Taisia Huckle
- College of Health, SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität, Dresden, Germany.,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry & Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Bundit Sornpaisarn
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada.,Faculty of Public Health, Mahidol University, Thailand
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Smith L, Hilton A, Walker J, Alfred L, Ahankari A, Schölin L. Prevention of alcohol related harm though preconception care: A scoping review of barriers and enablers. DIALOGUES IN HEALTH 2022; 1:100040. [PMID: 38515881 PMCID: PMC10953971 DOI: 10.1016/j.dialog.2022.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 03/23/2024]
Abstract
Objective To understand the perspectives of healthcare practitioners and women of reproductive age regarding addressing prevention of an alcohol exposed pregnancy before conception. Methods A scoping review of mixed methods, qualitative and quantitative research was conducted. Medline, CINAHL, EMBASE and PsychInfo databases were searched for literature published by March 2022. Data were extracted and synthesized. Results Twenty-three studies were included. Views varied between healthcare practitioners and women about addressing alcohol with women before pregnancy. Healthcare practitioners agreed prevention was important but believed they were ill-prepared to provide support, and that it might be intrusive if women were not contemplating pregnancy. Whereas women would welcome advice from healthcare practitioners, particularly if offered during appointments or visits for services related to reproductive health. A knowledge deficit about pregnancy and fetal harms from alcohol was expressed by both healthcare practitioners and women. Conclusions Investment in alcohol education and skills training for healthcare professionals is required to ensure a coherent message is communicated across services, and that shared decision making about healthcare between service users and health professionals is facilitated. Future research should explore implementation of interventions to prevent alcohol exposed pregnancy in settings where women are seeking reproductive health support.
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Affiliation(s)
- Lesley Smith
- Institute of Clinical and Applied Health Research, University of Hull, Hull, UK
| | - Andrea Hilton
- Department of Paramedical, Perioperative and Advanced Practice, University of Hull, Hull, UK
| | - Jayne Walker
- Department of Paramedical, Perioperative and Advanced Practice, University of Hull, Hull, UK
| | - Lolita Alfred
- Department of Nursing, City, University of London, London, UK
| | - Anand Ahankari
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
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Neufeld M, Ferreira-Borges C, Bunova A, Gornyi B, Fadeeva E, Koshkina E, Nadezhdin A, Tetenova E, Vujnovic M, Yurasova E, Rehm J. Capturing Russian drinking patterns with the Alcohol Use Disorders Identification Test: An exploratory interview study in primary healthcare and narcology centers in Moscow. PLoS One 2022; 17:e0274166. [PMID: 36355666 PMCID: PMC9648709 DOI: 10.1371/journal.pone.0274166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/24/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite a considerable reduction in alcohol consumption, Russia has one of the highest levels of alcohol-attributable burden of disease worldwide due to heavy episodic drinking patterns. Further improvement of alcohol control measures, including early provision of screening and brief interventions (SBI), is needed. The legislative framework for delivering SBI in Russia was introduced in 2013. As part of the creation and validation of a Russian version of the Alcohol Use Disorders Identification Test (AUDIT), the present contribution explored challenges in using the AUDIT in Russia to inform a subsequent validation study of the tool. METHODS Qualitative in-depth expert interviews with patients and healthcare professionals from four primary healthcare and narcology facilities in Moscow. A total of 25 patients were interviewed, 9 from a preventive medicine hospital, 8 from a polyclinic, and 9 from narcology clinics. Also, 12 healthcare professionals were interviewed, 5 of whom were primary healthcare doctors and 7 were narcologists. RESULTS Patients and healthcare professionals expressed difficulties in dealing with the concept of a "standard drink" in the AUDIT, which is not used in Russia. Various patients struggled with understanding the meaning of "one drinking occasion" on the test, mainly because Russian drinking patterns center around festivities and special occasions with prolonged alcohol intake. Narcology patients had specific difficulties because many of them experienced zapoi-a dynamic drinking pattern with heavy use and a withdrawal from social life, followed by prolonged periods of abstinence. Surrogate alcohol use was described as a common marker of alcohol dependence in Russia, not accounted for in the AUDIT. CONCLUSIONS The provided analyses on the perception of the Russian AUDIT in different patient and professional groups suggest that a series of amendments in the test should be considered to capture the specific drinking pattern and its potential harms.
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Affiliation(s)
- Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
- * E-mail:
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Anna Bunova
- Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System, National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Boris Gornyi
- Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System, National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Eugenia Fadeeva
- National Research Centre on Addictions – branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Evgenia Koshkina
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Alexey Nadezhdin
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Elena Tetenova
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Melita Vujnovic
- WHO Country Office in the Russian Federation, Moscow, Russian Federation
| | - Elena Yurasova
- WHO Country Office in the Russian Federation, Moscow, Russian Federation
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH) Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Kuwabara Y, Kinjo A, Fujii M, Minobe R, Maesato H, Higuchi S, Yoshimoto H, Jike M, Otsuka Y, Itani O, Kaneita Y, Kanda H, Kasuga H, Ito T, Osaki Y. Effectiveness of nurse-delivered screening and brief alcohol intervention in the workplace: A randomized controlled trial at five Japan-based companies. Alcohol Clin Exp Res 2022; 46:1720-1731. [PMID: 35869628 DOI: 10.1111/acer.14909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Excessive alcohol use is a leading cause of global morbidity and premature mortality. This study evaluated the effectiveness of two types of nurse-delivered interventions to reduce excessive alcohol consumption among screened participants using the alcohol use disorders identification test (AUDIT) in the workplace. METHODS A randomized controlled trial involving AUDIT-positive employees of five Japan-based companies was conducted. A total of 351 participants were randomized into groups that received a patient information leaflet (PIL), 5 min of brief advice, or 15 min of brief advice and counseling. Outcomes (weekly alcohol consumption and drinking and binge drinking frequency in the previous 30 days) were evaluated at 6 and 12-month follow-up. RESULTS The follow-up rates were 96.3% (n = 338) and 94.9% (n = 333) at 6 and 12 months, respectively. At 6 months, the mean change in weekly alcohol consumption was -38.1 g (-1.64 US fluid oz/week) in the 15-min brief advice and counseling group, which differed significantly from the PIL group. The reduction in the advice and counseling group persisted at 12-month follow-up but was no longer significantly different from the PIL group. There was no significant change in alcohol consumption observed in the 5-min brief advice group. Improvement in drinking and binge drinking frequency was observed in all three groups. CONCLUSIONS Nurse-delivered 15-min brief advice and counseling was effective over a 6-month period in reducing alcohol consumption in a workplace setting. This finding suggests that the implementation of workplace screening and brief intervention could play a useful role in preventing the burden of harmful alcohol use.
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Affiliation(s)
- Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Maya Fujii
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Ruriko Minobe
- National Institute of Alcoholism, Kurihama National Hospital, Kanagawa, Japan
| | - Hitoshi Maesato
- National Institute of Alcoholism, Kurihama National Hospital, Kanagawa, Japan
| | - Susumu Higuchi
- National Institute of Alcoholism, Kurihama National Hospital, Kanagawa, Japan
| | - Hisashi Yoshimoto
- Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, Majors of Medical Science, University of Tsukuba, Ibaragi, Japan
| | - Maki Jike
- Department of Food Science and Nutrition, Faculty of Life and Environmental Science, Showa Women's University, Tokyo, Japan
| | - Yuichiro Otsuka
- Department of Public Health, School of Medicine, Nihon University, Tokyo, Japan
| | - Osamu Itani
- Department of Public Health, School of Medicine, Nihon University, Tokyo, Japan
| | - Yoshitaka Kaneita
- Department of Public Health, School of Medicine, Nihon University, Tokyo, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideaki Kasuga
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan
| | - Teruna Ito
- Department of Food and Nutrition, Koriyama Women's university, Koriyama, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
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Elemental profile of recorded and unrecorded fruit spirits and health risk assessment. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.104807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Sperkova K, Anderson P, Llopis EJ. Alcohol policy measures are an ignored catalyst for achievement of the sustainable development goals. PLoS One 2022; 17:e0267010. [PMID: 35507589 PMCID: PMC9067678 DOI: 10.1371/journal.pone.0267010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background By adopting Agenda 2030, governments agreed to review and report on their approach and action for achievement of sustainable development goals annually through the High-Level Political Forum (HLPF) on Sustainable Development. Health and well-being are at the heart of the United Nations Agenda 2030. Given the social and economic harm that can be done by alcohol, reducing the consumption of alcohol is a pre-requisite to achieve the sustainable development goals. We explored how selected European countries have considered alcohol-related harm as an obstacle to achievement of SDGs and the extent to which they view alcohol policy as a solution to the achievement of sustainable development by analysing their voluntary national reviews (VNRs) submitted to the HLPF between years 2016 and 2020. Methods We developed our own framework with 260 questions reflecting three dimensions of alcohol-harm considerations: indication, action, and evaluation. We analysed 36 VNRs of 32 European countries by first assessing them against the 260 questions to find out how they report on alcohol harm and whether they, in their action, refer to evidence-based, cost-effective alcohol policy solutions. Afterwards we used content analysis to assess the extent to which the countries addressed alcohol related harm, whether they refer to alcohol harm within SDG 3 (good health and well-being) or look beyond the health goal and consider alcohol harm having impact on goals other than the Goal 3. Findings Nine countries (28.1%) did not mention alcohol in their report. Only eight countries (25%) mentioned one or more of the alcohol policy best buys among the actions they are taking to reduce alcohol related harm and only three (9.3%) explicitly elaborated on their impact on goals other than goal 3. Only five countries referred to the agreed indicator 3.5.2 measuring alcohol per capita consumption in the adult population. Many of the remaining countries used a range of terminology rather than alcohol per capita consumption, including “excessive use of alcohol”, “heavy use”, “too much alcohol “, “harmful alcohol consumption”, “use among young people”. Interpretation Alcohol use is, for example, associated with violence (SDG 5 and 16), it contributes to inequalities (SDG 5 and 10), it hinders economic growth (SDG 8), disrupts sustainable consumption (SDG 12) and it adversely impacts environment (SDG 13 and 14). The findings of this study show that these effects are not considered in the design of measures to achieve these goals. Moreover, inaccurate language related to alcohol harm indicates a gap in understanding of extend of alcohol burden and the consequences for sustainable development. So does the choice of ineffective measures to reduce alcohol consumption. Education programs and awareness raising campaigns focusing on individual lifestyle are neither in line with WHO Global Strategy to reduce the harm caused by alcohol that all selected countries adopted in 2010, nor do they reflect the seriousness of the problems related to alcohol use. Effective alcohol policy measures, so called three best buys, are missing from the transformative action that the Agenda 2030 calls for and governments committed to.
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Affiliation(s)
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Eva Jané Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- University Ramon Llull, ESADE, Barcelona, Spain
- Institute for Mental Health Policy Research, CAMH, Toronto, Canada
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Kuwabara Y, Kinjo A, Fujii M, Minobe R, Maesato H, Higuchi S, Yoshimoto H, Jike M, Otsuka Y, Itani O, Kaneita Y, Kanda H, Osaki Y. Effectiveness of Screening and Brief Alcohol Intervention at the Workplace: A Study Protocol for a Randomized Controlled Trial at Five Japan-Based Companies. Yonago Acta Med 2021; 64:330-338. [PMID: 34840512 DOI: 10.33160/yam.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/13/2021] [Indexed: 11/05/2022]
Abstract
Background Despite evidence regarding the effectiveness of screening and brief interventions for excessive alcohol use in primary care, these tools are not a part of routine practice. It has been suggested that using these tools at the workplace may be critical to alcohol-associated harm; however, evidence for this claim is unclear. The aim of this article is to develop a study protocol which evaluates the effect of brief alcohol intervention at the workplace to reduce harmful alcohol drinking. Methods A randomized controlled trial involving employees (aged 20-74 years) of five Japan-based companies who were screened "positive" by Alcohol Use Disorder Identification Test (AUDIT) is on-going. Participants were randomized into "Patient Information Leaflet" (control group), "Brief Advice and Counselling," and "Five-minute Brief Advice" groups. A self-administered questionnaire was used to assess alcohol consumption, lifestyle behavior, health status, work performance, and consequences of alcohol use. Data of laboratory markers were collected from routine health checkups. Results A total of 351 participants were randomized into Patient Information Leaflet (n = 111), Brief Advice and Counselling (n = 128), and Five-minute Brief Advice (n = 112) groups. Participants were mostly men with a median age of 49 years. Median AUDIT score and weekly alcohol consumption were 11 points and 238 g/week, respectively. Two-thirds of the participants were manufacturing workers. Conclusion This study protocol developed the first trial in Japan to investigate the effect of brief alcohol intervention combined with a recommended screening tool at the workplace. Our findings can provide evidence on the effectiveness and relevance of these tools to occupational health.
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Affiliation(s)
- Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Maya Fujii
- Division of Environmental and Preventive Medicine, Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Ruriko Minobe
- National Institute of Alcoholism, Kurihama National Hospital, Yokosuka 239-0841, Japan
| | - Hitoshi Maesato
- National Institute of Alcoholism, Kurihama National Hospital, Yokosuka 239-0841, Japan
| | - Susumu Higuchi
- National Institute of Alcoholism, Kurihama National Hospital, Yokosuka 239-0841, Japan
| | - Hisashi Yoshimoto
- Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, Majors of Medical Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Maki Jike
- Department of Food Science and Nutrition, Faculty of Life and Environmental Science, Showa Women's University, Tokyo 154-8533, Japan
| | - Yuichiro Otsuka
- Department of Public Health, School of Medicine, Nihon University, Tokyo 101-0061, Japan
| | - Osamu Itani
- Department of Public Health, School of Medicine, Nihon University, Tokyo 101-0061, Japan
| | - Yoshitaka Kaneita
- Department of Public Health, School of Medicine, Nihon University, Tokyo 101-0061, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8530, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Monteiro MG, Martins CB, Sanchez ZM, Rehm J, Shield K, Falade R, MacDiarmid J, Trangenstein P. Assessing Sustainable Development Goal Target Indicator 3.5.2: Trends in alcohol per capita consumption in the Americas 1990-2016. Rev Panam Salud Publica 2021; 45:e142. [PMID: 34703464 PMCID: PMC8530001 DOI: 10.26633/rpsp.2021.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to estimate trends in alcohol per capita consumption from 1990 to 2016 in the Region of the Americas, covering 35 Member States. Data from the WHO Global Information System on Alcohol and Health were used to calculate the annual percent change of alcohol per capita consumption in each of the 35 countries of the Americas. The Americas as a whole showed no change in the total period, with a slight decrease in the period 2010-2016. From 1990 to 2016, all the countries that presented a trend of annual increase in annual percent change of alcohol per capita consumption were in the Caribbean and Central America. Large increases were found in the recent years in Cuba, Colombia, Uruguay, El Salvador, and several countries of the Non-Latin Caribbean. In conclusion, alcohol use remains a significant obstacle to the achievement of Sustainable Development Goal 3.5. To date, the policy response has been inadequate in protecting the people in the Americas from alcohol-attributable harms. Improving country capacity to collect and analyze data on alcohol per capita consumption is urgently needed to monitor progress on the Sustainable Development Goals and to serve to promote proven alcohol policies for reducing the harmful use of alcohol.
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Affiliation(s)
- Maristela G. Monteiro
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Camila B. Martins
- Universidade Federal de São PauloSão PauloBrazilUniversidade Federal de São Paulo, São Paulo, Brazil
| | - Zila M. Sanchez
- Universidade Federal de São PauloSão PauloBrazilUniversidade Federal de São Paulo, São Paulo, Brazil
| | - Jürgen Rehm
- Centre for Addiction and Mental HealthTorontoCanadaCentre for Addiction and Mental Health, Toronto, Canada
- University of TorontoTorontoCanadaUniversity of Toronto, Toronto, Canada
| | - Kevin Shield
- Centre for Addiction and Mental HealthTorontoCanadaCentre for Addiction and Mental Health, Toronto, Canada
- University of TorontoTorontoCanadaUniversity of Toronto, Toronto, Canada
| | - Rachael Falade
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Jacqueline MacDiarmid
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Pamela Trangenstein
- University of North CarolinaChapel Hill, N.C.United States of AmericaUniversity of North Carolina, Chapel Hill, N.C., United States of America
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15
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Manthey J, Solovei A, Anderson P, Carr S, Rehm J. Can alcohol consumption in Germany be reduced by alcohol screening, brief intervention and referral to treatment in primary health care? Results of a simulation study. PLoS One 2021; 16:e0255843. [PMID: 34352005 PMCID: PMC8341530 DOI: 10.1371/journal.pone.0255843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Screening, brief intervention and referral to treatment (SBIRT) is a programme to reduce alcohol consumption for drinkers with high alcohol consumption levels. Only 2.9% of patients in primary health care (PHC) are screened for their alcohol use in Germany, despite high levels of alcohol consumption and attributable harm. We developed an open-access simulation model to estimate the impact of higher SBIRT delivery rates in German PHC settings on population-level alcohol consumption. METHODS AND FINDINGS A hypothetical population of drinkers and non-drinkers was simulated by sex, age, and educational status for the year 2009 based on survey and sales data. Risky drinking persons receiving BI or RT were sampled from this population based on screening coverage and other parameters. Running the simulation model for a ten-year period, drinking levels and heavy episodic drinking (HED) status were changed based on effect sizes from meta-analyses. In the baseline scenario of 2.9% screening coverage, 2.4% of the adult German population received a subsequent intervention between 2009 and 2018. If every second PHC patient would have been screened for alcohol use, 21% of adult residents in Germany would have received BI or RT by the end of the ten-year simulation period. In this scenario, population-level alcohol consumption would be 11% lower than it was in 2018, without any impact on HED prevalence. Screening coverage rates below 10% were not found to have a measurable effect on drinking levels. CONCLUSIONS Large-scale implementation of SBIRT in PHC settings can yield substantial reductions of alcohol consumption in Germany. As high screening coverage rates may only be achievable in the long run, other effective alcohol policies are required to achieve short-term reduction of alcohol use and attributable harm in Germany. There is large potential to apply this open-access simulation model to other settings and for other alcohol interventions.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Medical Faculty, Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Adriana Solovei
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Peter Anderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Sinclair Carr
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jürgen Rehm
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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16
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Trethewey SP. Reorganisation of UK public health agencies: meaningful change or smoke and mirrors? BMJ 2021; 373:n1281. [PMID: 34031122 DOI: 10.1136/bmj.n1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Adebiyi BO, Mukumbang FC, Beytell AM. Policy Requirements for the Prevention and Management of Fetal Alcohol Spectrum Disorder in South Africa: A Policy Brief. Front Public Health 2021; 9:592726. [PMID: 33937161 PMCID: PMC8082060 DOI: 10.3389/fpubh.2021.592726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
This policy brief is aimed to guide policymakers in developing a comprehensive and multi-sectoral policy for the prevention and management of fetal alcohol spectrum disorder (FASD). FASD is a leading source of non-genetic developmental and intellectual disability globally and is usually associated with primary and secondary disabilities. South Africa has been identified to have the highest reported prevalence of FASD in the world. Nevertheless, evidence shows that there is no specific policy for FASD, albeit there are clauses that could be attributed to its prevention and management in other existing policies. In this brief, we present a guideline to inform programmes and interventions to tackle the FASD problem in South Africa and other relevant contexts through developing a policy.
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Affiliation(s)
- Babatope O Adebiyi
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
| | | | - Anna-Marie Beytell
- Department of Social Work, University of the Western Cape, Cape Town, South Africa
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18
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Ghanem L, Lee JP, Sumetsky N, Pagano A, Gruenewald P, Mair C. Place management in off-premise alcohol outlets: Results of a multi-methods study in a six-city California area. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 80:102735. [PMID: 32416539 DOI: 10.1016/j.drugpo.2020.102735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Associations between neighborhood crime and alcohol outlets are often theorized as resulting from poor place management. Barriers and supports to place management have been examined for on-premise (bars, restaurants) but not for off-premise alcohol outlets. Few studies have assessed place management issues across a range of off-premise outlet and neighborhood types, and none have included the perspectives of off-premise outlet managers themselves. Combining qualitative and quantitative methods within an ethnographic approach, we investigated barriers and supports to place management across off-premise outlets in a large urban area. METHODS We unobtrusively assessed outlet operating characteristics including crime prevention strategies at all 403 off-premise outlets in six contiguous California cities; interviewed managers in 40 outlets; and conducted extensive naturalistic observations in 15 of these 40 outlets. We analyzed data for frequencies and thematic content. RESULTS Small and independently operated off-premise outlets were the most common type of outlet in our study, but demonstrated fewer resources and more challenges to place management compared to large and chain establishments. Security guards were more observed in large and chain outlets. Small and independent outlets were more likely to post signs prohibiting loitering and to enable surveillance of interior spaces. Problems most commonly cited by managers were theft and loitering. Challenges to place management included physical and verbal threats from customers and intoxicated persons, and insufficient law enforcement. Managers evidenced some ability to assert authority over interior, private space, but less so over exterior, public space. CONCLUSIONS Although tasked with maintaining public health and safety, small and independent store managers reported challenges that are seldom acknowledged in policy or research literature. Managers may provide valuable insights on preventing and reducing neighborhood-level problems associated with off-premise alcohol outlets. Local communities should consider enhancing place management resources for managers of small and independent outlets.
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Affiliation(s)
- Lina Ghanem
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Juliet P Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Natalie Sumetsky
- School of Public Health, University of Pittsburgh, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, United States.
| | - Anna Pagano
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Christina Mair
- School of Public Health, University of Pittsburgh, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, United States.
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