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Kim KV, Rehm J, Kaplan MS, Lange S. Relationship Between Alcohol Use and Firearm-Involved Suicide: Findings From the National Violent Death Reporting System, 2003-2020. Am J Prev Med 2024; 66:832-839. [PMID: 38000484 DOI: 10.1016/j.amepre.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Acute alcohol intoxication is a contributing factor in firearm-involved suicides. However, knowledge of the relationship between alcohol intoxication and firearm-involved suicide by age and sex (defined herein as the biological sex of the decedent) is limited. The purpose of the current study was to evaluate the sex- and age group-specific relationship between alcohol intoxication and firearm-involved suicide. METHODS Data from the National Violent Death Reporting System, 2003-2020, on suicide decedents (18+ years of age) were utilized. Age-group- and sex-specific multivariate binary logistic regression analyses were conducted. Statistical analyses were performed in 2023. RESULTS Alcohol intoxication (i.e., having a blood alcohol concentration of 0.08 g/dL or more) was significantly associated with using a firearm as the method of suicide for young (18-34 years; relative risk (RR)=1.31, 95% CI: 1.22-1.40) and middle-aged (35-64 years; RR=1.34, 95% CI: 1.27-1.39) females but not among older females (65+ years; RR=1.01, 95% CI: 0.87-1.17). Among males, the association was significant for all age-groups (young: RR=1.28, 95% CI: 1.25-1.30; middle-aged: RR=1.17, 95% CI: 1.15-1.19; and older: RR=1.04, 95% CI: 1.01-1.07). CONCLUSIONS Among males of all ages and young and middle-aged females, alcohol intoxication was associated with increased risk of suicide by firearm-an extremely lethal method that accounts for a majority of suicides in the U.S.-compared to their non-intoxicated counterparts. Interventions targeting excessive alcohol consumption may be effective in reducing suicide mortality rates.
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Affiliation(s)
- Kawon V Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; 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
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
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Russell C, Ashley J, Ali F, Bozinoff N, Corace K, Marsh DC, Mushquash C, Wyman J, Zhang M, Lange S. Examining inequities in access to opioid agonist treatment (OAT) take-home doses (THD): A Canadian OAT guideline synthesis and systematic review. Int J Drug Policy 2024; 127:104343. [PMID: 38554565 DOI: 10.1016/j.drugpo.2024.104343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/08/2024] [Accepted: 01/30/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND Daily supervised Opioid Agonist Treatment (OAT) medication has been identified as a barrier to treatment retention. Canadian OAT guidelines outline take-home dose (THD) criteria, yet, OAT prescribers use their clinical judgement to decide whether an individual is 'clinically stable' to receive THD. There is limited information regarding whether these decisions may result in inequitable access to THD, including in the context of updated COVID-19 guidance. The current Canadian OAT THD guideline synthesis and systematic review aimed to address this knowledge gap. METHODS This systematic review included a two-pronged approach. First, we searched available academic literature in Embase, Medline, and PsychINFO up until October 12th, 2022, to identify studies that compared characteristics of individuals on OAT who had and had not been granted access to THD to explore potential inequities in access. Next, we identified all Canadian national and provincial OAT guidelines through a semi-structured grey literature search (conducted between September-October 2022) and extracted all THD 'stability' and allowances/timeline criteria to compare against characteristics identified in the literature search. Data from both review arms were synthesized and narratively presented. RESULTS A total of n = 56 guidelines and n = 7 academic studies were included. The systematic review identified a number of patient characteristics such as age, sex, race/ethnicity, marital status, housing, employment, neighborhood income, drug use, mental health, health service utilization, as well as treatment duration that were associated with differential access to THD. The Canadian OAT THD guideline synthesis identified many of these same characteristics as 'stability' criteria, underscoring the potential for Canadian OAT guidelines to result in inequitable access to THD. CONCLUSIONS This two-pronged literature review demonstrated that current guidelines likely contribute to inequitable OAT THD access due primarily to inconsistent 'stability' criteria across guidelines. More research is needed to understand differential OAT THD access with a focus on prescriber decision-making and evaluating associated treatment and safety outcomes. The development of a client-centered, equity-focused, and evidence-informed decision making framework that incorporates more clear definitions of 'stability' criteria and indications for prescriber discretion is warranted.
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Affiliation(s)
- Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, M5S 2S1; Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Centre for Addiction and Mental Health (CAMH), Toronto, Canada, M5S 2S1; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, Canada, M5S 1A8.
| | - Jenna Ashley
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, M5S 2S1
| | - Farihah Ali
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, M5S 2S1; Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Centre for Addiction and Mental Health (CAMH), Toronto, Canada, M5S 2S1
| | - Nikki Bozinoff
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario, Canada, M5T 1R8; Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th floor, Toronto, Canada, M5G1V7
| | - Kim Corace
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, Ontario, Canada, K1H 8M5; Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Center, 1145 Carling Avenue, Ottawa, Ontario, Canada, K1Z 7K4; University of Ottawa Institute of Mental Health Research, The Royal Ottawa Mental Health Center, 1145 Carling Avenue, Ottawa, Ontario, Canada, K1Z 7K4
| | - David C Marsh
- NOSM University, 935 Ramsey Lake Road, Sudbury, Ontario, Canada, P3E 2C6; ICES North, 56 Walford Road, Sudbury, Ontario, Canada, P3E 2H3; Health Science North Research Institute, 56 Walford Road, Sudbury, Ontario, Canada, P3E 2H3
| | - Christopher Mushquash
- Department of Psychology, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada
| | - Jennifer Wyman
- Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th floor, Toronto, Canada, M5G1V7; Women's College Hospital, 76 Grenville St, Toronto, Ontario, M5S 1B2, Canada
| | - Maria Zhang
- Pharmacy Services, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada, M6J 1H4; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Canada, M5S 3M2
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, M5S 2S1; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, Canada, M5S 1A8; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario, Canada, M5T 1R8; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, Canada, M5T 1R8
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Rehm J, Rovira P, Jiang H, Lange S, Shield KD, Tran A, Štelemėkas M. Trends of alcohol-attributable deaths in Lithuania 2001-2021: epidemiology and policy conclusions. BMC Public Health 2024; 24:774. [PMID: 38475821 DOI: 10.1186/s12889-024-18237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Lithuania, a Baltic country in the European Union, can be characterized by high alcohol consumption and attributable burden. The aim of this contribution is to estimate the mortality burden due to alcohol use for the past two decades based on different relative risk functions, identify trends, and analyse the associations of alcohol-attributable burden with alcohol control policies and life expectancy. METHODS The standard methodology used by the World Health Organization for estimating alcohol-attributable mortality was employed to generate mortality rates for alcohol-attributable mortality, standardized for Lithuania's 2021 population distribution. Joinpoint analysis, T-tests, correlations, and regression analyses including meta-regressions were used to describe trends and associations. RESULTS Age-standardized alcohol-attributable mortality was high in Lithuania during the two decades between 2001 and 2021, irrespective of which relative risks were used for the estimates. Overall, there was a downward trend, mainly in males, which was associated with four years of intensive implementation of alcohol control policies in 2008, 2009, 2017, and 2018. For the remaining years, the rates of alcohol-attributable mortality were stagnant. Among males, the correlations between alcohol-attributable mortality and life expectancy were 0.90 and 0.76 for Russian and global relative risks respectively, and regression analyses indicated a significant association between changes in alcohol-attributable mortality and life expectancy, after controlling for gross domestic product. CONCLUSIONS Male mortality and life expectancy in Lithuania were closely linked to alcohol-attributable mortality and markedly associated with strong alcohol control policies. Further implementation of such policies is predicted to lead to further improvements in life expectancy.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, M5T 1R8, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 1P8, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, M5S 1A8, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, ON, Canada.
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, 08005, Barcelona, Spain.
| | - Pol Rovira
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, 08005, Barcelona, Spain
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 1P8, Toronto, ON, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, M5T 1R8, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, ON, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, M5T 1R8, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 1P8, Toronto, ON, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
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Lange S, Kim KV, Lasserre AM, Orpana H, Bagge C, Roerecke M, Rehm J. Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e241941. [PMID: 38470417 PMCID: PMC10933726 DOI: 10.1001/jamanetworkopen.2024.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/21/2024] [Indexed: 03/13/2024] Open
Abstract
Importance Despite individual studies suggesting that sex differences exist in the association between alcohol use disorder (AUD) and suicide, most existing systematic reviews and meta-analyses have reported associations across the sexes. Objective To estimate the sex-specific association between AUD and suicide mortality. Data Sources Embase, MEDLINE (including MEDLINE In-Process), PsycINFO, PubMed, and Web of Science were searched from database inception to April 27, 2022. Study Selection Inclusion criteria consisted of the following: (1) original, quantitative study, (2) inclusion of a measure of association and its corresponding measure of variability (or sufficient data to calculate these [eg, 95% CI]), and (3) results stratified by sex. Data Extraction and Synthesis Data extraction was completed by one reviewer and then cross-checked by a second reviewer. Risk of bias was assessed by study design. Categorical random-effects meta-analyses were conducted to obtain sex-specific pooled estimates of the association between AUD and suicide mortality risk. Methodological moderators (ie, study design and comparator group) were assessed using sex-stratified meta-regressions. Main Outcomes and Measures The association between AUD and suicide mortality. Results A total of 16 347 unique records were identified in the systematic search; 24 studies were ultimately included for 37 870 699 participants (59.7% male and 40.3% female) (23 risk estimates for male and 17 for female participants). Participants ranged in age from 15 years to 65 years or older. Sex-specific meta-regression models indicated that study design (ie, longitudinal vs cross-sectional study design) affected the observed association between AUD and suicide mortality for both male participants (log odds ratio, 0.68 [95% CI, 0.08-1.28]; P = .03) and female participants (log odds ratio, 1.41 [95% CI, 0.57-2.24]; P < .001). For males and females, among longitudinal studies, the pooled odds ratios were 2.68 (95% CI, 1.86-3.87; I2 = 99% [n = 14]) and 2.39 (95% CI, 1.50-3.81; I2 = 90% [n = 11]), respectively. Conclusions and Relevance This systematic review and meta-analysis yielded substantive evidence that AUD was associated with suicide mortality and that the association was similar across the sexes. The findings underscore the importance of identifying and treating AUD as part of a comprehensive suicide prevention strategy.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Kawon V. Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aurélie M. Lasserre
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Heather Orpana
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Center for Clinical Management Research, Department of Veterans Affairs, Ann Arbor, Michigan
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- 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, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Program on Substance Abuse and World Health Organization European Region Collaboration Centre, Public Health Agency of Catalonia, Barcelona, Spain
- Zentrum für Interdisziplinäre Suchtforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Somé NH, Noormohammadpour P, Lange S. The use of machine learning on administrative and survey data to predict suicidal thoughts and behaviors: a systematic review. Front Psychiatry 2024; 15:1291362. [PMID: 38501090 PMCID: PMC10944962 DOI: 10.3389/fpsyt.2024.1291362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
Background Machine learning is a promising tool in the area of suicide prevention due to its ability to combine the effects of multiple risk factors and complex interactions. The power of machine learning has led to an influx of studies on suicide prediction, as well as a few recent reviews. Our study distinguished between data sources and reported the most important predictors of suicide outcomes identified in the literature. Objective Our study aimed to identify studies that applied machine learning techniques to administrative and survey data, summarize performance metrics reported in those studies, and enumerate the important risk factors of suicidal thoughts and behaviors identified. Methods A systematic literature search of PubMed, Medline, Embase, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Allied and Complementary Medicine Database (AMED) to identify all studies that have used machine learning to predict suicidal thoughts and behaviors using administrative and survey data was performed. The search was conducted for articles published between January 1, 2019 and May 11, 2022. In addition, all articles identified in three recently published systematic reviews (the last of which included studies up until January 1, 2019) were retained if they met our inclusion criteria. The predictive power of machine learning methods in predicting suicidal thoughts and behaviors was explored using box plots to summarize the distribution of the area under the receiver operating characteristic curve (AUC) values by machine learning method and suicide outcome (i.e., suicidal thoughts, suicide attempt, and death by suicide). Mean AUCs with 95% confidence intervals (CIs) were computed for each suicide outcome by study design, data source, total sample size, sample size of cases, and machine learning methods employed. The most important risk factors were listed. Results The search strategy identified 2,200 unique records, of which 104 articles met the inclusion criteria. Machine learning algorithms achieved good prediction of suicidal thoughts and behaviors (i.e., an AUC between 0.80 and 0.89); however, their predictive power appears to differ across suicide outcomes. The boosting algorithms achieved good prediction of suicidal thoughts, death by suicide, and all suicide outcomes combined, while neural network algorithms achieved good prediction of suicide attempts. The risk factors for suicidal thoughts and behaviors differed depending on the data source and the population under study. Conclusion The predictive utility of machine learning for suicidal thoughts and behaviors largely depends on the approach used. The findings of the current review should prove helpful in preparing future machine learning models using administrative and survey data. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022333454 identifier CRD42022333454.
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Affiliation(s)
- Nibene H. Somé
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Pardis Noormohammadpour
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Minian N, Gayapersad A, Coroiu A, Dragonetti R, Zawertailo L, Zaheer J, O’Neill B, Lange S, Thomson N, Crawford A, Kennedy SH, Selby P. Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study. Front Psychiatry 2024; 15:1286078. [PMID: 38333892 PMCID: PMC10850298 DOI: 10.3389/fpsyt.2024.1286078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. Study objectives The objectives of the study are to understand barriers/facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. Methods The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. Results Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. Conclusion Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes.
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Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Allison Gayapersad
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adina Coroiu
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Juveria Zaheer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Braden O’Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Lange
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicole Thomson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Arthur Sommer Rotenberg Program in Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Bell M, Lange S, Sejdiu BI, Ibanez J, Shi H, Sun X, Meng X, Nguyen P, Sutton M, Wagner J, Kc A, Langfitt D, Patil SL, Tan H, Pandey RV, Li Y, Yuan ZF, Anido AA, Ho M, Sheppard H, Vogel P, Yu J, Peng J, Chi H, Babu MM, Krenciute G, Gottschalk S. Modular chimeric cytokine receptors with leucine zippers enhance the antitumour activity of CAR T cells via JAK/STAT signalling. Nat Biomed Eng 2023:10.1038/s41551-023-01143-w. [PMID: 38036617 DOI: 10.1038/s41551-023-01143-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/20/2023] [Indexed: 12/02/2023]
Abstract
The limited availability of cytokines in solid tumours hinders maintenance of the antitumour activity of chimeric antigen receptor (CAR) T cells. Cytokine receptor signalling pathways in CAR T cells can be activated by transgenic expression or injection of cytokines in the tumour, or by engineering the activation of cognate cytokine receptors. However, these strategies are constrained by toxicity arising from the activation of bystander cells, by the suboptimal biodistribution of the cytokines and by downregulation of the cognate receptor. Here we show that replacement of the extracellular domains of heterodimeric cytokine receptors in T cells with two leucine zipper motifs provides optimal Janus kinase/signal transducer and activator of transcription signalling. Such chimeric cytokine receptors, which can be generated for common γ-chain receptors, interleukin-10 and -12 receptors, enabled T cells to survive cytokine starvation without induction of autonomous cell growth, and augmented the effector function of CAR T cells in vitro in the setting of chronic antigen exposure and in human tumour xenografts in mice. As a modular design, leucine zippers can be used to generate constitutively active cytokine receptors in effector immune cells.
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Affiliation(s)
- Matthew Bell
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
- Graduate School of Biomedical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Shannon Lange
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Besian I Sejdiu
- Center of Excellence for Data Driven Discovery, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jorge Ibanez
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Hao Shi
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Xiang Sun
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Xiaoxi Meng
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Phuong Nguyen
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Morgan Sutton
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
- Graduate School of Biomedical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jessica Wagner
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Anil Kc
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Deanna Langfitt
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sagar L Patil
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Haiyan Tan
- Center for Proteomics and Metabolomics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ram Vinay Pandey
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yuxin Li
- Center for Proteomics and Metabolomics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Zuo-Fei Yuan
- Center for Proteomics and Metabolomics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Alejandro Allo Anido
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Mitchell Ho
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Heather Sheppard
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Peter Vogel
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jiyang Yu
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Junmin Peng
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Center for Proteomics and Metabolomics, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Hongbo Chi
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - M Madan Babu
- Center of Excellence for Data Driven Discovery, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Giedre Krenciute
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Stephen Gottschalk
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Lange S, Zhu Y, Probst C. Evaluation of the risk relationship between average alcohol volume consumed and suicide: An analysis of mortality linked cohort data. medRxiv 2023:2023.11.22.23298895. [PMID: 38045329 PMCID: PMC10690349 DOI: 10.1101/2023.11.22.23298895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Objective To evaluate the relationship between average alcohol volume consumed per day and suicide. Methods Data from the annual, cross-sectional US National Health Interview Survey, 1997-2018, was obtained, and linked to the 2019 National Death Index. The association between average alcohol volume consumed in grams per day (g/day) and suicide was quantified using Cox proportional hazards model (multiplicative) and Aalen's additive hazard model. All analyses were stratified by sex, and adjusted for education, marital status, race/ethnicity, and survey year. Results On the multiplicative scale, for males, former drinkers and those who consumed on average (40, 60] g/day had about 53% (HR=1.53, 95% CI: 1.10, 2.13) and 77% (HR=1.77, 95% CI: 1.17, 2.66) greater risk of dying by suicide, compared to lifetime abstainers, respectively. There was no significant association found for former or current drinkers among females, on the multiplicative scale. On the additive scale, for males and females, being a former drinker was associated with 11.4 (95% CI: 2.3, 20.4) and 5.6 (95% CI: 0.8, 10.4) additional deaths per 100,000 person years, compared to lifetime abstainers. For males only, drinking (40, 60] g/day on average was associated with 23.2 (95% CI: 6.7, 39.7) additional deaths per 100,000 person years. Level of education was not found to modify the focal relationship for males or females. Conclusions The findings suggest that the relationship between average alcohol volume consumed per day and suicide is nuanced. Additional research on the respective relationship is needed, including repeated measures of average alcohol consumption over time. What is already known on this topic There is a dearth of studies on the sex-specific relationship between average alcohol volume consumed per day and suicide. The one existing study, from South Korea, found that for males as average alcohol volume consumed increased, the likelihood of death by suicide also increased. For females it was not possible to estimate the risk associated with the upper level of consumption due to a zero-cell count. What this study adds This is the first systematic investigation of the sex-specific relationship between average alcohol volume consumed per day and death by suicide using a large linked dataset from the United States. It is also the first to evaluate the modifying effect of education, an important indicator of socioeconomic status, on the respective relationship. How this study might affect research practice or policy The findings were not in line with the sparse existing literature, indicating that this line of research is not yet resolved and more research is needed.
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Štelemėkas M, Goštautaitė Midttun N, Lange S, Liutkutė-Gumarov V, Manthey J, Miščikienė L, Petkevičienė J, Radišauskas R, Rehm J, Trišauskė J, Telksnys T, Thompson MJ. Unrecorded alcohol consumption in Lithuania: a modelling study for 2000-2021. Alcohol Alcohol 2023; 58:612-618. [PMID: 37807756 PMCID: PMC10642605 DOI: 10.1093/alcalc/agad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/30/2023] [Accepted: 09/10/2023] [Indexed: 10/10/2023] Open
Abstract
The aim of the study was to estimate unrecorded alcohol consumption in Lithuania for the period 2000-2021 using an indirect method for modelling consumption based on official consumption data and indicators of alcohol-related harm. Methodology employed for estimating the unrecorded alcohol consumption was proposed by Norström and was based on the country's 2019 European Health Interview Survey and indicators of fully alcohol-attributable mortality. The proportion of unrecorded alcohol consumption was estimated as 8.30% (95% CI 7.7-8.9%) for 2019 in Lithuania. The estimated total (recorded and unrecorded) alcohol per capita consumption among individuals 15 years of age and older in 2019 was 12.2 L of pure alcohol, 1.01 (95% CI 0.94-1.09%) L of which is likely unrecorded. The lowest unrecorded alcohol level was estimated for 2009 and 2014, while 2018 had the highest level (i.e. 9.33% of total alcohol per capita consumption). Unrecorded alcohol consumption in Lithuania is likely to be modest when compared to recorded alcohol consumption, the latter of which still remains a major challenge to public health.
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Affiliation(s)
- Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Lithuanian Tobacco and Alcohol Control Coalition, Stiklių st. 8, Vilnius 01131, Lithuania
| | - Nijolė Goštautaitė Midttun
- Lithuanian Tobacco and Alcohol Control Coalition, Stiklių st. 8, Vilnius 01131, Lithuania
- Mental Health Initiative, Teatro st. 3-10, Vilnius 03107, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8thfloor, Toronto, ON M5T1R8, Canada
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Lithuanian Tobacco and Alcohol Control Coalition, Stiklių st. 8, Vilnius 01131, Lithuania
| | - Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, Leipzig 04103,Germany
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Ričardas Radišauskas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių pr. 15, Kaunas 50103, Lithuania
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8thfloor, Toronto, ON M5T1R8, Canada
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON M5T1P8, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S1A8, Canada
| | - Justina Trišauskė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Mark James Thompson
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Institute for Wealth and Asset Management, Zurich University of Applied Sciences, Winterthur, Switzerland
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Radišauskas R, Štelemėkas M, Petkevičienė J, Trišauskė J, Telksnys T, Miščikienė L, Gobina I, Stoppel R, Reile R, Janik-Koncewicz K, Zatonski W, Lange S, Tran A, Rehm J, Jiang H. Alcohol-attributable mortality and alcohol control policy in the Baltic Countries and Poland in 2001-2020: an interrupted time-series analysis. Subst Abuse Treat Prev Policy 2023; 18:65. [PMID: 37946282 PMCID: PMC10636906 DOI: 10.1186/s13011-023-00574-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The Baltic countries-Lithuania, Latvia and Estonia-are characterized by a high rate of fully alcohol-attributable mortality, compared with Poland. Alcohol control policy measures implemented since 2001 in the Baltic countries included a restriction on availability and an increase in excise taxation, among others. The aim of the current study was to evaluate the relationship between alcohol control policy implementation and alcohol-attributable mortality in the Baltic countries and Poland. METHODS Alcohol-attributable mortality data for 2001-2020 was defined by codes 100% alcohol-attributable for persons aged 15 years and older in the Baltic countries and Poland. Alcohol control policies implemented between 2001 and 2020 were identified, and their impact on alcohol-attributable mortality was evaluated using an interrupted time-series methodology by employing a generalized additive model. RESULTS Alcohol-attributable mortality was significantly higher in the Baltic countries, compared with Poland, for both males and females. In the final reduced model, alcohol control policy significantly reduced male alcohol-attributable mortality by 7.60% in the 12 months post-policy implementation. For females, the alcohol control policy mean-shift effect was higher, resulting in a significant reduction of alcohol-attributable mortality by 10.77% in the 12 months post-policy implementation. The interaction effects of countries and policy tested in the full model were not statistically significant, which indicated that the impact of alcohol control policy on alcohol-attributable mortality did not differ across countries for both males and females. CONCLUSIONS Based on the findings of the current study, alcohol control policy in the form of reduced availability and increased taxation was associated with a reduction in alcohol-attributable mortality among both males and females.
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Affiliation(s)
- Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania.
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Av. 15, 50162, Kaunas, Lithuania.
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
| | - Justina Trišauskė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181, Kaunas, Lithuania
| | - Inese Gobina
- Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia
- Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia
| | - Relika Stoppel
- Department of Economics, University of Potsdam, August-Bebel-Straße 89, 14482, Potsdam, Germany
| | - Rainer Reile
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Kinga Janik-Koncewicz
- Institute - European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland
| | - Witold Zatonski
- Institute - European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland
| | - Shannon Lange
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8Th Floor, Toronto, ON, M5T 1R8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
| | - Alexander Tran
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8Th Floor, Toronto, ON, M5T 1R8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
- Centre for Addiction and Mental Health, World Health Organization / Pan American Health Organization Collaborating Centre, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, 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, Public Health Agency of Catalonia, Program On Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, 08005, Barcelona, Spain
| | - Huan Jiang
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
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Lange S, Jeschke S, Pauschek J, Charisius M, Makiello P, Bertsche T, Neininger MP, Bertsche A. How do parents perceive their children's epileptic seizures? Experiences of the first seizure and changes during the course of the epilepsy. Epilepsy Behav 2023; 148:109459. [PMID: 37806289 DOI: 10.1016/j.yebeh.2023.109459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023]
Abstract
PROBLEM Experiencing a child's seizure can be challenging for parents. METHODS We investigated parental experiences of their child's first seizure and how their perception and management of seizures changed over time. From September 2020 to March 2021, we invited parents who had witnessed at least two of their child's seizures to take part in a semi-structured interview. Parents whose children experienced solely absence seizures were excluded. RESULTS Of the parents, 52/74 (70%) did not recognize their child's first epileptic seizure and assumed the event to be due to a different cause, for instance teething. Parents overwhelmingly reported fear (48/74; 65%) and surprise (13/74; 18%) as the predominant emotional responses to the first seizure. In response to the most recently observed seizure parents reported feelings related to fear (33/74; 45%) and happiness (16/74; 22%), with regard to the latter, especially "being calm" or "feeling safe". Asked for thoughts in response to the first seizure, 22/74 (30%) reported concerns about their child's future, with regard to the most recent seizure, 15/74 (20%) expressed such thoughts. Of the parents, 53/74 (72%) did not know how to respond to the first seizure. Concerning the most recent seizure, 48/74 (65%) said they felt confident in managing the seizure. CONCLUSION Experiencing the child's first seizure was very challenging for parents. During the course of the epilepsy, changes were observed in both parental perception of and confidence in managing the seizures. Physicians should consider these changes when counselling parents in order to better target their evolving needs.
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Affiliation(s)
- S Lange
- University Medicine Rostock, Hospital for Children and Adolescents, Department of Neuropaediatrics, Rostock, Germany; University Medicine Greifswald, Hospital for Children and Adolescents, Department of Neuropaediatrics, Greifswald, Germany.
| | - S Jeschke
- University Medicine Rostock, Hospital for Children and Adolescents, Department of Neuropaediatrics, Rostock, Germany; University Medicine Greifswald, Hospital for Children and Adolescents, Department of Neuropaediatrics, Greifswald, Germany.
| | - J Pauschek
- University Medicine Rostock, Hospital for Children and Adolescents, Department of Neuropaediatrics, Rostock, Germany.
| | - M Charisius
- University Medicine Rostock, Hospital for Children and Adolescents, Department of Neuropaediatrics, Rostock, Germany; University Medicine Greifswald, Hospital for Children and Adolescents, Department of Neuropaediatrics, Greifswald, Germany.
| | - P Makiello
- University Medicine Greifswald, Hospital for Children and Adolescents, Department of Neuropaediatrics, Greifswald, Germany.
| | - T Bertsche
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Bruederstraße 32, 04103 Leipzig, Germany.
| | - M P Neininger
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Bruederstraße 32, 04103 Leipzig, Germany.
| | - A Bertsche
- University Medicine Rostock, Hospital for Children and Adolescents, Department of Neuropaediatrics, Rostock, Germany; University Medicine Greifswald, Hospital for Children and Adolescents, Department of Neuropaediatrics, Greifswald, Germany.
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Weiss L, Dorman K, Boukovala M, Schwinghammer F, Jordan P, Fey T, Hasselmann K, Subklewe M, Bücklein V, Bargou R, Goebeler M, Sayehli C, Spoerl S, Lüke F, Heudobler D, Claus R, von Luettichau I, Lorenzen S, Lange S, Westphalen CB, von Bergwelt-Baildon M, Heinemann V, Gießen-Jung C. Early clinical trial unit tumor board: a real-world experience in a national cancer network. J Cancer Res Clin Oncol 2023; 149:13383-13390. [PMID: 37490102 PMCID: PMC10587227 DOI: 10.1007/s00432-023-05196-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Early clinical trials are the first step into clinical therapies for new drugs. Within the six Bavarian university-based hospitals (Augsburg, Erlangen, Regensburg, Munich (LMU and TU), Würzburg) we have enrolled a virtual network platform for patient discussion. METHODS The virtual Early Clinical Trial Unit Tumor Board (ECTU Tumor Board) is a secured web-based meeting to evaluate early clinical trial options for patients, where representatives from local ECTUs participate. We retrospectively analyzed patient cases discussed between November 2021 and November 2022. RESULTS From November 2021 to November 2022, a total of 43 patients were discussed in the ECTU Tumor Board. Median age at diagnosis was 44.6 years (range 10-76 years). The median number of previous lines of therapies was 3.7 (range 1-9 therapies) including systemic treatment, surgery, and radiation therapy. A total of 27 different tumor entities were presented and 83.7% (36/43) patients received at least one trial recommendation. In total, 21 different active or shortly recruiting clinical trials were recommended: ten antibody trials, four BiTE (bispecific T cell engager) trials, six CAR (chimeric antigen receptor) T-cell trials, and one chemotherapy trial. Only six trials (28.6%) were recommended on the basis of the previously performed comprehensive genetic profiling (CGP). CONCLUSION The ECTU Tumor Board is a feasible and successful network, highlighting the force of virtual patient discussions for improving patient care as well as trial recruitment in advanced diseases. It can provide further treatment options after local MTB presentation, aiming to close the gap to access clinical trials.
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Affiliation(s)
- L Weiss
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - K Dorman
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - M Boukovala
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - F Schwinghammer
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - P Jordan
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - T Fey
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
| | - K Hasselmann
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
| | - M Subklewe
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - V Bücklein
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - R Bargou
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - M Goebeler
- Early Clinical Trials Unit, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - C Sayehli
- Early Clinical Trials Unit, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Spoerl
- Department of Internal Medicine 5 (Hematology and Clinical Oncology), Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - F Lüke
- Department of Internal Medicine III (Hematology and Oncology), University Hospital Regensburg, Regensburg, Germany
- Division of Personalized Tumor Therapy, Fraunhofer Institute for Toxicology and Experimental Medicine, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - D Heudobler
- Department of Internal Medicine III (Hematology and Oncology), University Hospital Regensburg, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - R Claus
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - I von Luettichau
- Department of Pediatrics and Children's Cancer Research Center, TUM School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Lorenzen
- Department of Medicine II (Gastroenterology), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Lange
- Department of Medicine II (Gastroenterology), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - C B Westphalen
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - M von Bergwelt-Baildon
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - V Heinemann
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - C Gießen-Jung
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany.
- Bavarian Cancer Research Center (BZKF), Munich, Germany.
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Rehm J, Badaras R, Ferreira-Borges C, Galkus L, Gostautaite Midttun N, Gobiņa I, Janik-Koncewicz K, Jasilionis D, Jiang H, Kim KV, Lange S, Liutkutė-Gumarov V, Manthey J, Miščikienė L, Neufeld M, Petkevičienė J, Radišauskas R, Reile R, Room R, Stoppel R, Tamutienė I, Tran A, Trišauskė J, Zatoński M, Zatoński WA, Zurlytė I, Štelemėkas M. Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020. Lancet Reg Health Eur 2023; 33:100704. [PMID: 37953993 PMCID: PMC10636269 DOI: 10.1016/j.lanepe.2023.100704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 11/12/2023]
Abstract
Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.
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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
- World Health Organization/Pan American Health Organization Collaborating Centre, 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, 250 College St., Toronto, Ontario M5T 1R8, Canada
- Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
| | - Robertas Badaras
- Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Centre of Toxicology, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Lithuania
| | - Carina Ferreira-Borges
- World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark
| | - Lukas Galkus
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Nijole Gostautaite Midttun
- Lithuanian Tobacco and Alcohol Control Coalition, Stikliu 8, Vilnius 01131, Lithuania
- Mental Health Initiative, Teatro 3-10, Vilnius 03107, Lithuania
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia
- Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia
| | - Kinga Janik-Koncewicz
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
- Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Laboratory of Demographic Data, Konrad-Zuse-Str. 1, Rostock 18057, Germany
- Vytautas Magnus University, Demographic Research Centre, Jonavos g. 66, Kaunas 44191, Lithuania
| | - Huan Jiang
- 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, Toronto, Ontario M5T 1P8, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Shannon Lange
- 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, 250 College St., Toronto, Ontario M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada
| | - Vaida Liutkutė-Gumarov
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Jakob Manthey
- Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany
- Medical Faculty, Department of Psychiatry, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany
| | - Laura Miščikienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Maria Neufeld
- World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark
| | - Janina Petkevičienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Ričardas Radišauskas
- Faculty of Public Health, Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, Kaunas 50162, Lithuania
| | - Rainer Reile
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, Tallinn 11619, Estonia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria 3086, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm 106 91, Sweden
| | - Relika Stoppel
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Ilona Tamutienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Department of Public Administration, Faculty of Political Science and Diplomacy at Vytautas Magnus University, V.Putvinskio Str 23, Kaunas LT-44243, Lithuania
| | - Alexander Tran
- 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, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Justina Trišauskė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Mateusz Zatoński
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
| | - Witold A. Zatoński
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
- Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland
| | - Ingrida Zurlytė
- WHO Country Office Lithuania, A. Jakšto g. 12, LT-01105 Vilnius, Lithuania
| | - Mindaugas Štelemėkas
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
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Sornpaisarn B, Rehm J, Tamdee D, Wisutthananon A, Thummathai K, Tongtua K, Rutivarnich V, Suriyalangka A, Hengboonphan D, Lange S. Evaluating the efficacy of a community participatory intervention to prevent suicide in Thailand: a randomised controlled trial protocol. BMJ Open 2023; 13:e066201. [PMID: 37474176 PMCID: PMC10357749 DOI: 10.1136/bmjopen-2022-066201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION The age-standardised suicide mortality rate in Thailand has been stable at a high level in recent years, highlighting the need for suicide prevention interventions. In Thailand, community involvement plays a key role in health promotion. The aim of this ongoing trial is to evaluate the efficacy of a community participatory intervention in two subdistricts in Thailand for reducing suicidality symptoms among individuals considered at high risk for suicide and compare the outcomes to two control subdistricts. METHODS AND ANALYSIS In this cluster (subdistrict) randomised controlled trial, we randomised two districts to either the community participatory intervention arm or the control arm. From each district, we selected one large and one small subdistricts. We estimated that we need 235 participants per study arm, who were recruited from subdistrict health centres. The primary outcome is suicidality symptoms. Secondary outcomes are depression symptoms, quality of life, stress level and health and community service accessibility. ETHICS AND DISSEMINATION This trial has been approved by the Research Ethics Committee, Faculty of Nursing, Chiangmai University (number 050/2022). All participants were required to provide informed consent. The findings of the study will be disseminated in peer-reviewed journals and via conferences. TRIAL REGISTRATION NUMBER TCTR20220620003; the Thai Clinical Trials Registry.
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Affiliation(s)
- Bundit Sornpaisarn
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Decha Tamdee
- Faculty of Nursing, Chiang Mai University, Muang, Chiangmai, Thailand
| | | | | | - Kanjana Tongtua
- Institute for Community Development, Civil Society Foundation, Muang, Ubonratchathanee, Thailand
| | | | | | - Duangporn Hengboonphan
- Healthy Community Strengthening Section, Thai Health Promotion Foundation, Bangkok, Thailand
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health Queen Street Site, Toronto, Ontario, Canada
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15
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Abramovich A, Pang N, Kim KV, Stark RK, Lange S, Chaiton M, Logie CH, Hamilton HA, Kidd SA. A longitudinal investigation of the effects of the COVID-19 pandemic on 2SLGBTQ+ youth experiencing homelessness. PLoS One 2023; 18:e0288591. [PMID: 37459299 PMCID: PMC10351701 DOI: 10.1371/journal.pone.0288591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION The objective of this study was to examine the impacts of the coronavirus 2019 (COVID-19) pandemic on various dimensions of wellbeing among 2SLGBTQ+ youth experiencing homelessness over a 12-month period during the COVID-19 pandemic. METHODS 2SLGBTQ+ youth (recruited using a convenience sampling method) participated in three online surveys to assess mental health (depression, anxiety, suicidality), substance and alcohol use, health care access, and violence for 12-months between 2021-2022. Quantitative data analysis included non-parametric one-sample proportion tests, paired t-test and McNemar's test. Longitudinal data collected across all three timepoints were treated as paired data and compared to baseline data using non-parametric exact multinomial tests, and if significant, followed by pairwise post-hoc exact binomial tests. For the purposes of analysis, participants were grouped according to their baseline survey based on pandemic waves and public health restrictions. RESULTS 2SLGBTQ+ youth experiencing homelessness (n = 87) reported high rates of mental health challenges, including anxiety and depression, over 12-months during the pandemic. Youth participants reported experiencing poor mental health during the early waves of the pandemic, with improvements to their mental health throughout the pandemic; however, results were not statistically significant. Likewise, participants experienced reduced access to mental health care during the early waves of the pandemic but mental health care access increased for youth throughout the pandemic. CONCLUSION Study results showed high rates of mental health issues among 2SLGBTQ+ youth, but reduced access to mental health care, due to the COVID-19 pandemic. Findings highlight the need for 2SLGBTQ+ inclusive and affirming mental health care and services to address social and mental health issues that have been exacerbated by the pandemic.
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Affiliation(s)
- Alex Abramovich
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nelson Pang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rowen K. Stark
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael Chaiton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Carmen H. Logie
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Hayley A. Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sean A. Kidd
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Kim KV, Russell C, Kaplan MS, Rehm J, Lange S. Types of suicide pacts: a comparative analysis using the National Violent Death Reporting System. Front Psychiatry 2023; 14:1139305. [PMID: 37215672 PMCID: PMC10196347 DOI: 10.3389/fpsyt.2023.1139305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Suicide pacts are lethal acts of violence involving multiple decedents. No study has ever compared suicide pact types using a large sample, limiting our understanding of this rare but serious phenomenon. The objective of the current study was to describe suicide pacts in the United States and empirically compare suicide pacts wherein all decedents died by self-harm with those that involved assisted suicide. Methods Using restricted access incident-level data from the National Violent Death Reporting System, we identified 277 suicide pact incidents (225 suicide pacts wherein all decedents died by self-harm and 52 suicide pacts wherein one pact member died by assisted suicide). The two suicide pact types were compared for demographics, pact characteristics, and preceding circumstances. Results Compared with decedents of suicide pacts involving assisted suicide, decedents of suicide pacts wherein both members died by self-harm had significantly lower odds of being non-white, Hispanic or non-Hispanic (OR = 0.33, 95%CI: 0.18, 0.64), using an active method of suicide (i.e., ICD-10 codes X70-X83) (OR = 0.01, 95%CI: <0.01, 0.04), and experiencing interpersonal relationship problems (OR = 0.48, 95%CI: 0.27, 0.87) and a crisis within two weeks of their death (OR = 0.58, 95%CI: 0.36, 0.97), but greater odds of preceding physical health problems (OR = 3.25, 95%CI: 1.84, 6.04). Discussion Overall, our findings indicate that suicide pacts wherein all decedents died by self-harm and suicide pacts that involved an assisted suicide appear to have largely distinct profiles. While further research is required, the discrete characteristics of these two types of suicide pacts have important implications for prevention.
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Affiliation(s)
- Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mark S. Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, CA, United States
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Gobiņa I, Isajeva L, Spriņģe L, Vrobļevska E, Pelne A, Mārtiņsone U, Lange S. A narrative review of alcohol control policies in Latvia between 1990 and 2020. Drug Alcohol Rev 2023; 42:946-959. [PMID: 36974381 PMCID: PMC10897783 DOI: 10.1111/dar.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/29/2023]
Abstract
ISSUES Latvia has one of the highest alcohol per capita consumption in Europe. This study provides a narrative review of all evidence-based population-level alcohol control policies implemented in Latvia during the past 30 years. APPROACH A review of country-level alcohol control policies implemented in Latvia between 1990 and 2020 was conducted. The World Health Organization's "best buys" and other recommended interventions for alcohol control were used to guide the search. KEY FINDINGS Alcohol control policies in Latvia have evolved significantly over the last three decades. The most changes to alcohol control policy occurred in the transitional period between regaining independence in 1991 and joining the European Union in 2004. A number of significant alcohol control policies have been implemented to reduce alcohol availability and affordability, to restrict alcohol marketing and to counter drunk-driving. However, since 2010, when an increasing trend of alcohol consumption was observed, there has been a reluctance to pursue national public health policy actions to reduce alcohol consumption, and few adjustments to legislation to increase alcohol control have been made. IMPLICATIONS Despite the progress in alcohol control, Latvia still has considerable potential for strengthening alcohol control to reduce the high levels of alcohol consumption. CONCLUSION Although several alcohol control policies have been established in Latvia, many of the planned activities to limit alcohol intake and related harm have not been executed. Public health goals rather than political and economic incentives should be prioritised to reduce high levels of alcohol consumption in Latvia.
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Affiliation(s)
- Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Laura Isajeva
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
| | - Lauma Spriņģe
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
| | - Elīna Vrobļevska
- Department of Political Science, Riga Stradiņš University, Riga, Latvia
| | - Aija Pelne
- Addiction Monitoring Unit, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Una Mārtiņsone
- Addiction Monitoring Unit, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Vaitkevičiūtė J, Gobiņa I, Janik-Koncewicz K, Lange S, Miščikienė L, Petkevičienė J, Radišauskas R, Reile R, Štelemėkas M, Stoppel R, Telksnys T, Tran A, Rehm J, Zatoński WA, Jiang H. Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020. Sci Rep 2023; 13:6326. [PMID: 37072446 PMCID: PMC10112307 DOI: 10.1038/s41598-023-32926-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023] Open
Abstract
Alcohol consumption in the Baltic countries and Poland is among the highest globally, causing high all-cause mortality rates. Contrary to Poland, the Baltic countries have adopted many alcohol control policies, including the World Health Organization (WHO) "best buys". The aim of this study was to evaluate the impact of these policies, which were implemented between 2001 and 2020, on all-cause mortality. Monthly mortality data for men and women aged 20+ years of age in Estonia, Latvia, Lithuania, and Poland were analysed for 2001 to 2020. A total of 19 alcohol control policies, fulfilling an a-priori defined definition, were implemented between 2001 and 2020 in the countries of interest, and 18 of them could be tested. Interrupted time-series analyses were conducted by employing a generalized additive mixed model (GAMM) for men and women separately. The age-standardized all-cause mortality rate was lowest in Poland and highest in Latvia and had decreased in all countries over the time period. Taxation increases and availability restrictions had short-term effects in all countries, on average reducing the age-standardized all-cause mortality rate among men significantly (a reduction of 2.31% (95% CI 0.71%, 3.93%; p = 0.0045)). All-cause mortality rates among women were not significantly reduced (a reduction of 1.09% (95% CI - 0.02%, 2.20%; p = 0.0554)). In conclusion, the alcohol control policies implemented between 2001 and 2020 reduced all-cause mortality among men 20+ years of age in Baltic countries and Poland, and thus, the practice should be continued.
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Affiliation(s)
- Justina Vaitkevičiūtė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia
- Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia
| | - Kinga Janik-Koncewicz
- European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių av. 15, 50162, Kaunas, Lithuania
| | - Rainer Reile
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Relika Stoppel
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Economics, University of Potsdam, August-Bebel-Straße 89, 14482, Potsdam, Germany
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain
| | - Witold A Zatoński
- European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
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Lange S, Cayetano C, Jiang H, Tausch A, Oliveira e Souza R. Contextual factors associated with country-level suicide mortality in the Americas, 2000-2019: a cross-sectional ecological study. Lancet Reg Health Am 2023; 20:100450. [PMID: 37095770 PMCID: PMC10122114 DOI: 10.1016/j.lana.2023.100450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/23/2022] [Accepted: 02/01/2023] [Indexed: 04/26/2023]
Abstract
Background The suicide mortality rate in the Region of the Americas has been increasing, while decreasing in all other World Health Organization regions; highlighting the urgent need for enhanced prevention efforts. Gaining a better understanding of population-level contextual factors associated with suicide may aid such efforts. We aimed to evaluate the contextual factors associated with country-level, sex-specific suicide mortality rates in the Region of the Americas for 2000-2019. Methods Annual sex-specific age-standardized suicide mortality estimates were obtained from the World Health Organization (WHO) Global Health Estimates database. To investigate the sex-specific suicide mortality rate trend over time in the region, we performed joinpoint regression analysis. We then applied a linear mixed model to estimate the effects of specific contextual factors on the suicide mortality rate across countries in the region over time. All potentially relevant contextual factors, obtained from the Global Burden of Disease Study 2019 covariates and The World Bank, were selected in a step-wise manner. Findings We found that the mean country-level suicide mortality rate among males in the region decreased as health expenditure per capita and the proportion of the country with a moderate population density increased; and increased as the death rate due to homicide, prevalence of intravenous drug use, risk-weighted prevalence of alcohol use, and unemployment rate increased. The mean country-level suicide mortality rate among females in the region decreased as the number of employed medical doctors per 10,000 population and the proportion of the country with a moderate population density increased; and increased when relative education inequality and unemployment rate increased. Interpretation Although there was some overlap, the contextual factors that significantly impacted the suicide mortality rate among males and females were largely different, which mirrors the current literature on individual-level risk factors for suicide. Taken together, our data supports that sex should be considered when adapting and testing suicide risk reduction interventions, and when developing national suicide prevention strategies. Funding This work received no funding.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Corresponding author. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, T521, Toronto, ON, Canada M5S 2S1.
| | - Claudina Cayetano
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, DC, USA
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Amy Tausch
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, DC, USA
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Lange S, Jiang H, Štelemėkas M, Tran A, Cherpitel C, Giesbrecht N, Midttun NG, Jasilionis D, Kaplan MS, Manthey J, Xuan Z, Rehm J. Evaluating the Impact of Alcohol Policy on Suicide Mortality: A Sex-Specific Time-Series Analysis for Lithuania. Arch Suicide Res 2023; 27:339-352. [PMID: 34779348 PMCID: PMC9098693 DOI: 10.1080/13811118.2021.1999873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE It is reasonable to believe that the alcohol policy environment can impact the suicide mortality rates in a given country, considering the well-known link between alcohol use and death by suicide. The current literature, albeit limited, suggests that an increase in alcohol taxation may result in a decrease in deaths by suicide and that the effect is sex-specific. Therefore, the objective of the current study was to test the impact of three alcohol control policy enactments (in 2008, 2017 and 2018) on suicide mortality among adults 25-74 years of age in Lithuania, by sex. METHODS To estimate the unique impact of three alcohol control policies, we conducted interrupted time-series analyses by employing a generalized additive mixed model on monthly sex-specific age-standardized suicide mortality rates from January 2001 to December 2018. RESULTS Analyses showed a significant impact of the 2017 (p = 0.016) alcohol control policy on suicide mortality for men only. Specifically, we estimated that in the year following the 2017 policy enactment, approximately 57 (95% CI: 9-107) deaths by suicide were prevented among men, 25-74 years of age. The three policy enactments tested were not found to significantly impact the suicide mortality rate among women. CONCLUSION Alcohol control policies involving pricing, which result in a notable decrease in alcohol affordability, could be a cost-effective indirect suicide prevention mechanism in not only countries of the former Soviet Union, but in other high-income countries with a comparable health care system to that in Lithuania. HIGHLIGHTSIncreasing excise tax on alcohol was found to have a sex-specific impact on suicide mortalityThe 2017 alcohol policy prevented 57 deaths by suicide among men, 25-74 years of age, in the following yearAlcohol pricing policies may be a cost-effective indirect suicide prevention mechanism.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Cheryl Cherpitel
- Public Health Institute, Alcohol Research Group, Emeryville CA, USA
| | - Norman Giesbrecht
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | | | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Mark S. Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles CA, USA
| | - Jakob Manthey
- 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
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston MA, USA
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
- Institute of Medical Science, University of Toronto, Toronto ON, Canada
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- 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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Kim KV, Rehm J, Feng X, Jiang H, Manthey J, Radišauskas R, Štelemėkas M, Tran A, Zafar A, Lange S. Impact of alcohol control policy on hemorrhagic and ischemic stroke mortality rates in Lithuania: An interrupted time series analysis. Adicciones 2023; 0:1828. [PMID: 36975071 PMCID: PMC10884980 DOI: 10.20882/adicciones.1828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Given the causal impact of alcohol use on stroke, alcohol control policies should presumably reduce stroke mortality rates. This study aimed to test the impact of three major Lithuanian alcohol control policies implemented in 2008, 2017 and 2018 on sex- and stroke subtype-specific mortality rates, among individuals 15+ years-old. Joinpoint regression analyses were performed for each sex- and stroke subtype-specific group to identify timepoints corresponding with significant changes in mortality rate trends. To estimate the impact of each policy, interrupted time series analyses using a generalized additive mixed model were performed on monthly sex- and stroke subtype-specific age-standardized mortality rates from January 2001-December 2018. Significant average annual percent decreases were found for all sex- and stroke subtype-specific mortality rate trends. The alcohol control policies were most impactful on ischemic stroke mortality rates among women. The 2008 policy was followed by a positive level change of 4,498 ischemic stroke deaths per 100,000 women and a negative monthly slope change of -0.048 ischemic stroke deaths per 100,000 women. Both the 2017 and 2018 policy enactment timepoints coincided with a significant negative level change for ischemic stroke mortality rates among women, at -0.901 deaths and -1.431 deaths per 100,000 population, respectively. Hemorrhagic stroke mortality among men was not affected by any of the policies, and hemorrhagic stroke mortality among women and ischemic stroke mortality among men were only associated with the 2008 policy. Our study findings suggest that the impact of alcohol control policies on stroke mortality may vary by sex and subtype.
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Affiliation(s)
- Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON Dalla Lana School of Public Health, University of Toronto, Toronto ON.
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22
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Rehm J, Lange S, Gobiņa I, Janik-Koncewicz K, Miščikienė L, Reile R, Stoppel R, Tran A, Ferreira-Borges C, Jasilionis D, Jiang H, Kim KV, Manthey J, Neufeld M, Petkevičienė J, Radišauskas R, Room R, Liutkutė-Gumarov V, Zatoński WA, Štelemėkas M. Classifying alcohol control policies enacted between 2000 and 2020 in Poland and the Baltic countries to model potential impact. Addiction 2023; 118:449-458. [PMID: 36471145 PMCID: PMC10884981 DOI: 10.1111/add.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
AIMS The study's aim is to identify and classify the most important alcohol control policies in the Baltic countries (Estonia, Latvia and Lithuania) and Poland between 2000 and 2020. METHODS Policy analysis of Baltic countries and Poland, predicting potential policy impact on alcohol consumption, all-cause mortality and alcohol-attributable hospitalizations was discussed. RESULTS All Baltic countries implemented stringent availability restrictions on off-premises trading hours and different degrees of taxation increases to reduce the affordability of alcoholic beverages, as well as various degrees of bans on alcohol marketing. In contrast, Poland implemented few excise taxation increases or availability restrictions and, in fact, reduced stipulations on prior marketing bans. CONCLUSIONS This classification of alcohol control policies in the Baltic countries and Poland provides a basis for future modeling of the impact of implementing effective alcohol control policies (Baltic countries), as well as the effects of loosening such policies (Poland).
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, 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, Russia
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Shannon Lange
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Kinga Janik-Koncewicz
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, Poland
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rainer Reile
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department for Epidemiology and Biostatistics, National institute for Health Development, Tallinn, Estonia
| | - Relika Stoppel
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Economics, University of Potsdam, Potsdam, Germany
| | - Alexander Tran
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | | | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Huan Jiang
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kawon Victoria Kim
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Maria Neufeld
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Witold A Zatoński
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, Poland
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Lange S, Jiang H, Kaplan MS, Kim KV, Rehm J. Association Between Acute Alcohol Use and Firearm-Involved Suicide in the United States. JAMA Netw Open 2023; 6:e235248. [PMID: 36988957 PMCID: PMC10061235 DOI: 10.1001/jamanetworkopen.2023.5248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Importance Firearms are the method of suicide used most often in the US. Acute alcohol use is associated with an increased risk of suicide by firearm. However, the dose-response association between acute alcohol use and the probability of using a firearm as the method of suicide is unknown. Objective To evaluate the association between the amount of alcohol consumed and the probability of using a firearm as the method of suicide. Design, Setting, and Participants This cross-sectional study used mortality data from the US National Violent Death Reporting System on suicide decedents aged 18 years or older with a positive blood alcohol concentration (BAC; ie, ≥0.01 g/dL). Statistical analysis was performed from January 2003 to December 2020. Exposure Acute alcohol use, ascertained via postmortem toxicologic examination. Main Outcomes and Measures Probability of using a firearm as the method of suicide compared with all other methods of suicide. Results The study included 45 959 male suicide decedents (mean [SD] age, 42.6 [14.8] years) and 12 136 female suicide decedents (mean [SD] age, 44.2 [13.8] years) with a positive BAC; of those, 24 720 male decedents (53.8%) and 3599 female decedents (29.7%) used a firearm as the method of suicide. The probability of using a firearm as the method of suicide when alcohol is consumed was higher for male decedents, with the probability starting at just below 0.50 and increasing to approximately 0.75. In contrast, for female decedents, the probability began at just above 0.30 and increased to approximately 0.55. For both male and female decedents, the dose-response curves were an inverted U shape; as BAC increased, the probability of firearm-involved suicide initially increased and then decreased at very high BACs (approximately 0.40 g/dL for male decedents and approximately 0.30 g/dL for female decedents; these BACs were present among only a small percentage of alcohol-involved suicides: male decedents, 589 [1.3%]; female decedents, 754 [6.2%]). Conclusions and Relevance This cross-sectional study of suicide decedents who had consumed alcohol prior to their death suggests that, as alcohol consumption increased, the probability of a firearm-involved suicide increased until a certain BAC, at which point the probability started to decrease.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Miščikienė L, Tran A, Petkevičienė J, Rehm J, Vaitkevičiūtė J, Galkus L, Lange S, Štelemėkas M. A mystery-shopping study to test enforcement of minimum legal purchasing age in Lithuania in 2022. Eur J Public Health 2023; 33:317-322. [PMID: 36840664 PMCID: PMC10066479 DOI: 10.1093/eurpub/ckad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND According to the Lithuanian law to prevent the sale of alcohol to customers below the legal minimum purchasing age of 20 years, young adults below 25 years must be asked to show an age-verification document when purchasing alcohol. The aim of this study was to assess whether off-premise outlets comply with the law. METHODS In 2022, mystery-shopping study was carried out in three consecutive phases: (i) in a representative sample (n = 239) of off-premise alcohol outlets covering all Lithuanian district centres, (ii) after lifting the requirement to wear a mask and (iii) after warning the outlets that a mystery-shopping study was ongoing. Phases 2 and 3 were held in two cities. The mystery shopping involved attempts by young, but legally eligible customers to purchase alcohol. Across the three study phases, we compared compliance with the law by measuring overall success of purchase attempts and included situational characteristics (working day or weekend), time of day and number of customers in line as an additional predictor. RESULTS Out of 239 attempts to purchase alcohol from off-premise outlets in the main phase of the study, 107 (or 44.8%) were considered to be successful (visits in which staff were willing to sell alcohol). There was a significantly higher chance of success to purchase alcohol with no ID request if a mystery shopper was the only customer in a queue and on weekends. CONCLUSIONS The results indicate an insufficient level of age-verification control in Lithuania, and that additional action is needed to increase compliance.
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Affiliation(s)
- Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Justina Vaitkevičiūtė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Lukas Galkus
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Rehm J, Jiang H, Kim KV, Room R, Rovira P, Shield KD, Tran A, Lange S, Štelemėkas M. Using Direct and Indirect Estimates for Alcohol-Attributable Mortality: A Modelling Study Using the Example of Lithuania. Eur Addict Res 2023:1-8. [PMID: 36750037 DOI: 10.1159/000529200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 12/23/2022] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Comparative risk assessments (CRAs) for alcohol use are based on indirect estimates of attributable harm, and usually combine country-specific exposure estimates and global risk relations derived from meta-analyses. CRAs for Eastern European countries, such as Lithuania, base their risk relations not on global risk relations, but on a large Russian cohort study. The availability of a direct estimate of alcohol-attributable mortality following the 2017 implementation of a large increase in alcohol excise taxes in Lithuania has allowed a comparison of these indirect estimates with a country-specific gold standard. METHODS A statistical modelling study compared direct (predictions based on a time-series methodology) and indirect (predictions based on an attributable-fraction methodology) estimates of alcohol-attributable mortality before and after a large increase in alcohol excise taxes in Lithuania. Specifically, Russia-specific versus global relative risks were compared against the gold standard of time-series based predictions. RESULTS Compared to direct estimates, indirect estimates markedly underestimated the reduction of alcohol-attributable mortality 12 months post intervention by at least 63%. While both of the indirect estimates differed markedly from the direct estimates, the Russia-specific estimates were closer to the direct estimates, primarily due to higher estimates for alcohol-attributable cardiovascular mortality. DISCUSSION As all indirect estimates were markedly lower than direct estimates, current overall relative risks and price elasticities should be re-evaluated. In particular, global estimates should be replaced by new regional estimates based on cohort studies.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, 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.,Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and Designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia.,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and Designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Kevin David Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Jiang H, Tran A, Petkevičienė J, Štelemėkas M, Lange S, Rehm J. Are restrictions in sales hours of alcohol associated with fewer emergency room visits in Lithuania? An interrupted time-series analysis. Drug Alcohol Rev 2023; 42:487-494. [PMID: 36514305 PMCID: PMC9898194 DOI: 10.1111/dar.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION On 1 January 2018, an amendment to the alcohol control law was introduced in Lithuania which, among other changes, reduced trading hours for alcoholic beverages by 4 h for weekdays and Saturdays, and by 9 h for Sundays. The objective of the current study was to quantify the potential association of this law with the numbers and types of emergency room (ER) visits in Lithuania, in general and specifically for Sundays, for all ER visits, for injury-related ER visits and specifically for alcohol poisoning as a 100% alcohol-attributable cause. METHODS Sex-stratified time-series analysis-based models for the period 2016-2019 were used to test for associations and for potential alternative explanations (e.g., the increase in minimum legal drinking age, which occurred at the same time). RESULTS Overall, while the reduction in sales hours for both sexes was associated with slight increases in all types and in injury-related ER visits on a weekly basis, the association with ER visits for alcohol poisoning was in the opposite direction for men in all models. Specifically, among men, it was associated with an approximate decrease of 20% of alcohol poisoning-related ER visits on Sundays and an approximate decrease of 12% of alcohol poisoning-related ER visits for all seven weekdays. DISCUSSION AND CONCLUSIONS As predicted, restrictions on availability were associated with marked reductions in ER visits for alcohol poisoning in men. However, contrary to expectations, there were no overall reductions in overall ER visits, nor reductions in injury-related ER visits.
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Affiliation(s)
- Huan Jiang
- 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, Health Sciences Building, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
| | - Shannon Lange
- 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 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
| | - Jürgen Rehm
- 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, Health Sciences Building, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 3M1, Canada
- Department of Psychiatry, 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
- Program on Substance Abuse, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, 119991, Russian Federation
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Ashley J, Kim KV, Russell C, Lange S. A comparative analysis of solitary suicides, suicides following homicide, and suicide pacts using the National Violent Death Reporting System. BMC Psychiatry 2023; 23:1. [PMID: 36593442 PMCID: PMC9808963 DOI: 10.1186/s12888-022-04495-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/23/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Incidents of suicide can be categorized into three main types: solitary suicides, suicides following homicide, and suicide pacts. Although these three suicide incidents vary by definition, no studies to-date have simultaneously examined and compared them for potential differences. The objective of the current study was to empirically and descriptively compare solitary suicides, suicides following homicide, and suicide pacts in the United States. METHODS Restricted-access data from the National Violent Death Report System for 2003-2019 for 262,679 solitary suicides, 4,352 suicides following homicide, and 450 suicide pacts were used. Pairwise comparisons of the three suicide incident types were made for demographic factors, method of suicide, preceding circumstances, mental health status, and toxicology findings. RESULTS Solitary suicides, suicides following homicide, and suicide pacts have distinct profiles, with statistically significant (p < 0.05) differences across all pairwise comparisons of sex, race, ethnicity, marital status, education, method of suicide, financial problems, interpersonal relationship problems, physical health problems, mental health problems, mood disorders, suicide attempt history, and opiate use at the time of death. CONCLUSION Despite sharing a few commonalities, solitary suicides, suicides following homicide, and suicide pacts represent distinct phenomena. Each of these suicide incident types likely have their own unique prevention pathways.
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Affiliation(s)
- Jenna Ashley
- grid.25073.330000 0004 1936 8227Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, L8S 4K1 Hamilton, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St, M5S 2S1 Toronto, ON Canada
| | - Kawon Victoria Kim
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St, M5S 2S1 Toronto, ON Canada
| | - Cayley Russell
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St, M5S 2S1 Toronto, ON Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St, M5S 2S1, Toronto, ON, Canada. .,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, 250 College St. 8th Floor, M5T 1R8, Toronto, ON, Canada.
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Correa J, Mehrjoo M, Battistelli R, Lehmkühler F, Marras A, Wunderer CB, Hirono T, Felk V, Krivan F, Lange S, Shevyakov I, Vardanyan V, Zimmer M, Hoesch M, Bagschik K, Guerrini N, Marsh B, Sedgwick I, Cautero G, Stebel L, Giuressi D, Menk RH, Greer A, Nicholls T, Nichols W, Pedersen U, Shikhaliev P, Tartoni N, Hyun HJ, Kim SH, Park SY, Kim KS, Orsini F, Iguaz FJ, Büttner F, Pfau B, Plönjes E, Kharitonov K, Ruiz-Lopez M, Pan R, Gang S, Keitel B, Graafsma H. The PERCIVAL detector: first user experiments. J Synchrotron Radiat 2023; 30:242-250. [PMID: 36601943 PMCID: PMC9814071 DOI: 10.1107/s1600577522010347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 06/17/2023]
Abstract
The PERCIVAL detector is a CMOS imager designed for the soft X-ray regime at photon sources. Although still in its final development phase, it has recently seen its first user experiments: ptychography at a free-electron laser, holographic imaging at a storage ring and preliminary tests on X-ray photon correlation spectroscopy. The detector performed remarkably well in terms of spatial resolution achievable in the sample plane, owing to its small pixel size, large active area and very large dynamic range; but also in terms of its frame rate, which is significantly faster than traditional CCDs. In particular, it is the combination of these features which makes PERCIVAL an attractive option for soft X-ray science.
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Affiliation(s)
- J. Correa
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - M. Mehrjoo
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - R. Battistelli
- Helmholtz Zentrum Berlin HZB, Hahn-Meitner-Platz 1, Berlin, Germany
| | - F. Lehmkühler
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- The Hamburg Centre for Ultrafast Imaging CUI, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - A. Marras
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - C. B. Wunderer
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - T. Hirono
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - V. Felk
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - F. Krivan
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - S. Lange
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - I. Shevyakov
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - V. Vardanyan
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - M. Zimmer
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - M. Hoesch
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - K. Bagschik
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - N. Guerrini
- Science and Technology Faculties STFC, Rutherford Appleton Laboratory RAL, Didcot, United Kingdom
| | - B. Marsh
- Science and Technology Faculties STFC, Rutherford Appleton Laboratory RAL, Didcot, United Kingdom
| | - I. Sedgwick
- Science and Technology Faculties STFC, Rutherford Appleton Laboratory RAL, Didcot, United Kingdom
| | - G. Cautero
- Elettra Sincrotrone Trieste, Trieste, Italy
| | - L. Stebel
- Elettra Sincrotrone Trieste, Trieste, Italy
| | | | - R. H. Menk
- Elettra Sincrotrone Trieste, Trieste, Italy
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5A2
| | - A. Greer
- Observatory Sciences Ltd, Cambridge, United Kingdom
| | - T. Nicholls
- Science and Technology Faculties STFC, Rutherford Appleton Laboratory RAL, Didcot, United Kingdom
| | - W. Nichols
- Diamond Light Source, Didcot, United Kingdom
| | - U. Pedersen
- Diamond Light Source, Didcot, United Kingdom
| | | | - N. Tartoni
- Diamond Light Source, Didcot, United Kingdom
| | - H. J. Hyun
- Pohang Accelerator Laboratory PAL, Pohang, Gyeongbuk 37673, Republic of Korea
| | - S. H. Kim
- Pohang Accelerator Laboratory PAL, Pohang, Gyeongbuk 37673, Republic of Korea
| | - S. Y. Park
- Pohang Accelerator Laboratory PAL, Pohang, Gyeongbuk 37673, Republic of Korea
| | - K. S. Kim
- Pohang Accelerator Laboratory PAL, Pohang, Gyeongbuk 37673, Republic of Korea
| | - F. Orsini
- Synchrotron SOLEIL, Saint Aubin, France
| | | | - F. Büttner
- Helmholtz Zentrum Berlin HZB, Hahn-Meitner-Platz 1, Berlin, Germany
| | - B. Pfau
- Max-Born-Institute MBI, Max-Born-Straße 2A, Berlin, Germany
| | - E. Plönjes
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - K. Kharitonov
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - M. Ruiz-Lopez
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - R. Pan
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - S. Gang
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - B. Keitel
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - H. Graafsma
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
- Mid Sweden University, Sundsvall, Sweden
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Lange S, Roerecke M, Orpana H, Bagge C, Rehm J. Alcohol use and the gender-specific risk of suicidal behavior: a systematic review and meta-analysis protocol. Syst Rev 2022; 11:279. [PMID: 36564843 PMCID: PMC9783973 DOI: 10.1186/s13643-022-02159-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Alcohol use is an important risk factor for suicidal behavior, with a heightened risk found among women. The objective of this study is to determine the gender-specific risk of suicidal behaviors (suicide attempt and death by suicide) for different levels and dimensions of alcohol use-i.e., for (1) average alcohol volume consumed, (2) binge drinking, and (3) individuals with an alcohol use disorder. METHODS We will systematically search the available literature for primary studies on the risk relationships specified above. Using a predetermined set of keywords, a comprehensive systematic literature search will be conducted in the following electronic databases: Embase, PsycINFO, PubMed, and Web of Science. The basic inclusion criteria will be (1) an original, quantitative (cohort, case-control or cross-sectional) study; with (2) a measure of risk of at least one dimension of our alcohol exposures in relation to at least one of our outcomes of interest (suicide attempt or death by suicide), and its corresponding measure of variability is reported (or sufficient data to calculate these); and (3) estimates of risk stratified by gender. Studies (1) that use only qualitative labels of alcohol use, and (2) where suicide attempt and non-suicidal self-harm cannot be disaggregated will be excluded. There will be no restrictions on language, geographical region, or year of publication. Two reviewers will independently perform the search and systematic assessment of each identified study and subsequent extraction of data. Categorical random-effects meta-analyses will be conducted to obtain gender-specific pooled risk estimates. Risk of bias will be assessed using the Risk of Bias In Non-randomised Studies-of Interventions tool and the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of evidence. DISCUSSION This study will synthesize all available data on the gender-specific relationship between various dimensions of alcohol use and suicidal behavior simultaneously in a coherent framework. We will provide risk estimates with the detail needed to better understand the respective risk relationships and appreciate the burden of alcohol-attributable suicide. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022320918.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St. T521, ON, M5S 2S1, Toronto, Canada. .,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada. .,Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada.
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St. T521, ON, M5S 2S1, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Heather Orpana
- Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON, K1A 0K9, Canada.,School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Cres, Ottawa, ON, K1G 5Z3, Canada.,Royal Ottawa Institute for Mental Health Research, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.,Department of Veterans Affairs, Center for Clinical Management Research, 2215 Fuller Rd., Ann Arbor, MI, 48105, USA
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St. T521, ON, M5S 2S1, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.,Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.,Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Street 8, B. 2, Moscow, 119991, Russian Federation.,Zentrum Für Interdisziplinäre Suchtforschung (ZIS), Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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30
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Rehm J, Tran A, Gobiņa I, Janik-Koncewicz K, Jiang H, Kim KV, Liutkutė-Gumarov V, Miščikienė L, Reile R, Room R, Štelemėkas M, Stoppel R, Zatoński WA, Lange S. Do alcohol control policies have the predicted effects on consumption? An analysis of the Baltic countries and Poland 2000-2020. Drug Alcohol Depend 2022; 241:109682. [PMID: 36402051 PMCID: PMC9772294 DOI: 10.1016/j.drugalcdep.2022.109682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Many population-based alcohol control policies are postulated to work via changes in adult alcohol per capita consumption (APC). However, since APC is usually assessed on a yearly basis, often there are not enough data to conduct interrupted time-series or other controlled analyses. The current dataset, with 21 years of observation from four countries (Estonia, Latvia, Lithuania, and Poland), had sufficient power to test for average effects and potential interactions of the World Health Organization's (WHO) three "best buys" for alcohol control: taxation increases leading to a decrease in affordability; reduced availability (via a decrease in opening hours of at least 20 %); and advertising and marketing restrictions. We postulated that the former two would have immediate effects, while the latter would have mid- to long-term effects. METHODS Linear regression analysis. RESULTS Taxation increases and availability reductions in all countries were associated with an average reduction in APC of 0.83 litres (ℓ) of pure alcohol per year (95 % confidence interval: -1.21 ℓ, -0.41 ℓ) in the same year, with no significant differences between countries. Restrictions on advertising and/or marketing had no significant immediate associations with APC (average effect 0.04 ℓ per year; 95 % confidence interval: -0.65 ℓ, 0.73 ℓ). Several sensitivity analyses corroborated these main results. CONCLUSIONS The WHO "best buy" alcohol control policies of taxation increases and availability restrictions worked as postulated in these four northeastern European Union countries.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada; Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, the Russian Federation; Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia; Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Kinga Janik-Koncewicz
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland; Health Promotion Foundation, Nadarzyn, Poland
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rainer Reile
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department for Epidemiology and Biostatistics, National institute for Health Development, Tallinn, Estonia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Relika Stoppel
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania; University of Potsdam, Department of Economics, Potsdam, Germany
| | - Witold A Zatoński
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland; Health Promotion Foundation, Nadarzyn, Poland
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Vaičiūnas T, Žemaitaitytė M, Lange S, Štelemėkas M, Oja L, Petkevičienė J, Kowalewska A, Pudule I, Piksööt J, Šmigelskas K. Trends in Adolescent Substance Use: Analysis of HBSC Data for Four Eastern European Countries, 1994-2018. Int J Environ Res Public Health 2022; 19:15457. [PMID: 36497532 PMCID: PMC9737814 DOI: 10.3390/ijerph192315457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED The aim of the study was to analyze the trends of adolescent substance use in four eastern European countries over the time period from 1994 to 2018. The four countries in focus were selected based on their shared historical backgrounds and major economic and social transformations experienced. METHODS Two decades (1993/1994-2017/2018) of repeated cross-sectional data from the Estonian, Latvian, Lithuanian, and Polish Health Behaviour in School-aged Children survey were used. Data comprised 42,169 school children 15 years of age (9th grade). The following categories of substance use were included: regular alcohol consumption and drunkenness, tobacco smoking, electronic cigarette smoking, and cannabis use. Trends in substance use over time were tested using Jonckheere's trend test. RESULTS Prevalence of substance use among adolescents over time revealed that the Baltic states and Poland have faced relatively different temporal trends. In the Baltic states, there was a general increase during the period of 1994-2002, which was followed by a period of peaking or stability between 2002-2010, and then decreasing trends of these risky behaviors from 2010 onwards. In Poland, the same period had less consistent patterns, with decreasing trends starting much earlier on. The prevalence of cannabis use, which had been measured since 2006, had its own unique pattern with many fluctuations within and between countries. CONCLUSIONS The findings on the prevalence of substance use among adolescents from 1994 to 2018 revealed that the Baltic states and Poland have faced relatively different temporal trends. These countries might be facing new public health challenges in a near future, e.g., use of electronic cigarettes and cannabis use among adolescents.
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Affiliation(s)
- Tomas Vaičiūnas
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Monika Žemaitaitytė
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Shannon Lange
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON M5S 2S1, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON M5G 2C1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A4, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Leila Oja
- National Institute for Health Development, 11619 Tallinn, Estonia
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Anna Kowalewska
- Department of Biomedical Aspects of Development and Sexology, Faculty of Education, Warsaw University, 00-927 Warsaw, Poland
| | - Iveta Pudule
- Centre for Disease Prevention and Control, 1005 Riga, Latvia
| | - Jaanika Piksööt
- National Institute for Health Development, 11619 Tallinn, Estonia
| | - Kastytis Šmigelskas
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
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Tran A, Stoppel R, Jiang H, Kim KV, Lange S, Petkevičienė J, Radišauskas R, Štelemėkas M, Telksnys T, Zafar A, Rehm J. The temporal trend of cause-specific mortality: comparing Estonia and Lithuania, 2001 - 2019. BMC Public Health 2022; 22:1984. [PMID: 36310159 PMCID: PMC9618211 DOI: 10.1186/s12889-022-14354-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite being two Baltic countries with similar histories, Estonia and Lithuania have diverged in life expectancy trends in recent years. We investigated this divergence by comparing cause-specific mortality trends. METHODS We obtained yearly mortality data for individuals 20 + years of age from 2001-2019 (19 years worth of data) through Statistics Lithuania, the Lithuanian Institute for Hygiene, and the National Institute for Health Development (Estonia). Using ICD-10 codes, we analyzed all-cause mortality rates and created eight major disease categories: ischemic heart disease, cerebrovascular disease, all other cardiovascular disease, cancers (neoplasms), digestive diseases, self-harm and interpersonal violence, unintentional injuries and related conditions, and other mortality (deaths per 100,000 population). We used joinpoint regression analysis, and analyzed the proportional contribution of each category to all-cause mortality. RESULTS There was a steeper decline in all-cause mortality in Estonia (average annual percent change, AAPC = -2.55%, 95% CI: [-2.91%, -2.20%], P < .001) as compared to Lithuania (AAPC = -1.26%, 95% CI: [-2.18%, -0.57%], P = .001). For ischemic heart disease mortality Estonia exhibited a relatively larger decline over the 19-year period (AAPC = -6.61%, 95% CI: [-7.02%, -6.21%], P < .001) as compared to Lithuania (AAPC = -2.23%, 95% CI: [-3.40%, -1.04%], P < .001). CONCLUSION Estonia and Lithuania showed distinct mortality trends and distributions of major disease categories. Our findings highlight the role of ischemic heart disease mortality. Differences in public health care, management and prevention of ischemic heart disease, alcohol control policies may explain these differences.
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Affiliation(s)
- Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada. .,Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada.
| | - Relika Stoppel
- grid.11348.3f0000 0001 0942 1117Department of Economics, University of Potsdam, August-Bebel-Straße 89, 14482 Potsdam, Germany ,grid.45083.3a0000 0004 0432 6841Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, 47181 Kaunas, Lithuania
| | - Huan Jiang
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6Th Floor, Toronto, ON M5T 3M7 Canada
| | - Kawon Victoria Kim
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6Th Floor, Toronto, ON M5T 3M7 Canada
| | - Shannon Lange
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8Th Floor, Toronto, ON M5T 1R8 Canada
| | - Janina Petkevičienė
- grid.45083.3a0000 0004 0432 6841Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, 47181 Kaunas, Lithuania ,grid.45083.3a0000 0004 0432 6841Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes Str. 18, 47181 Kaunas, Lithuania
| | - Ričardas Radišauskas
- grid.45083.3a0000 0004 0432 6841Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181 Kaunas, Lithuania ,grid.45083.3a0000 0004 0432 6841Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Str. 15, 50162 Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- grid.45083.3a0000 0004 0432 6841Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, 47181 Kaunas, Lithuania ,grid.45083.3a0000 0004 0432 6841Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes Str. 18, 47181 Kaunas, Lithuania
| | - Tadas Telksnys
- grid.45083.3a0000 0004 0432 6841Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, 47181 Kaunas, Lithuania
| | - Anush Zafar
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Jürgen Rehm
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6Th Floor, Toronto, ON M5T 3M7 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8Th Floor, Toronto, ON M5T 1R8 Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, World Health Organization / Pan American Health Organization Collaborating Centre, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S 1A8 Canada ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, B. 2, 119992 Moscow, Russian Federation ,grid.500777.2Program On Substance Abuse & Designated WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, 08005 Barcelona, Spain
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Galkus L, Lange S, Liutkutė-Gumarov V, Miščikienė L, Petkevičienė J, Rehm J, Štelemėkas M, Tran A, Vaitkevičiūtė J. The Comprehensive Alcohol Advertising Ban in Lithuania: A Case Study of Social Media. Int J Environ Res Public Health 2022; 19:ijerph191912398. [PMID: 36231698 PMCID: PMC9566760 DOI: 10.3390/ijerph191912398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 05/31/2023]
Abstract
Alcohol advertising exposure is a risk factor for earlier alcohol initiation and higher alcohol consumption. Furthermore, engagement in digital alcohol marketing, such as liking or sharing an ad on social media, is associated with increased alcohol consumption and binge or hazardous drinking behavior. In light of these challenges, Lithuania has enacted a total prohibition on alcohol advertising, including social media. This study monitored the two most popular social media networks, Facebook and Instagram, to determine compliance with current legislation. In total, 64 Facebook and 51 Instagram profiles were examined. During the 60-day study period, 1442 and 749 posts on the selected Facebook and Instagram profiles, respectively, were published. There were a total of 163 distinct social media alcohol-related posts. Alcohol-related posts accounted for 5.9 percent of total Instagram posts and 8.3 percent of total Facebook posts. Alcohol advertisements accounted for 1.4 percent of all posts (infringement of the Alcohol Control Law). Influencers were responsible for nearly half (45.5 percent) of all observed alcohol-related Instagram posts. The study demonstrates high compliance with Lithuania's total alcohol advertising ban on social media and emphasizes the importance of adequately monitoring the growing prominence of influencers on social media.
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Affiliation(s)
- Lukas Galkus
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, b. 2, 119992 Moscow, Russia
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
| | - Justina Vaitkevičiūtė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
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Lange S, Kaplan MS, Tran A, Rehm J. Growing alcohol use preceding death by suicide among women compared with men: age-specific temporal trends, 2003-18. Addiction 2022; 117:2530-2536. [PMID: 35491753 PMCID: PMC9357152 DOI: 10.1111/add.15905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS In the United States, until 2018 both the prevalence of heavy alcohol use and the suicide mortality rate increased among men and women; however, women had experienced a notably higher increase in both. As heavy alcohol use may have contributed to the observed sex disparity in the suicide mortality rate increase, the aim of the current study was to estimate the temporal trend of the sex- and age-group-specific proportion of suicides that were alcohol-involved in the United States. DESIGN Using restricted-access data from the National Violent Death Reporting System, we performed joinpoint regression analyses to investigate temporal trends in the sex- and age-group (young adults = 18-34 years; middle-aged adults = 35-64 years; and older adults = 65+ years)-specific proportion of suicides that were alcohol-involved. SETTING United States. PARTICIPANTS A total of 115 202 suicide decedents 18+ years of age from 2003 to 2018. MEASUREMENTS The sex- and age-group-specific proportion of suicides that were alcohol-involved, among all suicide decedent, for which the decedent had a blood alcohol concentration (BAC) (a) ≥ 0.04 g/dl and (b) ≥ 0.08 g/dl. FINDINGS For 2003-18, the proportion of suicides that were alcohol-involved wherein the decedent had a BAC ≥ 0.08 g/day significantly increased on average annually for women of all age groups [young women: 2.80%, 95% confidence interval (CI) = 1.86%, 3.75%; middle-aged women: 2.20%, 95% CI = 1.20%, 3.21%; older women: 10.48%, 95% CI = 1.17%, 20.65%], while only middle-aged men experienced a significant average annual percentage increase (0.81%, 95% CI = 0.003%, 1.62%). CONCLUSION In the United States between 2003 and 2018, alcohol use preceding death by suicide increased among women compared with men.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto ON, Canada M5S 2S1,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto ON, Canada M5T 1R8,Department of Psychiatry, University of Toronto, 250 College St., Toronto ON, Canada M5T 1R8,Corresponding author: Shannon Lange, MPH, PhD, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, T521, Toronto ON, Canada M5S 2S1, Tel: 416-535-8501 ext. 34512,
| | - Mark S. Kaplan
- Luskin School of Public Affairs, University of California, 3250 Public Affairs Building. Los Angeles CA, USA 90095-1656
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto ON, Canada M5S 2S1
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto ON, Canada M5S 2S1,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto ON, Canada M5T 1R8,Department of Psychiatry, University of Toronto, 250 College St., Toronto ON, Canada M5T 1R8,Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto ON, Canada M5T 3M7,Institute of Medical Science, University of Toronto, 1 King’s College Circle, Toronto ON, Canada M5S 1A8,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Street 8, b. 2, Moscow, 119991, Russian Federation
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35
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Dernick K, Lange S, Hoeber J, Loskil P, Kustermann S. S-24-04 Novel in vitro models to address toxicity in the eye and brain. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Carnevale J, Shifrut E, Kale N, Nyberg WA, Blaeschke F, Chen YY, Li Z, Bapat SP, Diolaiti ME, O'Leary P, Vedova S, Belk J, Daniel B, Roth TL, Bachl S, Anido AA, Prinzing B, Ibañez-Vega J, Lange S, Haydar D, Luetke-Eversloh M, Born-Bony M, Hegde B, Kogan S, Feuchtinger T, Okada H, Satpathy AT, Shannon K, Gottschalk S, Eyquem J, Krenciute G, Ashworth A, Marson A. RASA2 ablation in T cells boosts antigen sensitivity and long-term function. Nature 2022; 609:174-182. [PMID: 36002574 PMCID: PMC9433322 DOI: 10.1038/s41586-022-05126-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 07/20/2022] [Indexed: 12/17/2022]
Abstract
The efficacy of adoptive T cell therapies for cancer treatment can be limited by suppressive signals from both extrinsic factors and intrinsic inhibitory checkpoints1,2. Targeted gene editing has the potential to overcome these limitations and enhance T cell therapeutic function3-10. Here we performed multiple genome-wide CRISPR knock-out screens under different immunosuppressive conditions to identify genes that can be targeted to prevent T cell dysfunction. These screens converged on RASA2, a RAS GTPase-activating protein (RasGAP) that we identify as a signalling checkpoint in human T cells, which is downregulated upon acute T cell receptor stimulation and can increase gradually with chronic antigen exposure. RASA2 ablation enhanced MAPK signalling and chimeric antigen receptor (CAR) T cell cytolytic activity in response to target antigen. Repeated tumour antigen stimulations in vitro revealed that RASA2-deficient T cells show increased activation, cytokine production and metabolic activity compared with control cells, and show a marked advantage in persistent cancer cell killing. RASA2-knockout CAR T cells had a competitive fitness advantage over control cells in the bone marrow in a mouse model of leukaemia. Ablation of RASA2 in multiple preclinical models of T cell receptor and CAR T cell therapies prolonged survival in mice xenografted with either liquid or solid tumours. Together, our findings highlight RASA2 as a promising target to enhance both persistence and effector function in T cell therapies for cancer treatment.
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Affiliation(s)
- Julia Carnevale
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA.
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
- Parker Institute for Cancer Immunotherapy, University of California, San Francisco, San Francisco, CA, USA.
| | - Eric Shifrut
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA.
- The School of Neurobiology, Biochemistry and Biophysics, The George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel.
- Department of Pathology Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Varda and Boaz Dotan Center for Advanced Therapies, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - Nupura Kale
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - William A Nyberg
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Parker Institute for Cancer Immunotherapy, University of California, San Francisco, San Francisco, CA, USA
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA
| | | | - Yan Yi Chen
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
| | - Zhongmei Li
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
| | - Sagar P Bapat
- Diabetes Center, University of California San Francisco, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Morgan E Diolaiti
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Patrick O'Leary
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Shane Vedova
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
| | - Julia Belk
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Bence Daniel
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Theodore L Roth
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Stefanie Bachl
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Alejandro Allo Anido
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Brooke Prinzing
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Jorge Ibañez-Vega
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Shannon Lange
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Dalia Haydar
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Marie Luetke-Eversloh
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Maelys Born-Bony
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Bindu Hegde
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Scott Kogan
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Tobias Feuchtinger
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Dr von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Hideho Okada
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Parker Institute for Cancer Immunotherapy, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Ansuman T Satpathy
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
- Department of Pathology, Stanford University, Stanford, CA, USA
- Parker Institute for Cancer Immunotherapy, Stanford University, Stanford, CA, USA
| | - Kevin Shannon
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Stephen Gottschalk
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Justin Eyquem
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA.
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- Parker Institute for Cancer Immunotherapy, University of California, San Francisco, San Francisco, CA, USA.
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA.
| | - Giedre Krenciute
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA.
| | - Alan Ashworth
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
| | - Alexander Marson
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA.
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
- Parker Institute for Cancer Immunotherapy, University of California, San Francisco, San Francisco, CA, USA.
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA.
- Diabetes Center, University of California San Francisco, San Francisco, CA, USA.
- Chan Zuckerberg Biohub, San Francisco, CA, USA.
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA, USA.
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Jiang H, Feng X, Lange S, Tran A, Manthey J, Rehm J. Estimating effects of health policy interventions using interrupted time-series analyses: a simulation study. BMC Med Res Methodol 2022; 22:235. [PMID: 36045338 PMCID: PMC9429656 DOI: 10.1186/s12874-022-01716-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 08/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A classic methodology used in evaluating the impact of health policy interventions is interrupted time-series (ITS) analysis, applying a quasi-experimental design that uses both pre- and post-policy data without randomization. In this paper, we took a simulation-based approach to estimating intervention effects under different assumptions. METHODS Each of the simulated mortality rates contained a linear time trend, seasonality, autoregressive, and moving-average terms. The simulations of the policy effects involved three scenarios: 1) immediate-level change only, 2) immediate-level and slope change, and 3) lagged-level and slope change. The estimated effects and biases of these effects were examined via three matched generalized additive mixed models, each of which used two different approaches: 1) effects based on estimated coefficients (estimated approach), and 2) effects based on predictions from models (predicted approach). The robustness of these two approaches was further investigated assuming misspecification of the models. RESULTS When one simulated dataset was analyzed with the matched model, the two analytical approaches produced similar estimates. However, when the models were misspecified, the number of deaths prevented, estimated using the predicted vs. estimated approaches, were very different, with the predicted approach yielding estimates closer to the real effect. The discrepancy was larger when the policy was applied early in the time-series. CONCLUSION Even when the sample size appears to be large enough, one should still be cautious when conducting ITS analyses, since the power also depends on when in the series the intervention occurs. In addition, the intervention lagged effect needs to be fully considered at the study design stage (i.e., when developing the models).
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Affiliation(s)
- Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 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.
| | - Xinyang Feng
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7 Canada
| | - Shannon Lange
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8 Canada
| | - Alexander Tran
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada
| | - Jakob Manthey
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany ,grid.9647.c0000 0004 7669 9786Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Jürgen Rehm
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8 Canada ,grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany ,grid.17063.330000 0001 2157 2938Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8 Canada ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow, Russian Federation 119992
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Russell C, Lange S, Kouyoumdjian F, Butler A, Ali F. Opioid agonist treatment take-home doses ('carries'): Are current guidelines resulting in low treatment coverage among high-risk populations in Canada and the USA? Harm Reduct J 2022; 19:89. [PMID: 35948961 PMCID: PMC9363267 DOI: 10.1186/s12954-022-00671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/02/2022] [Indexed: 11/12/2022] Open
Abstract
Opioid agonist treatment (OAT) is the primary intervention for opioid use disorder (OUD) in Canada and the USA. Yet, a number of barriers contribute to sub-optimal treatment uptake and retention, including daily-supervised medication administration. Thus, clients are eventually granted access to take-home OAT doses (i.e., ‘carries’) to reduce this burden. However, this decision is based on physician discretion and whether patients can demonstrate stability in various life domains, many of which are inextricably linked to the social determinants of health (SDOH). Current Canadian and USA OAT carry guidance documents are not standardized and do not take the SDOH into consideration, resulting in the potential for inequitable access to OAT carries, which may be the case particularly among marginalized populations such as individuals with OUD who have been released from custody. This perspective article posits that current OAT guidelines contribute to inequities in access to OAT carries, and that these inequities likely result in disproportionately low coverage for OUD treatment among some high-risk groups, including individuals on release from incarceration in particular. Relevant impacts of COVID-19 and related policy changes are considered, and suggestions and recommendations to amend current OAT guidance documents are provided.
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Affiliation(s)
- Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin St, Toronto, ON, M5S 2S1, Canada. .,Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), 33 Ursula Franklin St, ON, M5S 2S1, Toronto, Canada.
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin St, Toronto, ON, M5S 2S1, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), ON, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Fiona Kouyoumdjian
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Amanda Butler
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Farihah Ali
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin St, Toronto, ON, M5S 2S1, Canada.,Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), 33 Ursula Franklin St, ON, M5S 2S1, Toronto, Canada
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Koch M, Carlin G, Lange S, Umek W, Krall C, Bodner-Adler B. Dauer der Pessartherapie bei Beckenorganprolaps: eine retrospektive Kohortenstudie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- M Koch
- Univ. Klinik für Frauenheilkunde, Medizinische Universität Wien
| | - G Carlin
- Univ. Klinik für Frauenheilkunde, Medizinische Universität Wien
| | - S Lange
- Univ. Klinik für Frauenheilkunde, Medizinische Universität Wien
| | - W Umek
- Univ. Klinik für Frauenheilkunde, Medizinische Universität Wien
| | - C Krall
- Institut für medizinische Statistik, Medizinische Universität Wien
| | - B Bodner-Adler
- Univ. Klinik für Frauenheilkunde, Medizinische Universität Wien
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Zafar A, Rehm J, Feng X, Jiang H, Kim KV, Manthey J, Radišauskas R, Štelemėkas M, Petkevičienė J, Tran A, Lange S. The Impact of Alcohol Control Policy on Pneumonia Mortality in Lithuania: An Interrupted Time-Series Analysis. Epidemiol Infect 2022; 150:1-25. [PMID: 35440352 PMCID: PMC9128348 DOI: 10.1017/s0950268822000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 12/04/2022] Open
Abstract
Despite the growing body of evidence suggesting that alcohol consumption is associated with an increased risk of and poorer treatment outcomes from pneumonia, little is known about the association between alcohol control policy and pneumonia mortality. As such, this study aimed to assess the impact of three alcohol control policies legislated in 2008, 2017 and 2018 in Lithuania on sex-specific pneumonia mortality rates among individuals 15+ years of age. An interrupted time-series analysis using a generalised additive mixed model was performed for each policy. Of the three policies, only the 2008 policy resulted in a significant slope change (i.e. decline) in pneumonia mortality rates among males; no significant slope change was observed among females. The low R 2 values for all sex-specific models suggest that other external factors are likely also influencing the sex-specific pneumonia mortality rates in Lithuania. Overall, the findings from this study suggest alcohol control policy's targeting affordability may be an effective way to reduce pneumonia mortality rates, among males in particular. However, further research is needed to fully explore their impact.
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Affiliation(s)
- Anush Zafar
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
- Institute of Medical Science, University of Toronto, Toronto ON, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, L.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Xinyang Feng
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
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Lange S, Jiang H, Bagge C, Probst C, Tran A, Rehm J. Gender-specific risk relationship between heavy alcohol use/alcohol use disorders and suicidal thoughts and behavior among adults in the United States over time. Soc Psychiatry Psychiatr Epidemiol 2022; 57:721-726. [PMID: 35032174 PMCID: PMC8969096 DOI: 10.1007/s00127-022-02225-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Suicidal thoughts and behaviors have been on the rise in the recent years in the US. There is a well-known link between heavy alcohol use/alcohol use disorders (AUDs) and suicidal thoughts and behaviors. An increase in the respective risk relationships is one way in which heavy alcohol use/AUDs may be driving the increase in the rate of suicidal thoughts and behaviors. The objective of the current study was to investigate whether the gender-specific risk relationships between heavy alcohol use/AUDs and past-year (1) suicidal thoughts and (2) attempted suicide have increased over time. METHODS Individual-level annual data from the National Survey on Drug Use and Health for the past 12 years (2008-2019) were utilized. Year- and gender-specific multivariate binary logistic regression analyses were first conducted. Gender-stratified random-effects meta-regressions across study years were then conducted. RESULTS Heavy alcohol use/AUDs were associated with elevated odds of past-year suicidal thoughts and attempted suicide for both men and women; however, a linear increase in the risk relationships over time was not found. CONCLUSION Although a temporal increase in the risk relationships of interest was not found, until additional research in this area is conducted, heavy alcohol use/AUDs cannot be ruled out as being a driving force behind the increasing rate of suicidal thoughts and behaviors in the US.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Heidelberg Institute for Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- 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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Tran A, Jiang H, Lange S, Manthey J, Štelemėkas M, Badaras R, Petkevičienė J, Radišauskas R, Room R, Rehm J. Can alcohol control policies reduce cirrhosis mortality? An interrupted time-series analysis in Lithuania. Liver Int 2022; 42:765-774. [PMID: 35023617 PMCID: PMC8930681 DOI: 10.1111/liv.15151] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS The relationship between alcohol consumption and cirrhosis is well established. Policies that can influence population-level use of alcohol should, in turn, impact cirrhosis. We examined the effect of population-level alcohol control policies on cirrhosis mortality rates in Lithuania - a high-income European Union country with high levels of alcohol consumption. METHODS Age-standardized, monthly liver mortality data (deaths per 100,000 adults, aged 15+) from Lithuania were analysed from 2001 to 2018 (n = 216 months) while controlling for economic confounders (gross domestic product and inflation). An interrupted time-series analysis was conducted to estimate the effect of three alcohol control policies implemented in 2008, 2017 and 2018 and the number of cirrhosis deaths averted. RESULTS There was a significant effect of the 2008 (P < .0001) and 2017 (P = .0003) alcohol control policies but a null effect of the 2018 policy (P = .40). Following the 2008 policy, the cirrhosis mortality rate dropped from 4.93 to 3.41 (95% CI: 3.02-3.80) deaths per 100,000 adults, which equated to 493 deaths averted. Further, we found that following the 2017 policy, the mortality rate dropped from 2.85 to 2.01 (95% CI: 1.50-2.52) deaths per 100,000 adults, corresponding to 245 deaths averted. CONCLUSIONS Our findings support the hypothesis that alcohol control policies can have a significant, immediate effect on cirrhosis mortality. These policy measures are cost-effective and aid in reducing the burden of liver disease.
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Affiliation(s)
- Alexander Tran
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Huan Jiang
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shannon Lange
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robertas Badaras
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada,Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Centre of Toxicology, Vilnius University, Vilnius, Lithuania,Vilnius University Emergency Hospital, Vilnius, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - 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
| | - Jürgen Rehm
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany,Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King’s College Circle, 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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Vannier C, Völkel A, Martens U, Decker T, Köchling G, Lange S, Von der Heyde E, Emde TO, Wortmann A, Grunewald R, Frank M, Niemeier B, Flum M, Kasenda B. 31P Molecular testing, treatment and outcome of patients with advanced solid tumors harboring a NTRK1, NTRK2 or NTRK3 gene fusion: Study design and first results of the REALTRK registry. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Tran A, Jiang H, Kim KV, Room R, Štelemėkas M, Lange S, Rovira P, Rehm J. Predicting the Impact of Alcohol Taxation Increases on Mortality-A Comparison of Different Estimation Techniques. Alcohol Alcohol 2022; 57:500-507. [PMID: 35217852 PMCID: PMC9270989 DOI: 10.1093/alcalc/agac003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/22/2021] [Accepted: 01/17/2022] [Indexed: 11/12/2022] Open
Abstract
AIMS To examine how standard analytical approaches to model mortality outcomes of alcohol use compare to the true results using the impact of the March 2017 alcohol taxation increase in Lithuania on all-cause mortality as an example. METHODS Four methodologies were used: two direct methodologies: (a) interrupted time-series on mortality and (b) comparing predictions based on time-series modeling with the real number of deaths for the year following the implementation of the tax increase; and two indirect methodologies: (c) combining a regression-based estimate for the impact of taxation on alcohol consumption with attributable-fraction methodology and (d) using price elasticities from meta-analyses to estimate the impact on alcohol consumption before applying attributable-fraction methodology. RESULTS AND CONCLUSIONS While all methodologies estimated reductions in all-cause mortality, especially for men, there was substantial variability in the level of mortality reductions predicted. The indirect methodologies had lower predictions as the meta-analyses on elasticities and risk relations seem to underestimate the true values for Lithuania. Directly estimated effects of taxation based on the actual mortalities seem to best represent the true reductions in alcohol-attributable mortality. A significant increase in alcohol excise taxation had a marked impact on all-cause mortality in Lithuania.
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Affiliation(s)
- Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Bundoora, Victoria 3086, Australia
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Albanovägen 12, floor 5, Stockholm University, Stockholm 106 91, Sweden
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas 47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas 47181, Lithuania
| | - Shannon Lange
- 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, Ursula Franklin Street 33, Toronto, OntarioM5S 3M1, Canada
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
| | - Jürgen Rehm
- Corresponding author: Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Ursula Franklin Street 33, Toronto, Ontario M5S 3M1, Canada. Tel.: +1-416-535-8501 x 36173; E-mail:
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Lange S, Rehm J, Tran A, L. Bagge C, Jasilionis D, Kaplan MS, Meščeriakova-Veliulienė O, Štelemėkas M, Probst C. Comparing gender-specific suicide mortality rate trends in the United States and Lithuania, 1990-2019: putting one of the "deaths of despair" into perspective. BMC Psychiatry 2022; 22:127. [PMID: 35177011 PMCID: PMC8851770 DOI: 10.1186/s12888-022-03766-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/07/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The increase in the suicide mortality rate among middle-aged adults in the United States (US) has been well documented. Aside from a few studies from the United Kingdom, it is unclear whether the suicide mortality rate trend in the US is also occurring in other developed countries. Accordingly, we aimed to compare the suicide mortality rate trends over the past 30 years in the US to a country in the European Union-Lithuania. METHODS Joinpoint regression analyses were performed to identify secular trends in the gender-specific age-standardized suicide mortality rate among individuals 15 + years of age, as well as middle-aged adults (45-54 years of age), and suicide mortality rate ratio for men-to-women. RESULTS Age-standardized suicide mortality rates among middle-aged adults in the US increased annually, on average, by 0.89% (95% CI: 0.66%, 1.12%) among men and 1.21% (95% CI: 0.75%, 1.66%) among women between 1990 and 2019. In contrast to the US, there was an overall downward trend in the suicide mortality rates among middle-aged adults in Lithuania across the study period. The average annual percent change in the suicide mortality rate ratio for men-to-women were not statistically significant for either country. CONCLUSION The suicide mortality rate trend in the US does not appear to be an indicator of an upcoming global trend, but rather should be regarded as a cautionary example of what other countries should strive to avoid.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada. .,Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada. .,Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada.
| | - Jürgen Rehm
- grid.155956.b0000 0000 8793 5925 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 3M7 Canada ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, Medical Sciences Building, University of Toronto, King’s College Circle, Room 2374, Toronto, ON M5S 1A8 Canada ,grid.13648.380000 0001 2180 3484Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992 Moscow, Russian Federation
| | - Alexander Tran
- grid.155956.b0000 0000 8793 5925 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Courtney L. Bagge
- grid.214458.e0000000086837370Department of Psychiatry, University of Michigan Medical School, 2800 Plymouth Road, Ann Arbor, MI 48109 USA ,grid.418356.d0000 0004 0478 7015Center for Clinical Management Research, Department of Veterans Affairs, 2215 Fuller Road, Ann Arbor, MI 48105 USA
| | - Domantas Jasilionis
- grid.419511.90000 0001 2033 8007Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057 Rostock, Germany ,grid.19190.300000 0001 2325 0545Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Jonavos g. 66, 44191 Kaunas, Lithuania
| | - Mark S. Kaplan
- grid.19006.3e0000 0000 9632 6718Luskin School of Public Affairs, University of California, Los Angeles, 337 Charles E Young Drive East, Los Angeles, CA 90095 USA
| | - Olga Meščeriakova-Veliulienė
- grid.45083.3a0000 0004 0432 6841Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181 Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- grid.45083.3a0000 0004 0432 6841Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181 Kaunas, Lithuania ,grid.45083.3a0000 0004 0432 6841Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181 Kaunas, Lithuania
| | - Charlotte Probst
- grid.155956.b0000 0000 8793 5925 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8 Canada ,grid.7700.00000 0001 2190 4373 Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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Tran A, Jiang H, Lange S, Livingston M, Manthey J, Neufeld M, Room R, Štelemėkas M, Telksnys T, Petkevičienė J, Radišauskas R, Rehm J. The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis. Alcohol Alcohol 2021; 57:513-519. [PMID: 34864838 DOI: 10.1093/alcalc/agab076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/22/2021] [Accepted: 10/30/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS To determine the effect of an alcohol policy change, which increased the minimum legal drinking age (MLDA) from 18 years of age to 20 years of age on all-cause mortality rates in young adults (18-19 years old) in Lithuania. METHODS An interrupted time series analysis was conducted on a dataset from 2001 to 2019 (n = 228 months). The model tested the effects of the MLDA on all-cause mortality rates (deaths per 100,000 individuals) in three age categories (15-17 years old, 18-19 years old, 20-22 years old) in order to control for general mortality trends in young adults, and to isolate the effects of the MLDA from other alcohol control policies. Additional models that included GDP as a covariate and a taxation policy were tested as well. RESULTS There was a significant effect of the MLDA on all-cause mortality rates in those 18-19 years old, when modelled alone. Additional analyses controlling for the mortality rate of other age groups showed similar findings. Inclusion of confounding factors (policies on alcohol taxation, GDP) eliminated the effects of MLDA. CONCLUSIONS Although there was a notable decline in all-cause mortality rates among young adults in Lithuania, a direct causal impact of MLDA on all-cause mortality rates in young adults was not definitively found.
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Affiliation(s)
- Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Huan Jiang
- 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, Toronto, Ontario M5T 1P8, Canada
| | - Shannon Lange
- 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, 250 College St, Toronto, Ontario M5T 1R8, Canada
| | - Michael Livingston
- Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Plenty Rd. x Kingsbury Rd., Bundoora, Victoria 3086, Australia.,National Drug Research Institute, Health Sciences, Curtin University, Perth, 6102, Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Maria Neufeld
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.,Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.,WHO Regional Office for Europe, Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - Robin Room
- Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Plenty Rd. x Kingsbury Rd., Bundoora, Victoria 3086, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, 3rd floor, Sveavägen 160, 113 46 Stockholm, Sweden
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.,Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių str. 17, 50162 Kaunas, Lithuania
| | - Jürgen Rehm
- 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, Toronto, Ontario M5T 1P8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, Toronto, Ontario M5T 1R8, Canada.,Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,World Health Organization/ Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, 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.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario M5T 1R8, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, .M. Sechenov First Moscow State Medical University, ITrubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation
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Radisauskas R, Kim KV, Lange S, Liutkute-Gumarov V, Mesceriakova-Veliuliene O, Petkeviciene J, Stelemekas M, Telksnys T, Tran A, Rehm J. Cardiovascular diseases mortality and alcohol control policy in Lithuania: exploring a possible link. BMC Public Health 2021; 21:2116. [PMID: 34789207 PMCID: PMC8600709 DOI: 10.1186/s12889-021-12177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background Lithuania possesses one of the highest alcohol per capita consumption and has previously implemented alcohol control policies to reduce the alcohol-attributable burden. The aim of this study was to investigate Lithuanian cardiovascular disease (CVD) mortality rate trends between 2001 and 2018 and to explore a possible link between CVD mortality rate and alcohol control policy implementation. Methods Lithuanian population mortality and alcohol consumption data for 2001–2018 were obtained from Statistics Lithuania and The State Register of Death Cases and Their Causes, Institute of Hygiene. Sex-specific CVD mortality rates were directly standardized to the European standard population by five-year age groups and categorized according to the ICD-10 codes for all CVDs (I00-I99), ischemic heart disease (IHD) (I20-I25), cerebrovascular diseases (I60-I69) and alcoholic cardiomyopathy (ACM) (I42.6). Joinpoint regression analyses were performed to identify points of inflection to explore their alignment with five selected alcohol policy enactments. Results Overall, the 2001–2018 yearly mortality rates for all CVDs significantly decreased on average by − 1.6% (95% CI -2.0, − 1.2%) among men and − 2.1% (95% CI -2.5, − 1.8%) among women. Yearly changes in all CVDs, IHD, cerebrovascular diseases and ACM mortality rates were insignificant prior to their respective critical year points in 2006, 2005, 2008 and 2007, but significantly decreased afterwards by an average of − 2.4% (95% CI -2.7, − 2.0%), − 1.6% (95% CI -2.1, − 1.1%), − 1.2% (95 CI -1.7, − 0.6%) and − 4.5% (95% CI -7.3, − 1.6%) among men, and by − 2.7% (95% CI -3.0, − 2.3%), − 2.0% (95% CI -2.6, − 1.4%), − 1.8% (95% CI 2.4, − 1.3%) and − 6.6% (95% CI -10.7, − 2.2%) among women, respectively. The changes in the mortality rate trends for all CVDs, IHD, cerebrovascular diseases and especially ACM coincided with alcohol policies enacted on the January 1, 2008, January 1, 2009, April 1, 2014 and March 1, 2017. Conclusions Yearly mortality rates for all CVDs, IHD, cerebrovascular diseases and ACM have declined in Lithuania between 2001 and 2018, and declining trends were more prominent in women than in men. Among the ICD-10 CVD categories investigated, the points of inflection identified for the ACM mortality rate trend coincided best with the selected alcohol policy enactment dates.
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Affiliation(s)
- Ricardas Radisauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania. .,Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu av. 15, 50162, Kaunas, Lithuania.
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5T 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5T 2S1, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5T 2S1, Canada
| | - Vaida Liutkute-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
| | - Olga Mesceriakova-Veliuliene
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
| | - Janina Petkeviciene
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
| | - Mindaugas Stelemekas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5T 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5T 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5T 2S1, Canada.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer str. 46, 01187, Dresden, Germany.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.,Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow, Russian Federation, 119992
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Probst C, Lange S, Kilian C, Saul C, Rehm J. The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk-a systematic review and meta-analysis. BMC Med 2021; 19:268. [PMID: 34736475 PMCID: PMC8569998 DOI: 10.1186/s12916-021-02132-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/16/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. METHODS We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). RESULTS We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70-2.59], 50th: 3.43 [2.67-4.49], 75th: 4.43 [3.62-5.50], 100th: 4.50 [3.26-6.40]; men: 25th: 2.34 [1.98-2.76], 50th: 4.22 [3.38-5.24], 75th: 5.87 [4.75-7.10], 100th: 6.28 [4.89-8.07]. CONCLUSIONS The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.
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Affiliation(s)
- Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada.
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, 69120, Heidelberg, Germany.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187, Dresden, Germany
| | - Celine Saul
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, 69120, Heidelberg, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187, Dresden, Germany
- Dalla Lana School of Public Health, University of Toronto, M5T 3 M7, Toronto, ON, Canada
- Centre for Interdisciplinary Addiction Research, University of Hamburg, 20246, Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation, 125009
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Štelemėkas M, Manthey J, Badaras R, Casswell S, Ferreira-Borges C, Kalėdienė R, Lange S, Neufeld M, Petkevičienė J, Radišauskas R, Room R, Telksnys T, Zurlytė I, Rehm J. Alcohol control policy measures and all-cause mortality in Lithuania: an interrupted time-series analysis. Addiction 2021; 116:2673-2684. [PMID: 33751693 PMCID: PMC8873029 DOI: 10.1111/add.15470] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/24/2020] [Accepted: 02/24/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Alcohol use has been identified as a major risk factor for burden of mortality and disease, particularly for countries in eastern Europe. During the past two decades, several countries in this region have implemented effective alcohol policy measures to combat this burden. The aim of the current study was to measure the association between Lithuania's alcohol control policies and adult all-cause mortality. DESIGN Interrupted time-series methodology by means of general additive models. SETTING Lithuania. PARTICIPANTS Adult population of Lithuania, aged 20 years and older. MEASUREMENTS Alcohol control policies were ascertained via a document review of relevant legislation materials. Policy effects were evaluated as follows: (1) slope changes in periods of legislative (non-)activity with regard to alcohol control policy (analysis 1); (2) level changes of three interventions following recommendations of the World Health Organization (analysis 2); and (3) level changes of seven interventions judged a priori by an international panel of experts (analysis 3). Mortality was measured by sex-stratified and total monthly age-standardized rates of all-cause mortality for the adult population. FINDINGS During the period 2001-18, effective alcohol control policy measures were implemented on several occasions, and in those years the all-cause mortality rate declined by approximately 3.2% more than in years without such policies. In particular, the implementation of increased taxation in 2017 was associated with reduced mortality over and above the general trend for men and in total for all analyses, which amounted to 1452 deaths avoided (95% confidence interval = -166 to -2739) in the year following the implementation of the policy. CONCLUSIONS Alcohol control policies in Lithuania appear to have reduced the overall adult all-cause mortality over and above secular trends.
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Affiliation(s)
- Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jakob Manthey
- 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,,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Robertas Badaras
- Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Centre of Toxicology, Vilnius University, Vilnius, Lithuania,,Vilnius University Emergency Hospital, Vilnius, Lithuania
| | - Sally Casswell
- SHORE and Whariki Research Centre, College of Health, Massey University, New Zealand
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - Ramunė Kalėdienė
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,,WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia,,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,,Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia,,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Jürgen Rehm
- 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,,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada,,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,,Institute of Medical Science, University of Toronto, Toronto, ON, Canada,,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of International Health Projects, Institute for Leadership and Health Management, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
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Adler C, Ahammed Z, Allgower C, Amonett J, Anderson BD, Anderson M, Averichev GS, Balewski J, Barannikova O, Barnby LS, Baudot J, Bekele S, Belaga VV, Bellwied R, Berger J, Bichsel H, Billmeier A, Bland LC, Blyth CO, Bonner BE, Boucham A, Brandin A, Bravar A, Cadman RV, Caines H, Calderón de la Barca Sánchez M, Cardenas A, Carroll J, Castillo J, Castro M, Cebra D, Chaloupka P, Chattopadhyay S, Chen Y, Chernenko SP, Cherney M, Chikanian A, Choi B, Christie W, Coffin JP, Cormier TM, Cramer JG, Crawford HJ, Csanád M, Deng WS, Derevschikov AA, Didenko L, Dietel T, Draper JE, Dunin VB, Dunlop JC, Eckardt V, Efimov LG, Emelianov V, Engelage J, Eppley G, Erazmus B, Fachini P, Faine V, Filimonov K, Finch E, Fisyak Y, Flierl D, Foley KJ, Fu J, Gagliardi CA, Gagunashvili N, Gans J, Gaudichet L, Germain M, Geurts F, Ghazikhanian V, Grachov O, Grigoriev V, Guedon M, Gushin E, Hallman TJ, Hardtke D, Harris JW, Henry TW, Heppelmann S, Herston T, Hippolyte B, Hirsch A, Hjort E, Hoffmann GW, Horsley M, Huang HZ, Humanic TJ, Igo G, Ishihara A, Ivanshin YI, Jacobs P, Jacobs WW, Janik M, Johnson I, Jones PG, Judd EG, Kaneta M, Kaplan M, Keane D, Kiryluk J, Kisiel A, Klay J, Klein SR, Klyachko A, Konstantinov AS, Kopytine M, Kotchenda L, Kovalenko AD, Kramer M, Kravtsov P, Krueger K, Kuhn C, Kulikov AI, Kunde GJ, Kunz CL, Kutuev RK, Kuznetsov AA, Lakehal-Ayat L, Lamont MAC, Landgraf JM, Lange S, Lansdell CP, Lasiuk B, Laue F, Lebedev A, Lednický R, Leontiev VM, LeVine MJ, Li Q, Lindenbaum SJ, Lisa MA, Liu F, Liu L, Liu Z, Liu QJ, Ljubicic T, Llope WJ, LoCurto G, Long H, Longacre RS, Lopez-Noriega M, Love WA, Ludlam T, Lynn D, Ma J, Ma R, Majka R, Margetis S, Markert C, Martin L, Marx J, Matis HS, Matulenko YA, McShane TS, Meissner F, Melnick Y, Meschanin A, Messer M, Miller ML, Milosevich Z, Minaev NG, Mitchell J, Moiseenko VA, Moore CF, Morozov V, de Moura MM, Munhoz MG, Nelson JM, Nevski P, Niida T, Nikitin VA, Nogach LV, Norman B, Nurushev SB, Odyniec G, Ogawa A, Okorokov V, Oldenburg M, Olson D, Paic G, Pandey SU, Panebratsev Y, Panitkin SY, Pavlinov AI, Pawlak T, Perevoztchikov V, Peryt W, Petrov VA, Planinic M, Pluta J, Porile N, Porter J, Poskanzer AM, Potrebenikova E, Prindle D, Pruneau C, Putschke J, Rai G, Rakness G, Ravel O, Ray RL, Razin SV, Reichhold D, Reid JG, Retiere F, Ridiger A, Ritter HG, Roberts JB, Rogachevski OV, Romero JL, Rose A, Roy C, Rykov V, Sakrejda I, Salur S, Sandweiss J, Saulys AC, Savin I, Schambach J, Scharenberg RP, Schmitz N, Schroeder LS, Schüttauf A, Schweda K, Seger J, Seliverstov D, Seyboth P, Shahaliev E, Shestermanov KE, Shimanskii SS, Shvetcov VS, Skoro G, Smirnov N, Snellings R, Sorensen P, Sowinski J, Spinka HM, Srivastava B, Stephenson EJ, Stock R, Stolpovsky A, Strikhanov M, Stringfellow B, Struck C, Suaide AAP, Sugarbaker E, Suire C, Šumbera M, Surrow B, Symons TJM, Szanto de Toledo A, Szarwas P, Tai A, Takahashi J, Tang AH, Thomas JH, Thompson M, Tikhomirov V, Todoroki T, Tokarev M, Tonjes MB, Trainor TA, Trentalange S, Tribble RE, Trofimov V, Tsai O, Ullrich T, Underwood DG, Van Buren G, VanderMolen AM, Vasilevski IM, Vasiliev AN, Vigdor SE, Voloshin SA, Wang F, Ward H, Watson JW, Wells R, Westfall GD, Whitten C, Wieman H, Willson R, Wissink SW, Witt R, Wood J, Xu N, Xu Z, Yakutin AE, Yamamoto E, Yang J, Yepes P, Yurevich VI, Zanevski YV, Zborovský I, Zhang H, Zhang WM, Zoulkarneev R, Zubarev AN. Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]. Phys Rev Lett 2021; 127:089901. [PMID: 34477449 DOI: 10.1103/physrevlett.127.089901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.89.132301.
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