Addiction
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To describe three aspects of the epidemiology of alcohol-attributable deaths in Europe, dose, demography and place, and to illustrate how such knowledge can better be used to inform alcohol policy formulation and implementation. ⋯ Any reduction in the dose of alcohol consumed, at least down to 10 g/day, will reduce the annual and lifetime risk of an alcohol-related death. There is a need for alcohol policy to focus on measures in reducing alcohol consumption, throughout middle age, with immediacy of impact. Policy should strive to reduce alcohol-related health inequalities, with the specific recommendations for policy depending on the cost-effectiveness of interventions related to the epidemiological profile of the country or region under consideration. Fortunately, there are evidence-based policy options that reduce the amount of alcohol consumed and many alcohol-related harms with immediate effect, that reduce the risk of an alcohol-related death in middle age, and that would help to close the health gap between eastern and western Europe.
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The importance of building and strengthening effective infrastructures within the field of public health has increasingly been recognized. A wide variety of actors and structures can be identified for alcohol policy, including systems for policy development, monitoring, research and work-force development, but too little is known about the complex systems of infrastructure available across European countries and their impact on alcohol policy. ⋯ This study can contribute to building the scientific knowledge base on this topic as well to policy development. First, the Alcohol Measures for Public Health Research Alliance will produce an extended map of alcohol policy infrastructures in a wide range of European countries. Secondly, the Alcohol Measures for Public Health Research Alliance will foster a better understanding and expand the knowledge base on the role and influence of infrastructure on alcohol policy and practice. Recommendations deriving from this study will identify the need for better utilization of existing infrastructures and for the development of new infrastructures, necessary to develop and implement effective alcohol policy from a public health perspective.
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Randomized Controlled Trial
The acute effects of caffeinated versus non-caffeinated alcoholic beverage on driving performance and attention/reaction time.
Marketing that promotes mixing caffeinated 'energy' drinks with alcoholic beverages (e.g. Red Bull with vodka) targets young drinkers and conveys the expectation that caffeine will offset the sedating effects of alcohol and enhance alertness. Such beliefs could result in unwarranted risk taking (e.g. driving while intoxicated). The aim of this study was to assess the acute effects of caffeinated versus non-caffeinated alcoholic beverages on a simulated driving task and attention/reaction time. ⋯ The addition of caffeine to alcohol does not appear to enhance driving or sustained attention/reaction time performance relative to alcohol alone.
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To determine the comparative levels of and associations between policing interference and characteristics of US syringe exchange programs (SEPs). ⋯ Findings highlight limitations of the impact of legal reforms on aligning police activities with SEP operations. Systematic adverse event surveillance and evidence-based structural interventions are needed to maximize the benefits of public health prevention targeting IDUs and other criminalized populations. SEPs that report no adverse events may represent programs already working in harmony with law enforcement agencies, a priority highlighted in US Centers for Disease Control's new SEP guidelines. The significance of mechanisms translating criminal justice disparities into health disparities is discussed.
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Review Meta Analysis
Efficacy and safety of nicotine replacement therapy for smoking cessation in pregnancy: systematic review and meta-analysis.
To determine the efficacy and safety of nicotine replacement therapy (NRT) with or without behavioural support when used to support smoking cessation in pregnancy. ⋯ There is currently insufficient evidence to determine whether or not nicotine replacement therapy is effective or safe when used in pregnancy for smoking cessation; further research and, in particular, placebo-randomized controlled trials are required.