The purpose of this study was to report the "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs).A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560 different approaches. These outcomes were classified into outcome categories, and 150 participants from 19 countries participated in a two-round e-Delphi outcome prioritization exercise. This process prioritized 15 of 93 outcome categories for discussion at a consensus meeting of key stakeholders to decide the COS. A psychometric evaluation determined how to measure the outcomes.Ten outcomes were voted into the COS at the consensus meeting: (a) typical frequency, (b) typical quantity, (c) frequency of heavy episodic drinking, (d) combined consumption measure summarizing alcohol use, (e) hazardous or harmful drinking (average consumption), (f) standard drinks consumed in the past week (recent, current consumption), (g) alcohol-related consequences, (h) alcohol-related injury, (i) use of emergency health care services (impact of alcohol use), and (j) quality of life.The ORBITAL COS is an international consensus standard for future ABI trials and evaluations. It can improve the synthesis of new findings, reduce redundant/selective reporting (i.e., reporting only some, usually significant outcomes), improve between-study comparisons, and enhance the relevance of trial and evaluation findings to decision makers. The COS is the recommended minimum and does not exclude other, additional outcomes.
Abstract Background and aims To identify the nature of visual alcohol references in alcohol advertisements during televised broadcasts of the 2014 FIFA World Cup Tournament matches and to evaluate cross‐national differences according to alcohol marketing policy restrictiveness. Design Content analysis using the Delphi method and identification of in‐game sponsorships. Setting Television broadcasts of the 2014 FIFA World Cup in Argentina, Brazil, Canada, Finland, France, Mexico, Spain and the United States. Cases Eighty‐seven alcohol advertisements; 20 matches. Measurements Quantitative rating scales, combined with the Delphi rating technique, were used to determine compliance of the alcohol advertisements with the International Alliance for Responsible Drinking's (IARD) Guiding Principles. Recordings of five matches from four countries were also used to identify the number of in‐ and out‐of‐game alcohol brand appearances. Findings A total of 86.2% of all unique alcohol advertisements contained at least one violation of IARD's Guiding Principles, with violation rates ranging from 72.7% (Mexico) to 100% (Brazil). Countries with the least restrictive marketing policies had a higher prevalence of violations in guidelines designed to protect minors. There were 2.76 in‐game alcohol brand appearances and 0.83 out‐of‐game alcohol brand appearances per minute. Brand appearances did not differ across countries or according to a country's marketing policy restrictiveness. Conclusions Self‐regulation and statutory policies were ineffective at limiting alcohol advertising during the 2014 FIFA World Cup Tournament television broadcasts. Most advertisements contained content that violated the self‐regulation codes, and there were high levels of within‐broadcast brand appearances.
The pepstatins are linear peptides biosynthesized and excreted into culture filtrates by several species of Actinomycetes and are well known inhibitors of aspartic proteinases, such as pepsin and cathepsins D and E. Apart from their role as proteinase inhibitors, their other pharmacological and cellular activities remain unclear.
The World Health Organization (WHO) African Region is struggling with increasing harm associated with alcohol consumption. Legislators of Sao Tome and Principe, concerned about this harm and the high prevalence of alcohol use disorders, designed a comprehensive alcohol control bill to tackle this situation. Input into the design of the bill was obtained through interviews involving many stakeholders. The process had five phases: (i) scoping the problem to understand the social burden of the harm caused by alcohol consumption; (ii) updating the evidence on alcohol policies and identifying areas for legislative interventions; (iii) drafting the bill; (iv) aligning the legislative framework of the bill; and (v) initiating the parliamentary procedure. The new bill scored 92/100 using a standardized alcohol control policy scale. The bill covers all domains of WHO's 2010 global strategy to reduce the harmful use of alcohol, and includes the three most cost-effective interventions for reducing alcohol consumption: increased excise taxes on alcohol; bans or comprehensive restrictions on exposure to alcohol advertising; and restrictions on the availability of retailed alcohol through reduced hours of sale. The National Assembly plenary session upheld the bill, which is now under evaluation of the specialized First Commission on Political, Legal, Constitutional and Ethical Affairs. Approval of the bill requires the final voting once it is back with the National Assembly and its promulgation by the President. Drafting an alcohol control bill which is country-led, inclusive, evidence-based and free of interference by the alcohol industry helps prioritize public health objectives over other interests.La Région africaine de l'Organisation mondiale de la Santé (OMS) fait face à une hausse des dégâts causés par l'alcool. Préoccupés par la situation et par la forte prévalence des troubles liés à cette consommation, les législateurs de Sao Tomé-et-Principe ont élaboré un projet de loi détaillé afin d'y remédier. À l'origine de sa conception, plusieurs entretiens avec différentes parties prenantes. Le processus s'est divisé en cinq phases: (i) définir l'étendue du problème pour évaluer le fardeau que les dégâts provoqués par l'alcool font peser sur la société; (ii) actualiser les données probantes relatives aux politiques en matière d'alcool et identifier les domaines nécessitant une intervention législative; (iii) rédiger le projet de loi; (iv) aligner le cadre législatif du projet de loi; et enfin, (v) initier la procédure parlementaire. Le nouveau projet de loi a obtenu un score de 92/100 sur une échelle d'évaluation standard des mesures de lutte contre l'alcool. Il couvre tous les thèmes repris dans la Stratégie mondiale de l'OMS visant à réduire l'usage nocif de l'alcool, publiée en 2010. Il prévoit également les trois interventions les plus rentables en termes de diminution de la consommation d'alcool: l'augmentation des taxes d'accise sur l'alcool; l'interdiction ou l'instauration de conditions strictes en matière d'exposition à la publicité pour l'alcool; et une disponibilité restreinte des boissons alcoolisées dans le commerce en limitant les heures de vente. L'Assemblée nationale a soutenu le projet de loi en séance plénière. Il est désormais en cours d'évaluation au sein de la première Commission spécialisée en affaires politiques, juridiques, constitutionnelles et éthiques. Pour être adopté, le projet de loi doit revenir à l'Assemblée nationale pour un vote final, puis être promulgué par le président. Une loi globale de lutte contre l'alcool, élaborée par le pays lui-même, fondée sur des faits et n'ayant subi aucune ingérence de la part de l'industrie de l'alcool contribue à faire passer les objectifs de santé publique avant d'autres intérêts.La Región de África de la Organización Mundial de la Salud (OMS) está tratando de hacer frente a los crecientes daños derivados del consumo de alcohol. Los legisladores de Santo Tomé y Príncipe, preocupados por estos daños y por la alta prevalencia de los trastornos por consumo de alcohol, diseñaron un proyecto de ley integral para el control del alcohol con el fin de solucionar esta situación. Las contribuciones al diseño del proyecto de ley se obtuvieron a través de entrevistas en las que participaron muchas partes interesadas. El proceso constó de cinco fases: (i) la delimitación del problema para comprender la carga social de los daños causados por el consumo de alcohol; (ii) la actualización de los datos sobre las políticas de alcohol y la identificación de las áreas de intervención legislativa; (iii) la redacción del proyecto de ley; (iv) la adaptación del marco legislativo del proyecto de ley; y (v) el inicio del procedimiento parlamentario. El nuevo proyecto de ley obtuvo una puntuación de 92/100 según una escala estandarizada de políticas para el control del alcohol. El proyecto de ley abarca todos los ámbitos de la estrategia mundial que la OMS puso en marcha en 2010 para reducir el uso nocivo del alcohol, e incluye las tres intervenciones más rentables para reducir el consumo de alcohol: el aumento de los impuestos especiales sobre el alcohol; la prohibición o la restricción general de la exposición a la publicidad del alcohol; y la restricción de la disponibilidad del alcohol al por menor mediante la reducción del horario de venta. La sesión plenaria de la Asamblea Nacional respaldó el proyecto de ley, que ahora está bajo evaluación de la Comisión Primera especializada en Asuntos Políticos, Jurídicos, Constitucionales y Éticos. La aprobación del proyecto de ley requiere la votación final una vez que regrese a la Asamblea Nacional y que el Presidente lo promulgue. La elaboración de un proyecto de ley para el control del alcohol que sea liderado por el país, inclusivo, basado en la evidencia y libre de interferencias por parte de la industria del alcohol ayuda a priorizar los objetivos de salud pública sobre otros intereses.تعاني المنطقة الأفريقية التابعة لمنظمة الصحة العالمية (WHO) من الضرر المتزايد المرتبط باستهلاك الكحول. إن المشرعين المعنيين بهذا الضرر وبانتشار مشكلات تعاطي الكحول، في سان تومي وبرينسيبي، قاموا بوضع مشروع قانون شامل لمكافحة الكحول بهدف معالجة هذا الوضع. تم الحصول على معطيات تصميم القانون من خلال المقابلات الشخصية مع العديد من أصحاب المصلحة. تضمنت العملية خمس مراحل: (1) تحديد نطاق المشكلة لفهم العبء الاجتماعي للضرر الناجم عن استهلاك الكحول؛ و(2) تحديث الأدلة المتعلقة بسياسات الكحول وتحديد مجالات التدخل التشريعي؛ و(3) صياغة مشروع القانون؛ و(4) تنسيق الإطار التشريعي لمشروع القانون؛ و(5) بدء الإجراءات البرلمانية. سجل مشروع القانون الجديد 92/100 باستخدام مقياس موحد لسياسة مكافحة الكحول. يغطي مشروع القانون جميع نطاقات الاستراتيجية العالمية لمنظمة الصحة العالمية لعام 2010، للحد من الاستخدام الضار للكحول، ويتضمن التدخلات الثلاثة الأكثر فعالية من حيث التكلفة للحد من استهلاك الكحول: زيادة الضرائب المفروضة على الكحول؛ عمليات الحظر أو القيود الشاملة على التعرض لإعلانات الكحول؛ والقيود المفروضة على توافر المشروبات الكحولية بالتجزئة من خلال تخفيض ساعات البيع. وأيدت الجلسة العمومية للجمعية الوطنية مشروع القانون، والذي يخضع الآن لتقييم اللجنة الأولى المتخصصة للشؤون السياسية والقانونية والدستورية والأخلاقية. تتطلب الموافقة على مشروع القانون، التصويت النهائي بمجرد عودته إلى الجمعية الوطنية وإصداره من جانب الرئيس. إن صياغة مشروع قانون لمكافحة الكحول تحت قيادة الدولة، يتمتع بالشمولية، والاعتماد على الأدلة، ودون التدخل من جانب صناعة الكحول، يساعد في منح الأولوية لأهداف الصحة العامة على المصالح الأخرى.世卫组织 (WHO) 非洲区域办事处当前面临日益严重的饮酒危害问题。圣多美和普林西比的立法者担心这种危害加剧以及酒精使用障碍发病率过高，制定了一项全面的酒精控制法案来解决这一问题。在法案设计阶段，通过采访收集了许多利益相关者提供的建议。该过程分为五个阶段：(i) 界定问题范围以了解饮酒的危害及其造成的社会负担；(ii) 更新有关酒精政策的证据，并确定立法干预的领域；(iii) 起草法案；(iv) 调整法案的立法框架；以及 (v) 启动议会议事程序。根据标准化酒精控制政策量表，新法案得分为 92/100。新法案涵盖了世卫组织于 2010 年公布的减少有害使用酒精全球战略的所有领域，并列出了三个最具成本效益的饮酒量控制干预措施：增加酒精消费税；禁止或全面限制酒精类广告的宣传；通过缩短销售时间限制零售酒的供应。国民议会全体会议支持该法案，且第一政治、法律、宪法和道德事务特设委员会目前正在评估该法案。该法案需要在送回国民议会进行最终投票并由总统签署后方可生效。起草由国家主导、具有包容性、以证据为基础且不受酒精行业干预的酒精控制法案有助于优先实现公共卫生目标而不是考虑其他利益。.Африканский регион Всемирной организации здравоохранения (ВОЗ) борется с растущим вредом, связанным с употреблением алкоголя. Обеспокоенные этим вредом и высокой распространенностью расстройств, связанных с употреблением алкоголя, законодательные органы Сан-Томе и Принсипи разработали всеобъемлющий законопроект по борьбе с алкоголем для решения данной ситуации. Свой вклад в разработку законопроекта внесли многие заинтересованные стороны путем участия в опросах. Процесс состоял из пяти этапов: (i) определение масштаба проблемы для понимания социального бремени вреда, причиняемого употреблением алкоголя; (ii) обновление данных о политике в отношении употребления алкоголя и определение областей для законодательных мер; (iii) составление законопроекта; (iv) согласование законодательной основы законопроекта; (v) инициирование парламентской процедуры. Новый законопроект набрал 92 балла из 100 по стандартной шкале для оценки эффективности политики в отношении алкоголя. Законопроект охватывает все области глобальной стратегии ВОЗ сокращения вредного употребления алкоголя от 2010 г. и включает три наиболее эффективных с точки зрения затрат мероприятия по сокращению потребления алкоголя: повышение акцизов на алкоголь, запреты или всеобъемлющие ограничения воздействия рекламы алкоголя и ограничения доступности алкоголя в розничной сети за счет сокращения часов продажи. Пленарное заседание Национальной ассамблеи поддержало законопроект, который в настоящее время находится на рассмотрении специализированной Первой комиссии по политическим, правовым, конституционным и этическим вопросам. Утверждение законопроекта требует окончательного голосования после его возвращения в Национальную ассамблею и обнародования президентом. Разработка законопроекта по борьбе с алкоголем, который является инициативой страны, инклюзивен, основан на фактических данных и свободен от вмешательства алкогольной промышленности, помогает считать цели общественного здравоохранения приоритетными по отношению к другим интересам.
Adults need to be better informed about their alcohol marketing exposure and risks of drinking, and be protected from the marketing of harmful products so they can make informed decisions and support the protection of future generations from these same marketing practices. Niederdeppe et al. [1] introduce new analytical methods that allow data for adults to be added to the existing literature on how marketing exposure affects underage alcohol consumption. This complements other efforts made internationally and opens a path for research in further countries into adult drinking and marketing exposure. The vast marketing of alcohol described on television alone in a short time period was impressive. The general public is probably unaware of the volume of advertisement they are exposed to, and more efforts should be made to inform and educate them about how marketing in general and alcohol marketing in particular can shape their lives, choices, attitudes, and social norms [2]. Support for regulatory controls would then, hopefully, increase [3]. Marketing during sports programs is of particular interest. Sports are a significant part of the US culture and a way to socialize, within the family and community. Soccer, football, ice hockey, and basketball are all heavily sponsored by beer companies, and beer advertisements are shown frequently on television during each sport's season in the United States and globally. Watching sport is a period of shared entertainment, but it also risks exposing children, youth, and adults to alcohol marketing. This may result in the internalization of norms and habits, leading to increases in drinking across these age groups. Despite this, marketing exposure during sports broadcasts does not contravene the industry's self-regulatory guidelines, which aim to protect children and underage drinkers by prohibiting advertising that appeals primarily to youth [4, 5]. This is because these shared viewing occasions are considered “adult viewing”, because underage drinkers do not form a large portion of the audience. As such, they will not be protected by the guidelines from marketing exposure. It would be interesting to use Niederdeppe et al.’s methods to analyze marketing exposure and drinking following major sporting events. This would hopefully allow us to assess the immediate links between exposure to marketing and drinking intentions, attitudes, and behaviors among children, adolescents, young adults, and adults. It would also have been good to have included 18- to 20-year-olds in the study. Despite being underage drinkers in the United States, these youths are adults under the law and are within the legal age to drink in many other countries. They can also still access the adult content in any media and are therefore “legally” watching all of the TV programs that other adults watch. Because they will soon become legal consumers, this group is a particular target for marketing [6, 7], and it is no coincidence that, for example, alcohol companies sponsor college sports. As such, 18- to 20-year-olds are probably as, or more, exposed to alcohol marketing as the older adults in the study [8]. However, they are also of significant concern as an age group that has an incomplete level of brain development that places them at higher risk of negative consequences from drinking. Although concerns are increasing internationally over marketing in the digital world [9, 10], television remains a very important vehicle of communication globally, particularly in developing countries. Alcohol is like tobacco, and we could all benefit from less marketing of a harmful product. Adults need to be better informed about the risks and protected from the marketing of harmful products, so they can support the protection of future generations from these same marketing practices. We can all stand up to do the right thing if we understand how personal choices are shaped. None. The views expressed by the author are her own and do not necessarily reflect the views or position of the Pan American Health Organization
Discussions between the World Health Organization (WHO) and the International Society on Biomedical Research on Alcoholism (ISBRA) identified the need for a multiple-center international study on state and trait markers of alcohol abuse and alcohol dependence. The reasoning behind the generation of such a project included the need to understand the alcohol use characteristics of diverse populations and the performance of biological markers of alcohol use in a variety of settings throughout the world. A second major reason for initiating this study was to collect DNA for well-structured and stratified association studies between genetic markers and/or "candidate" genes and behavioral/physiological phenotypes of importance to predisposition to alcohol dependence.An extensive interview instrument was developed with leadership from the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA). The instrument was translated from English to Finnish, French, German, Japanese, and Portuguese (Brazilian). One thousand eight hundred sixty-three subjects were recruited at five clinical centers (Montreal, Canada; Helsinki, Finland; Sapporo, Japan; São Paulo, Brazil; and Sydney, Australia). The subjects responded to the structured interview and provided blood and urine samples for biochemical analysis. This article focuses on the demographic characteristics of the study subjects, their drinking habits, alcohol-dependence characteristics, comorbid psychiatric and other drug variables, and predictors for seeking treatment for alcohol dependence. Multiple logistic regression models were constructed and used to explore variables that contribute to various levels of alcohol consumption, to a diagnosis of alcohol dependence, and to seeking treatment for alcohol dependence. ANOVA with post hoc comparisons, chi2, and Pearson moment calculations were used as necessary to assess additional relationships between variables.A number of factors previously noted in disparate studies were confirmed in our analysis. Men consumed more alcohol than women, Asians consumed less alcohol than whites or Blacks, alcohol-dependent subjects consumed more alcohol than nondependent subjects, alcohol consumption increased with age, and an increased level of education (university or postgraduate education) reduced the percentage of such individuals in the category designated as heavy drinkers (>210 g alcohol/week) and in the group who were currently in treatment for dependence. However, our analysis allowed for much more detailed comparisons; for example, although men drank more than women on a g/day basis, the differences were less pronounced on g/kg/day basis, and alcohol-dependent women drank equal amounts of alcohol as alcohol-dependent men on a g/kg/day basis. Antisocial personality characteristics or reports of trouble sleeping when an individual stops drinking were associated with higher alcohol intake. The most important of the tested factors that contributed to a DSM-IV diagnosis of dependence, however, was the report of anxiety if an individual stopped drinking. In terms of the various criteria within the DSM-IV criteria for alcohol dependence, no one criterion seemed to be prominent for individuals who sought alcohol dependence treatment, but the higher the number of criteria met by the individual, the higher was the probability that he or she would be in treatment.This initial report is the beginning of the "data mining" of this rich data set. The cross-national/cross-cultural aspects of this study allowed for multiple comparisons of variables across several ethnic/racial groups and allowed for assessment of biochemical markers for alcohol intake and predisposition to alcohol dependence in diverse settings.
Introduction On 19 November 2021 the Pan American Health Organization (PAHO) developed and deployed the first-ever digital health worker dedicated to alcohol-related topics, named Pahola. This paper describes this developmental process and the first results of its uptake and interactions with the public. Methods PAHO secured a non-exclusive worldwide license with a technology company to use their Human OS ecosystem, which enables human-like interactions between digital people and users via an application. Google Digital flow ES was used to develop the conversations of Pahola on topics related to alcohol and health, screening of alcohol risk using the AUDIT and providing a quit/cut back plan to users, along with additional treatment services and resources in each country of the Americas. A communication campaign was also implemented from launching date until 31 December 2021. Results Pahola attracted good attention from the media, and potentially reached 1.6 million people, leading to 236,000 sessions on its landing page, mostly through mobile devices. The average time people effectively spent talking to Pahola was five minutes. Major dropouts were observed in different steps of the conversation flow. Discussion Pahola was quickly able to connect to a large worldwide population with reliable alcohol information. It could potentially increase the delivery of SBI and improve alcohol health literacy. However, its preliminary results pointed to much needed changes to its corpus and on its accessibility, which are being currently implemented.
The Functional Mockup Interface (FMI) is a tool independent standard for the exchange of dynamic models and for co-simulation.The development of FMI was initiated and organized by Daimler AG within the ITEA2 project MODELISAR.The primary goal is to support the exchange of simulation models between suppliers and OEMs even if a large variety of different tools are used.The FMI was developed in a close collaboration between simulation tool vendors and research institutes.In this article an overview about FMI is given and technical details about the solution are discussed.
AbstractData from a questionnaire sent to 704 male university students and nonacademic staff were reanalyzed to compare self-reports of drug and alcohol intake patterns and problems as well as family histories of psychiatric disorders for Jewish (N = 110, Group 1) and Christian men (N = 594, Group 2). Although the two groups did not differ significantly on the quantity and frequency of alcohol intake, men in Group 2 were more likely to report at least one episode of heavy drinking and alcohol-related problems, and their responses indicated a higher rate of a family history of alcoholism. There were no differences across the groups on the proportion of lifetime drug use and related difficulties, or on the family histories of other psychiatric disorders. The results are consistent with previous studies demonstrating a lower prevalence of heavy drinking and related problems among Jews.
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