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1.
Artículo en Inglés | MEDLINE | ID: mdl-34639847

RESUMEN

Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption translate into possible changes in the prevalence of heavy drinking. We used data from the European Survey on Alcohol use and COVID-19 (ESAC) conducted in Czechia, Denmark, Finland, Germany, Norway, Poland, Spain, and the UK (N = 31921). Past-year alcohol consumption and changes in consumption were measured by AUDIT-C. Drinking habits were compared according to percentiles of pre-pandemic consumption levels, below versus above the 90th percentile. Across countries, drinkers in the highest 10% for pre-pandemic consumption increased their drinking during the pandemic, whereas absolute changes among those initially drinking below this level were modest. The percentage of people reporting >28 alcohol units/week increased significantly in seven of eight countries. During the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of the drinkers increased as did the prevalence of heavy drinkers, in contrast with a declining consumption in other groups in the sample.


Asunto(s)
Intoxicación Alcohólica , COVID-19 , Consumo de Bebidas Alcohólicas/epidemiología , Humanos , Pandemias , SARS-CoV-2
3.
Addiction ; 116(12): 3369-3380, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34109685

RESUMEN

AIMS: To investigate changes in alcohol consumption during the first months of the COVID-19 pandemic in Europe as well as its associations with income and experiences of distress related to the pandemic. DESIGN: Cross-sectional on-line survey conducted between 24 April and 22 July 2020. SETTING: Twenty-one European countries. PARTICIPANTS: A total of 31 964 adults reporting past-year drinking. MEASUREMENTS: Changes in alcohol consumption were measured by asking respondents about changes over the previous month in their drinking frequency, the quantity they consumed and incidence of heavy episodic drinking events. Individual indicators were combined into an aggregated consumption-change score and scaled to a possible range of -1 to +1. Using this score as the outcome, multi-level linear regressions tested changes in overall drinking, taking into account sampling weights and baseline alcohol consumption [Alcohol Use Disorder Identification Test (AUDIT-C)] and country of residence serving as random intercept. Similar models were conducted for each single consumption-change indicator. FINDINGS: The aggregated consumption-change score indicated an average decrease in alcohol consumption of -0.14 [95% confidence interval (CI) = -0.18, -0.10]. Statistically significant decreases in consumption were found in all countries, except Ireland (-0.08, 95% CI = -0.17, 0.01) and the United Kingdom (+0.10, 95% CI = 0.03, 0.17). Decreases in drinking were mainly driven by a reduced frequency of heavy episodic drinking events (-0.17, 95% CI = -0.20, -0.14). Declines in consumption were less marked among those with low- or average incomes and those experiencing distress. CONCLUSIONS: On average, alcohol consumption appears to have declined during the first months of the COVID-19 pandemic in Europe. Both reduced availability of alcohol and increased distress may have affected consumption, although the former seems to have had a greater impact in terms of immediate effects.


Asunto(s)
COVID-19 , Pandemias , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Estudios Transversales , Europa (Continente)/epidemiología , Humanos , SARS-CoV-2
4.
Front Psychiatry ; 12: 675033, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34093282

RESUMEN

The standardization of cannabis doses is a priority for research, policy-making, clinical and harm-reduction interventions and consumer security. Scientists have called for standard units of dosing for cannabis, similar to those used for alcohol. A Standard Joint Unit (SJU) would facilitate preventive and intervention models in ways similar to the Standard Drink (SD). Learning from the SD experiences allows researchers to tackle emerging barriers to the SJU by applying modern forecasting methods. During a workshop at the Lisbon Addictions Conference 2019, a back-casting foresight method was used to address challenges and achieve consensus in developing an SJU. Thirty-two professionals from 13 countries and 10 disciplines participated. Descriptive analysis of the workshop was carried out by the organizers and shared with the participants in order to suggest amendments. Several characteristics of the SJU were defined: (1) core values: easy-to use, universal, focused on THC, accurate, and accessible; (2) key challenges: sudden changes in patterns of use, heterogeneity of cannabis compounds as well as in administration routes, variations over time in THC concentrations, and of laws that regulate the legal status of recreational and medical cannabis use); and (3) facilitators: previous experience with standardized measurements, funding opportunities, multi-stakeholder support, high prevalence of cannabis users, and widespread changes in legislation. Participants also identified three initial steps for the implementation of a SJU by 2030: (1) Building a task-force to develop a consensus-based SJU; (2) Expanded available national-level data; (3) Linking SJU consumption to the concept of "risky use," based on evidence of harms.

5.
Int J Methods Psychiatr Res ; 30(3): e1875, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33951258

RESUMEN

OBJECTIVES: This contribution provides insights into the methodology of a pan-European population-based online survey, performed without external funding during the COVID-19 pandemic. We present the impact of different dissemination strategies to collect data from a non-probabilistic convenience sample and outline post-stratification weighting schemes, to provide guidance for future multi-country survey studies. METHODS: Description and comparison of dissemination strategies for five exemplary countries (Czechia, Germany, Lithuania, Norway, Spain) participating in the Alcohol Use and COVID-19 Survey. Comparison of the sample distribution with the country's actual population distribution according to sociodemographics, and development of weighting schemes. RESULTS: The dissemination of online surveys through national newspapers, paid social media adverts and dissemination with the support of national health ministries turned out to be the most effective strategies. Monitoring the responses and adapting dissemination strategies to reach under-represented groups, and the application of sample weights were helpful to achieve an analytic sample matching the respective general population profiles. CONCLUSION: Reaching a large pan-European convenience sample, including most European countries, in a short time was feasible, with the support of a broad scientific network.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , COVID-19/epidemiología , Adolescente , Adulto , República Checa/epidemiología , Femenino , Alemania/epidemiología , Humanos , Lituania/epidemiología , Masculino , Persona de Mediana Edad , Noruega/epidemiología , España/epidemiología , Encuestas y Cuestionarios , Adulto Joven
6.
Subst Abuse Treat Prev Policy ; 16(1): 36, 2021 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-33902668

RESUMEN

BACKGROUND: SARS-CoV-2 reached Europe in early 2020 and disrupted the private and public life of its citizens, with potential implications for substance use. The objective of this study was to describe possible changes in substance use in the first months of the SARS-CoV-2 pandemic in Europe. METHODS: Data were obtained from a cross-sectional online survey of 36,538 adult substance users from 21 European countries conducted between April 24 and July 22 of 2020. Self-perceived changes in substance use were measured by asking respondents whether their use had decreased (slightly or substantially), increased (slightly or substantially), or not changed during the past month. The survey covered alcohol (frequency, quantity, and heavy episodic drinking occasions), tobacco, cannabis, and other illicit drug use. Sample weighted data were descriptively analysed and compared across substances. RESULTS: Across all countries, use of all substances remained unchanged for around half of the respondents, while the remainder reported either a decrease or increase in their substance use. For alcohol use, overall, a larger proportion of respondents indicated a decrease than those reporting an increase. In contrast, more respondents reported increases in their tobacco and cannabis use during the previous month compared to those reporting decreased use. No distinct direction of change was reported for other substance use. CONCLUSIONS: Our findings suggest changes in use of alcohol, tobacco and cannabis during the initial months of the pandemic in several European countries. This study offers initial insights into changes in substance use. Other data sources, such as sales statistics, should be used to corroborate these preliminary findings.


Asunto(s)
COVID-19/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Alcoholismo/epidemiología , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Abuso de Marihuana/epidemiología , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Factores Socioeconómicos , Adulto Joven
8.
J Ment Health Policy Econ ; 21(1): 11-16, 2018 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-29643264

RESUMEN

INTRODUCTION: The relationship between economic downturns and substance use has been studied in numerous economic crises occurring worldwide, but the precise relationship between the two remains unclear. AIMS: The aim of the present study was to undertake a survey on behaviour and perspectives related to the latest European economic crisis among illegal drug users attending substance treatment services. DESIGN AND METHODS: We conducted a questionnaire-based survey in drug dependence treatment settings, in three geographically different jurisdictions (England, Catalonia and Poland), including 180 drug users. RESULTS: Most of the participants of the survey (58.3%) reported an increase in drug use during the crisis, compared with only 25.6% of the sample who reported a decrease in drug use. The main reason given for increasing drug use was greater amount of free time available. Other important reasons were greater substance availability during this period, more stress at work and seeking comfort in response to the loss of a stable source of income, social status and/or family. Those who reported cutting down on the amount of drug use during the economic recession, reported economic difficulties as the main reason. Other important factors were family and friends' economic problems and the fear of losing their job. Illegal drug use reduction was compensated by increased smoking in 46.3% of the patients, and increased alcohol use in 39.4%. DISCUSSION AND CONCLUSIONS: While this result has potential interest for those developing policies and interventions to reduce drug-related harm, longitudinal studies and future research involving a broader population of drug-users (including those not in treatment) could shed further light on these behavioural mechanisms linking changes in drug use with economic recessions.


Asunto(s)
Recesión Económica , Centros de Tratamiento de Abuso de Sustancias , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Polonia/epidemiología , España/epidemiología
9.
Acad Emerg Med ; 25(5): 517-525, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29418049

RESUMEN

BACKGROUND: Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs have been developed, evaluated, and shown to be effective, particularly in primary care and general practice. Nevertheless, effectiveness of SBIRT in emergency departments (EDs) has not been clearly established. OBJECTIVE: We aimed to evaluate the feasibility and efficacy of an SBIRT program conducted by highly specialized professionals in the ED of a tertiary hospital. METHODS: We conducted a randomized controlled trial to study the feasibility and efficacy of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the three-item version of the Alcohol Use Disorder Identification Test (AUDIT-C). Patients were randomized to two groups, with the control group receiving two leaflets-one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment. The primary outcomes were the proportion of at-risk alcohol use measured by AUDIT-C scale and the proportion of patients attending specialized treatment at 1.5 months. RESULTS: Of 3,027 patients presenting to the ED, 2,044 (67%) were potentially eligible to participate, 247 (12%) screened positive for at-risk drinking, and 200 agreed to participate. Seventy-two percent of the participating sample were men, and the mean (±SD) age was 43 (±16.7) years. Follow-up rates were 76.5%. At 1.5 months, the intervention group showed greater reductions in alcohol consumption and fewer patients continuing with at-risk alcohol use (27.8% vs. 48.1%; p = 0.01). The SBIRT program also increased the probability of attending specialized treatment, compared to the control condition (23% vs. 9.8%, p = 0.0119) CONCLUSION: The SBIRT program in the ED was found to be feasible and effective in identifying at-risk drinkers, reducing at-risk alcohol use, and increasing treatment for alcohol problems.


Asunto(s)
Alcoholismo/diagnóstico , Servicio de Urgencia en Hospital/organización & administración , Tamizaje Masivo/métodos , Adulto , Consumo de Bebidas Alcohólicas/prevención & control , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Derivación y Consulta/estadística & datos numéricos
10.
J Psychopharmacol ; 24(9): 1403-10, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19939863

RESUMEN

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development and Infancy Study (DAISY) study of prenatal drug use and outcomes. Eighty-six of the women were interviewed prospectively while pregnant and/or soon after their infant was born. Participants reported on use immediately before and during pregnancy and on use over their lifetime. Levels of lifetime drug use of the women recruited were high, with women reporting having used at least four different illegal drugs over their lifetime. Most users of cocaine, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and other stimulants stopped using these by the second trimester and levels of use were low. However, in pregnancy, 64% of the sample continued to use alcohol, 46% tobacco and 48% cannabis. While the level of alcohol use reduced substantially, average tobacco and cannabis levels tended to be sustained at pre-pregnancy levels even into the third trimester (50 cigarettes and/or 11 joints per week). In sum, while the use of 'party drugs' and alcohol seems to reduce, levels of tobacco and cannabis use are likely to be sustained throughout pregnancy. The data provide polydrug profiles that can form the basis for the development of more realistic animal models.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Drogas Ilícitas , Fumar Marihuana/epidemiología , N-Metil-3,4-metilenodioxianfetamina , Complicaciones del Embarazo/epidemiología , Fumar/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Femenino , Alucinógenos , Humanos , Estudios Longitudinales , Embarazo , Trimestres del Embarazo , Detección de Abuso de Sustancias , Reino Unido/epidemiología
11.
Cognition ; 104(2): 377-396, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28933345

RESUMEN

While five-month-old infants show orientation-specific sensitivity to changes in the motion and occlusion patterns of human point-light displays, it is not known whether infants are capable of binding a human representation to these displays. Furthermore, it has been suggested that infants do not encode the same physical properties for humans and material objects. To explore these issues we tested whether infants would selectively apply the principle of solidity to upright human displays. In the first experiment infants aged six and nine months were repeatedly shown a human point-light display walking across a computer screen up to 10 times or until habituated. Next, they were repeatedly shown the walking display passing behind an in-depth representation of a table, and finally they were shown the human display appearing to pass through the table top in violation of the solidity of the hidden human form. Both six- and nine-month-old infants showed significantly greater recovery of attention to this final phase. This suggests that infants are able to bind a solid vertical form to human motion. In two further control experiments we presented displays that contained similar patterns of motion but were not perceived by adults as human. Six- and nine-month-old infants did not show recovery of attention when a scrambled display or an inverted human display passed through the table. Thus, the binding of a solid human form to a display in only seems to occur for upright human motion. The paper considers the implications of these findings in relation to theories of infants' developing conceptions of objects, humans and animals.

12.
Cognition ; 104(2): 377-96, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16930578

RESUMEN

While five-month-old infants show orientation-specific sensitivity to changes in the motion and occlusion patterns of human point-light displays, it is not known whether infants are capable of binding a human representation to these displays. Furthermore, it has been suggested that infants do not encode the same physical properties for humans and material objects. To explore these issues we tested whether infants would selectively apply the principle of solidity to upright human displays. In the first experiment infants aged six and nine months were repeatedly shown a human point-light display walking across a computer screen up to 10 times or until habituated. Next, they were repeatedly shown the walking display passing behind an in-depth representation of a table, and finally they were shown the human display appearing to pass through the table top in violation of the solidity of the hidden human form. Both six- and nine-month-old infants showed significantly greater recovery of attention to this final phase. This suggests that infants are able to bind a solid vertical form to human motion. In two further control experiments we presented displays that contained similar patterns of motion but were not perceived by adults as human. Six- and nine-month-old infants did not show recovery of attention when a scrambled display or an inverted human display passed through the table. Thus, the binding of a solid human form to a display in only seems to occur for upright human motion. The paper considers the implications of these findings in relation to theories of infants' developing conceptions of objects, humans and animals.


Asunto(s)
Percepción de Forma , Percepción Visual , Humanos , Lactante , Recién Nacido
13.
Dev Neuropsychol ; 23(1-2): 139-72, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12730023

RESUMEN

We examine hypotheses for the neural basis of the profile of visual cognition in young children with Williams syndrome (WS). These are:(a)that it is a consequence of anomalies in sensory visual processing,(b)that it is a de.cit of the dorsal relative to the ventral cortical stream,(c)that it reflects de.cit of frontal function, in particular of frontoparietal interaction, and (d)that it is related to impaired function in the right hemisphere relative to the left. The tests reported here are particularly relevant to hypotheses 2 and 3. They form part of a more extensive program of investigating visual, visuospatial, and cognitive function in large group of children with WS children, aged 8 months to 15 years. To compare performance across tests, avoiding floor and ceiling effects, we have measured performance in children with WS in terms of the "age equivalence " for typically developing children. In this article the relation between dorsal and ventral function is tested by motion and form coherence thresholds, respectively. We confirm the presence of a subgroup of children with WS who perform particularly poorly on the motion (dorsal) task. However, such performance is also characteristic of normally developing children up to 5 years; thus the WS performance may reflect an overall persisting immaturity of visuospatial processing that is particularly evident in the dorsal stream. Looking at the performance on the global coherence tasks of the entire WS group, we find that there is also a subgroup who have both high form and motion coherence thresholds, relative to the performance of children of the same chronological age and verbal age on the British Picture Vocabulary Scale, suggesting a more general global processing deficit. Frontal function was tested by a counterpointing task, ability to retrieve a ball from a "detour box," and the Stroop--like "day.night " task, all of which require inhibition of a familiar response. When considered in relation to overall development as indexed by vocabulary, the day.night task shows little specific impairment, the detour box shows a significant delay relative to controls,and the counterpointing task shows a marked and persistent deficit in many children. We conclude that frontal control processes show most impairment in WS when they are associated with spatially directed responses, reflecting a deficit of frontoparietal processing. However, children with WS may successfully reduce the effect of this impairment by verbally mediated strategies. On all these tasks we find a range of difficulties across individual children and a small subset of children with WS who show very good performance, equivalent to chronological age norms of typically developing children. Overall, we conclude that children with WS have specific processing difficulties with tasks involving frontoparietal circuits within the spatial domain. However, some children with WS can achieve similar performance to typically developing children on some tasks involving the dorsal stream although the strategies and processing may be different in the 2 groups.


Asunto(s)
Lóbulo Frontal/fisiopatología , Lóbulo Parietal/fisiopatología , Percepción Visual , Síndrome de Williams/fisiopatología , Adolescente , Estudios de Casos y Controles , Niño , Preescolar , Trastornos del Conocimiento/fisiopatología , Femenino , Percepción de Forma , Lateralidad Funcional , Humanos , Masculino , Percepción de Movimiento , Percepción Espacial , Síndrome de Williams/psicología
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