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1.
Subst Abuse Treat Prev Policy ; 16(1): 76, 2021 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620196

RESUMEN

The Alcohol Use Disorders Identification Test (AUDIT) is one of the most frequently used screening instrument for hazardous and harmful use of alcohol and potential alcohol dependence in primary health care (PHC) and other settings worldwide. It has been translated into many languages and adapted and modified for use in some countries, following formal adaptation procedures and validation studies. In the Russian Federation, the AUDIT has been used in different settings and by different health professionals, including addiction specialists (narcologists). In 2017, it was included as a screening instrument in the national guidelines of routine preventive health checks at the population-level (dispanserization). However, various Russian translations of the AUDIT are known to be in use in different settings and, so far, little is known about the empirical basis and validation of the instrument in Russia-a country, which is known for its distinct drinking patterns and their detrimental impact on health. The present contribution is the summary of two systematic reviews that were carried out to inform a planned national validation study of the AUDIT in Russia.Two systematic searches were carried out to 1) identify all validation efforts of the AUDIT in Russia and to document all reported problems encountered, and 2) identify all globally existing Russian translations of the AUDIT and document their differences and any reported issues in their application. The qualitative narrative synthesis of all studies that met the inclusion criteria of the first search highlighted the absence of any large-scale rigorous validation study of the AUDIT in primary health care in Russia, while a document analysis of all of the 122 Russian translations has revealed 61 unique versions, most of which contained inconsistencies and signaled obvious application challenges of the test.The results clearly signal the need for a validation study of the Russian AUDIT.


Asunto(s)
Alcoholismo , Alcoholismo/diagnóstico , Humanos , Lenguaje , Tamizaje Masivo , Atención Primaria de Salud , Federación de Rusia , Encuestas y Cuestionarios
3.
Bull World Health Organ ; 99(7): 496-505, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-34248222

RESUMEN

Objective: To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). Methods: We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. Findings: Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's α : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non-specific thresholds resulted in few women being identified. Conclusion: With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies.


Asunto(s)
Alcoholismo/diagnóstico , Tamizaje Masivo/métodos , Encuestas y Cuestionarios/normas , Consumo de Bebidas Alcohólicas/efectos adversos , Alcoholismo/epidemiología , Femenino , Humanos , Masculino , Atención Primaria de Salud , Psicometría , Reproducibilidad de los Resultados , Población Rural , Federación de Rusia/epidemiología , Población Urbana
5.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34048155

RESUMEN

PURPOSE: The purpose of this paper is to summarize activities being undertaken by the World Health Organization (WHO) Regional Office for Europe to prevent and control COVID-19 in and beyond prisons, activities specifically designed to increase information sharing and to support Member States, to comment on potential impacts of these initiatives at country-level responses and to underline the need for a rights-based approach to managing the pandemic, including the right to vaccination. DESIGN/METHODOLOGY/APPROACH: The Health in Prisons Programme (HIPP) of the WHO Regional Office for Europe worked with partner organizations to review regularly the evidence on best practices in prison health and use it to inform policy recommendations at the global level. HIPP issued overarching guidance and specific tools to support implementation of measures to prevent and control the spread of COVID-19 in prisons and other custodial settings. Moreover, to monitor the emergence of outbreaks, the HIPP developed a minimum data set for countries voluntarily to report COVID-19 cases and identify situations in need of direct support. FINDINGS: Since May 2020, the WHO has periodically received data from Member States, leading to the development of country-specific bulletins to support countries and, whenever appropriate, to organize virtual missions to further support ministries and public health bodies responsible for managing COVID-19 in prisons. ORIGINALITY/VALUE: The development of a specific set of indicators for prisons enables exploring data in a disaggregated manner. Monitoring response measures developed in prison enables judging their appropriateness to minimize the spread of SARS-CoV2 in prisons and alignment with guidance issued by the WHO.


Asunto(s)
COVID-19 , Brotes de Enfermedades/prevención & control , Prisiones , Control de Enfermedades Transmisibles , Europa (Continente) , Humanos , Pandemias , SARS-CoV-2 , Organización Mundial de la Salud
6.
Artículo en Inglés | MEDLINE | ID: mdl-33801260

RESUMEN

Due to the high levels of alcohol use, alcohol-attributable mortality and burden of disease, and detrimental drinking patterns, Lithuania implemented a series of alcohol control policies within a relatively short period of time, between 2008 and 2019. Based on their expected impact on alcohol consumption and alcohol-attributable harm, as well as their target population, these policies have been classified using a set of objective criteria and expert opinion. The classification criteria included: positive vs. negative outcomes, mainly immediate vs. delayed outcomes, and general population vs. specific group outcomes. The judgement of the alcohol policy experts converged on the objective criteria, and, as a result, two tiers of intervention were identified: Tier 1-highly effective general population interventions with an anticipated immediate impact; Tier 2-other interventions aimed at the general population. In addition, interventions directed at specific populations were identified. This adaptable methodological approach to alcohol control policy classification is intended to provide guidance and support for the evaluation of alcohol policies elsewhere, to lay the foundation for the critical assessment of the policies to improve health and increase life expectancy, and to reduce crime and violence.


Asunto(s)
Consumo de Bebidas Alcohólicas , Política Pública , Consumo de Bebidas Alcohólicas/epidemiología , Etanol , Conductas Relacionadas con la Salud , Humanos , Lituania/epidemiología
8.
Addiction ; 116(10): 2673-2684, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33751693

RESUMEN

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.


Asunto(s)
Consumo de Bebidas Alcohólicas , Política Pública , Adulto , Humanos , Análisis de Series de Tiempo Interrumpido , Lituania/epidemiología , Masculino , Mortalidad , Impuestos
9.
Drug Alcohol Rev ; 40(3): 350-367, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33155370

RESUMEN

ISSUES: The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. APPROACH: The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. KEY FINDINGS: Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three 'best buys' put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. IMPLICATIONS: In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions. CONCLUSION: Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.

10.
Eur Addict Res ; 27(3): 189-197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33271557

RESUMEN

INTRODUCTION: Prevention of cancer has been identified as a major public health priority for Europe, and alcohol is a leading risk factor for various types of cancer. This contribution estimates the number of cancer cases that could have potentially been averted in 2018 in 4 European countries if an increase in alcohol excise taxation had been applied. METHODS: Current country and beverage-specific excise taxation of 4 member states of the WHO European Region (Germany, Italy, Kazakhstan, and Sweden) was used as a baseline, and the potential impacts of increases of 20, 50, and 100% to current excise duties were modelled. A sensitivity analysis was performed, replacing the current tax rates in the 4 countries by those levied in Finland. The resulting increase in tax was assumed to be fully incorporated into the consumer price, and beverage-specific price elasticities of demand were obtained from meta-analyses, assuming less elasticity for heavy drinkers. Model estimates were applied to cancer incidence rates for the year 2018. RESULTS: In the 4 countries, >35,000 cancer cases in 2018 were caused by alcohol consumption, with the highest rate of alcohol-attributable cancers recorded in Germany and the lowest in Sweden. An increase in excise duties on alcohol would have significantly reduced these numbers, with between 3 and 7% of all alcohol-attributable cancer cases being averted if taxation had been increased by 100%. If the 4 countries were to adopt an excise taxation level equivalent to the one currently imposed in Finland, an even higher proportion of alcohol-attributable cancers could be avoided, with Germany alone experiencing 1,600 fewer cancer cases in 1 year. DISCUSSION/CONCLUSION: Increasing excise duties can markedly reduce cancer incidence in European countries.


Asunto(s)
Bebidas Alcohólicas , Neoplasias , Europa (Continente) , Femenino , Humanos , Masculino , Impuestos , Organización Mundial de la Salud
12.
Artículo en Inglés | MEDLINE | ID: mdl-33158307

RESUMEN

Alcohol is a major risk factor for burden of disease. However, there are known effective and cost-effective alcohol control policies that could reduce this burden. Based on reviews, international documents, and contributions to this special issue of International Journal of Environmental Research and Public Health (IJERPH), this article gives an overview of the implementation of such policies in the World Health Organization (WHO) European Region, and of best practices. Overall, there is a great deal of variability in the policies implemented between countries, but two countries, the Russian Federation and Lithuania, have both recently implemented significant increases in alcohol taxation, imposed restrictions on alcohol availability, and imposed bans on the marketing and advertising of alcohol within short time spans. Both countries subsequently saw significant decreases in consumption and all-cause mortality. Adopting the alcohol control policies of these best-practice countries should be considered by other countries. Current challenges for all countries include cross-border shopping, the impact from recent internet-based marketing practices, and international treaties.


Asunto(s)
Publicidad , Consumo de Bebidas Alcohólicas/prevención & control , Política Pública , Consumo de Bebidas Alcohólicas/epidemiología , Europa (Continente)/epidemiología , Política de Salud , Lituania , Federación de Rusia
13.
Artículo en Inglés | MEDLINE | ID: mdl-33172090

RESUMEN

Despite being a psychoactive substance and having a major impact on health, alcohol has to date escaped the required labeling regulations for either psychoactive substances or food. The vast majority of the countries in the WHO European Region have stricter labeling requirements for bottled water and health warning provisions for over-the-counter medications than for alcoholic beverages. However, more progress in implementing health warnings has been made in the eastern part of the WHO European Region, largely because of the recent technical regulation put in place by the newly formed Eurasian Economic Union. The present contribution provides an overview of the existing legislation regarding the placement of alcohol health warnings on advertisements and labels on alcohol containers in the countries of the Commonwealth of Independent States (CIS; Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, and Uzbekistan) and discusses their potential gaps and shortfalls. It also reviews the evolution of the Eurasian Economic Union Technical Regulation 047/2018, which is, to date, the only international document to impose binding provisions on alcohol labeling. The technical regulation's developmental process demonstrates how the comprehensive messages and strong requirements for health warnings that were suggested initially were watered down during the consultation process.


Asunto(s)
Bebidas Alcohólicas , Etiquetado de Productos , Adolescente , Azerbaiyán , Niño , Comunidad de Estados Independientes , Femenino , Humanos , Kazajstán , Federación de Rusia , Tayikistán , Uzbekistán
14.
Artículo en Inglés | MEDLINE | ID: mdl-33182377

RESUMEN

In the 2000s, Russia was globally one of the top 5 countries with the highest levels of alcohol per capita consumption and prevailing risky patterns of drinking, i.e., high intake per occasion, high proportion of people drinking to intoxication, and high frequency of situations where alcohol is consumed and tolerated. In 2009, in response to these challenges, the Russian government formed the Federal Service for Alcohol Market Regulation and published a national strategy concept to reduce alcohol abuse and alcohol-dependence at the population level for the period 2010-2020. The objectives of the present contribution are to analyze the evidence base of the core components of the concept and to provide a comprehensive evaluation framework of measures implemented (process evaluation) and the achievement of the formulated targets (effect evaluation). Most of the concept's measures were found to be evidence-based and aligned with eight out of 10 areas of the World Health Organization (WHO) policy portfolio. Out of the 14 tasks, 7 were rated as achieved, and 7 as partly achieved. Ten years after the concept's adoption, alcohol consumption seems to have declined by about a third and alcohol is conceptualized as a broad risk factor for the population's health in Russia.


Asunto(s)
Consumo de Bebidas Alcohólicas , Alcoholismo , Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Alcoholismo/prevención & control , Humanos , Políticas , Factores de Riesgo , Federación de Rusia/epidemiología
17.
Alcohol Alcohol ; 55(6): 624-630, 2020 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-32728707

RESUMEN

AIMS: To adapt and validate the Alcohol Use Disorders Identification Test (AUDIT) for use in the Russian Federation and countries with Russian-speaking populations by. METHODS: Systematic review of past use and validation of the Russian-language AUDIT. Interviews to be conducted with experts to identify problems encountered in the use of existing Russian-language AUDIT versions. A pilot study using a revised translation of the Russian-language AUDIT that incorporates country-specific drinking patterns in the Russian Federation. RESULTS AND CONCLUSIONS: The systematic review identified over 60 different Russian-language AUDIT versions without systematic validation studies. The main difficulties encountered with the use of the AUDIT in the Russian Federation were related to the lack of:A revised version of the Russian-language AUDIT was created based on the pilot studies, and was validated in primary healthcare facilities in all regions in 2019/2020.


Asunto(s)
Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Atención Primaria de Salud/normas , Encuestas y Cuestionarios/normas , Traducciones , Alcoholismo/terapia , Humanos , Proyectos Piloto , Atención Primaria de Salud/métodos , Reproducibilidad de los Resultados , Federación de Rusia/epidemiología
18.
Int J Drug Policy ; 80: 102636, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32417670

RESUMEN

Alcohol use has been determined to be one of the main risk factors of, and contributors to, premature mortality in Russia, but no formal analysis of the impact of alcohol control policies has been undertaken so far. The present contribution is a commentary on a policy impact study undertaken by the World Health Organization on the effects of alcohol control measures on mortality and life expectancy in the Russian Federation. As part of the case study, all alcohol control policies in Russia from 1990 to 2018 were examined, and periods with differing policy intensity were distinguished based on the known effectiveness of different measures. Trends in all-cause mortality during these periods, and the shifts in trends between periods, were analysed using interrupted-time series methodology. As predicted, the intensity of alcohol control policies strongly impacted all-cause mortality. The experience of the Russian Federation in reducing the burden of disease caused by alcohol is a strong argument that effective alcohol policies are essential for improving the prospects for long and healthy lives.


Asunto(s)
Consumo de Bebidas Alcohólicas , Política Pública , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/prevención & control , Etanol , Humanos , Esperanza de Vida , Federación de Rusia/epidemiología
19.
Drug Alcohol Rev ; 39(4): 301-304, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32358884

RESUMEN

Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios-with opposite predictions regarding the impact of the current COVID-19 pandemic on the level and patterns of alcohol consumption-are introduced. The first scenario predicts an increase in consumption for some populations, particularly men, due to distress experienced as a result of the pandemic. A second scenario predicts the opposite outcome, a lowered level of consumption, based on the decreased physical and financial availability of alcohol. With the current restrictions on alcohol availability, it is postulated that, for the immediate future, the predominant scenario will likely be the second, while the distress experienced in the first may become more relevant in the medium- and longer-term future. Monitoring consumption levels both during and after the COVID-19 pandemic will be necessary to better understand the effects of COVID-19 on different groups, as well as to distinguish them from those arising from existing alcohol control policies.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Betacoronavirus , COVID-19 , Humanos , Pandemias , Vigilancia en Salud Pública , SARS-CoV-2
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