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Gjerde H, Huestis MA, Mulima G, Kajombo C, Sundet M, Pechansky F. Recommendations for effective collaboration and capacity building in epidemiological studies on the effect of alcohol and drug use on traffic safety in low- and middle-income countries. TRAFFIC INJURY PREVENTION 2024; 25:313-321. [PMID: 38426896 DOI: 10.1080/15389588.2024.2316720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Alcohol or drug impairment is a major risk factor for road traffic crashes, and studies on this issue are essential to provide evidence-based data for policymakers. In low- and middle-income countries (LMICs), such studies are often conducted in partnership with one or more organizations in high-income countries (HICs). The aim of this article is to provide recommendations for improving project planning and decision-making processes in epidemiological studies on alcohol, drug and traffic safety in LMICs involving HICs. METHODS We searched Pubmed, Google Scholar, and Google Search for articles and reports in English about lessons learned when conducting collaborative research in LMIC as well as papers presenting recommendations for effective research collaboration with partners in LMICs. RESULTS Based on the search results, we selected 200 papers for full text examination. Few were related to studies on the effect of alcohol or drug use on road traffic safety. However, several conclusions and recommendations from other studies were found to be relevant. We combined the findings with our own experience in a narrative review. We also present a checklist for risk and quality assessment. CONCLUSIONS Many papers presented similar recommendations, which included the importance of addressing local needs, ensuring adequate resources, local project ownership and leadership, establishing strong partnerships among all involved stakeholders, promoting shared decision-making and planning, and implementing strategies to translate research findings into policy, practice, and publications. It is also important to avoid HIC bias, which prioritizes the interests or perspectives of HICs over those of LMICs.
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Affiliation(s)
- Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- International Council on Alcohol, Drugs and Traffic Safety (ICADTS)
| | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Severna Park, Maryland
| | | | | | - Mads Sundet
- Centre for Treatment of Rheumatic and Musculoskeletal Disease (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Flavio Pechansky
- International Council on Alcohol, Drugs and Traffic Safety (ICADTS)
- Center for Drug and Alcohol Research, Hospital de Clinicas of Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Assessing the Uniformity in Australian Animal Protection Law: A Statutory Comparison. Animals (Basel) 2020; 11:ani11010035. [PMID: 33375377 PMCID: PMC7824303 DOI: 10.3390/ani11010035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/06/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022] Open
Abstract
Simple Summary Australia does not have any federal legislation pertaining to animal welfare; thus, the responsibilities lie with each state and territory. This situation has led to eight different pieces of animal welfare legislation across the country, with potentially distinct content and avenues for interpretation. These differences may create problems for the enforcement of animal welfare law, and hence it has been suggested that a uniform approach is required. However, before such an approach can be considered, the extent of the inconsistencies between the states and territories needs to be assessed. This review compares the differences between state and territory animal welfare laws to determine the presence and nature of any major inconsistencies. A total of 436 primary pieces of legislation were reviewed, with 42 included in the detailed analysis. Animal welfare laws were found to be generally consistent across the states and territories of Australia, but with some important shortcomings that are discussed. Abstract Animal welfare is not included in the Australian Constitution, rendering it a residual power of the states and territories. Commentators have suggested that inconsistencies exist between the state and territory statutes, and that a uniform approach would be beneficial. However, there has been no comprehensive assessment of the nature or extent of these purported inconsistencies. This review addresses this gap by providing a state-by-state comparison of animal protection statutes based on key provisions. Utilizing systematic review methodology, every current Australian statute with an enforceable protection provision relating to animal welfare was identified. A total of 436 statutes were examined, with 42 statutes being included in the detailed analysis. The comparison showed that animal protection laws are generally consistent between each Australian jurisdiction and were found to have similar shortcomings, notably including lack of a consistent definition of ‘animal’ and reliance on forms of legal punishment to promote animal welfare which have questionable effectiveness. It is argued that there is a need for attention to definitions of key terms and future consideration of alternative forms of penalties, but that a uniform federal approach may not be necessary to address these shortcomings.
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Scherer JN, Schuch JB, Rocha MR, Assunção V, Silvestrin RB, Roglio VS, Limberger RP, Sousa TRV, Pechansky F. Drug use and driving behaviors among drivers with and without alcohol-related infractions. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:230-238. [PMID: 33084800 PMCID: PMC7879079 DOI: 10.1590/2237-6089-2019-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/12/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Brazil is one of the countries with the highest rates of alcohol-related traffic infractions, but little is known about the profile of the drivers who commit them. Identifying the characteristics of impaired drivers is essential for planning preventive actions. OBJECTIVE To compare drug use and driving behavior profiles of drivers with and without alcohol-related infractions. METHODS 178 drivers stopped at routine roadblocks were assessed by traffic agents who conducted standard roadblock procedures (document verification; request of a breathalyzer test [BT]). Drug use and driving behavior data were collected through semi-structured interviews. Subjects were divided into three groups: drivers who refused the BT (RDs, n = 72), drivers who tested positive on the BT (PDs, n = 34), and drivers who had committed other infractions (ODs, n = 72). RESULTS The proportion of alcohol use in the last year was higher among RDs (100%) than in the PD and OD groups (97.1% and 72.2% respectively, p < 0.001). Lifetime prevalence of cannabis and cocaine use for the overall sample was 44.3% and 18.2%, respectively. Fewer individuals in the OD group (31.5%) reported having been stopped at roadblocks in the previous year compared to the PDs (55.9%) and RDs (48.6%, p = 0.03). However, a higher proportion of RDs reported drunk driving in the same period (87.5%; PD 69.7%; OD 26.9%; p < 0.001). CONCLUSION Essential differences among groups were observed. RDs had a higher proportion of alcohol use and drunk driving in the previous year; drivers who fit into this particular group may be unresponsive or less responsive to social deterrence and enforcement actions.
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Affiliation(s)
- Juliana N Scherer
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jaqueline B Schuch
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Marcelo R Rocha
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Vanessa Assunção
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Roberta B Silvestrin
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Vinícius S Roglio
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Renata P Limberger
- Programa de Pós-Graduação em Ciências Farmacêuticas, UFRGS, Porto Alegre, RS, Brazil
| | - Tanara R V Sousa
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Erbella RA, Sanchez ZM, Wagner GA. Signs of altered psychomotor capacity and use of alcohol and other drugs among nightclub patrons who drive in the city of São Paulo, Brazil. TRAFFIC INJURY PREVENTION 2020; 21:330-334. [PMID: 32363941 DOI: 10.1080/15389588.2020.1759047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
Objectives: To investigate the occurrence of signs of altered psychomotor capacity (SAPC) associated with the violation of the dry law at the exits of nightclubs in the city of São Paulo, Brazil.Methods: Data from drivers participating in the Balada com Ciência project were used. Alcohol dosages were measured with breathalyzer test. The use of other drugs was obtained by interviewees' self-report. SAPC (speech, walking, glazed eyes, and alcohol odor) were verified by the interviewers at the time of the interview and categorized as "no sign" or "at least one sign". All measurements were evaluated at the exit of the nightclubs. The population description considered the sample weighting. Logistic regression analysis evaluated the association between the occurrence of SAPC, alcohol and other drugs use, controlling for sociodemographic variables.Results: At nightclubs, the SAPC among drivers are about 8 times higher when the breath alcohol concentration is above 0.05 mg/L if compared with those who did not drink alcohol, and about 30 times higher when the alcohol concentration was ≥ 0.34 mg/L in exhaled air. This finding is not generally verified in the literature for those who report the use of drugs inside nightclubs, which is interesting, since 20.4% of the interviewed population reported using drugs in the places surveyed.Conclusion: This study suggests the potential of using the Perham (2007) physical test for alcohol intoxication in sobriety checkpoints at the exit of nightclubs. However, the verification of these signs is not enough for the identification of drug use by drivers.
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Affiliation(s)
- Rafaella Aranha Erbella
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Zila M Sanchez
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Gabriela Arantes Wagner
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Borges G, Monteiro M, Cherpitel CJ, Orozco R, Ye Y, Poznyak V, Peden M, Pechansky F, Cremonte M, Reid SD, Mendez J. Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study. Alcohol Clin Exp Res 2017; 41:1731-1737. [PMID: 28905388 PMCID: PMC5679247 DOI: 10.1111/acer.13467] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/31/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). METHODS Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua, Panama, and Trinidad and Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the RTI with 2 control periods (prior d/wk), was performed using fractional polynomial analysis for dose-response. RESULTS About 1 in 6 RTI patients in EDs were positive for self-reported alcohol 6 hours prior to the injury (country range 8.6 to 24.1%). The likelihood of an RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50 to 15.00) and the more a person drinks the higher the risk. Every drink (12.8 g alcohol) increased the risk of an RTI by 13%, even 1 to 2 drinks were associated with a sizable increase in risk of an RTI and a dose-response was found. Differences in ORs for drivers (OR = 3.51; 95% CI = 2.25 to 5.45), passengers (OR = 8.12; 95% CI = 4.22 to 15.61), and pedestrians (OR = 6.30; 95% CI = 3.14 to 12.64) and attributable fractions were noted. Acute use of alcohol was attributable to 14% of all RTIs, varying from 7% for females to 19% for being injured as a passenger. CONCLUSIONS The finding that the presence of alcohol increases risk among drivers and nondrivers alike may further help to urge interventions targeting passengers and pedestrians. Routine screening and brief interventions in all health services could also have a beneficial impact in decreasing rates of RTIs. Higher priority should be given to alcohol as a risk factor for RTIs, particularly in Latin America and the Caribbean.
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Affiliation(s)
- Guilherme Borges
- National Institute of Psychiatry Ramon de la Fuente (Mexico City)- Calzada Mexico Xochimilco 101, Col. San Lorenzo Huipulco, Mexico City CP14370
| | | | | | - Ricardo Orozco
- National Institute of Psychiatry Ramon de la Fuente (Mexico City)- Calzada Mexico Xochimilco 101, Col. San Lorenzo Huipulco, Mexico City CP14370
| | - Yu Ye
- Alcohol Research Group (Emeryville, CA)
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, World Health Organization (WHO)
| | - Margie Peden
- Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization (WHO)
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clinicas de Porto Alegre - UFRGS / Federal University of Rio Grande do Sul, Brazil
| | | | - Sandra D Reid
- Caribbean Institute on Alcoholism and other Drug Problems, Trinidad & Tobago
| | - Jesus Mendez
- Instituto sobre Alcoholismo y Farmacodependencia, San Jose, Costa Rica
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