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Introduction and Aims: Research on corporate behaviour can contribute to the understanding of the possible adverse impacts of alcohol‐industry corporate social responsibility (CSR) initiatives and their potential influence on policymaking. This study explores the association between alcohol‐industry CSR activities and selected country features in Latin America and the Caribbean. Design and Methods: Nine health experts evaluated 148 CSR activities using a standardised protocol; activities were classified into the categories risk management CSR (rmCSR), that is, to avoid/rectify externalities (n = 67), and strategic CSR, that is, to fulfill philanthropic responsibilities (n = 81). We evaluated the associations, separately, between the number of rmCSR and of strategic CSR actions in each country with threats from public health measures (specifically, the level of research into alcohol consumption and harms, the existence of an alcohol surveillance system and the number of governmental alcohol policy actions) and per capita alcohol consumption; we adjusted by economic indices (country income level and the gross domestic product) and population size. Results: Multivariate analyses showed that the higher the level of alcohol research within a country and its per capita consumption, the more likely rmSCR activities were to occur, independently of the country's economic development or population. Discussion and Conclusions: Results suggest rmSCR actions could be implemented as a way to preserve markets by counteracting scientific evidence about alcohol related harms. This evidence could serve as a starting point to future research, contributing to the understanding of alcohol industry behaviour and the advancement of effective public policies. [ABSTRACT FROM AUTHOR]

Alcohol consumption is the leading risk factor for morbi‐mortality in many Latin American Countries. However, epidemiologic studies are relatively scarce. Among factors such as limited research capacity, disciplinary traditions and an emphasis on psychopathology within the field of psychology, have been postulated to account for this. The aim of this article is to review epidemiologic research on alcohol in Spanish Speaking Latin American Countries, and to measure the contribution of psychology to the field. A systematic search was performed in English and Spanish using regional and international data bases. We identified 269 articles. Most focused on consumption patterns in youth, with samples from a single school and using a variety of measures. With the exception of multinational efforts like Emergency Room Collaborative Alcohol Analysis Project or those supported by World Health Organization/Pan American Health Organization, studies reviewed reflected little cross country collaboration. Mexico accounted for most of the productivity, while many countries had very few or no articles. Most research was performed by health science researchers with a small contribution from psychology, but which increased significantly over time. The results of this review provide a broad identification of patterns regarding epidemiologic research on alcohol, and demonstrate the need for national scientific policies to promote research on public health topics. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aims The aims were to: (1) identify, monitor and analyse the Corporate Social Responsibility (CSR) practices of the alcohol industry in Latin America and the Caribbean (LAC) and (2) examine whether the alcohol industry is using these actions to market their products and brands. Methods Nine health experts from Argentina, Brazil and Uruguay conducted a content analysis of 218 CSR activities using a standardized protocol. A content rating procedure was used to evaluate the marketing potential of CSR activities as well as their probable population reach and effectiveness. The LEAD procedure (longitudinal, expert and all data) was applied to verify the accuracy of industry-reported descriptions. Results A total of 55.8% of the actions were found to have a marketing potential, based on evidence that they are likely to promote brands and products. Actions with marketing potential were more likely to reach a larger audience than actions classified with no marketing potential. Most actions did not fit into any category recommended by the World Health Organization; 50% of the actions involving classroom and college education for young people were found to have marketing potential; 62.3% were classified as meeting the definition of risk management CSR. Conclusion Alcohol industry Corporate Social Responsibility activities in Latin America and the Caribbean appear to have a strategic marketing role beyond their stated philanthropic and public health purpose. [ABSTRACT FROM AUTHOR]

Current research suggests that Diagnostic and Statistical Manual of Mental Disorder (DSM)-IV alcohol abuse and dependence form a unidimensional continuum in emergency department (ED) patients in 4 countries: Argentina, Mexico, Poland, and the United States. In this continuum of alcohol use disorder (AUD), there are no clear-cut distinctions between the criteria for dependence and abuse in the severity dimension based on prior results from item response theory (IRT) analysis. Nevertheless, it is desirable to find a threshold for identifying cases for clinical practice and cut-points of clinical utility in this continuum to distinguish between patients more or less affected by an AUD, using a scale of symptoms count. Data from 5,193 patients in 7 ED sites in the same 4 countries (3,191 current drinkers) were used to study the structure, threshold, and possible cut-points for the diagnoses of AUD. The proposed changes in the DSM-V, dropping the abuse item 'legal problems' and adding an item on 'craving,' did not impact the IRT performance and unidimensionality of AUD in this sample. With a total set of 11 items (deleting 'legal problems' and adding 'craving' to the current set of DSM criteria), an endorsement of 2 or more criteria can be used as the threshold to define those with an AUD in clinical practice. Furthermore, we can distinguish at least 2 levels of clinical severity, 2 to 3 criteria (moderate), and 4 or more criteria (severe). A dimensional approach to AUD using the proposed new set of criteria for the DSM-V can be used to propose a threshold and levels of severity. More research in different populations and countries is needed to further substantiate a threshold and cut-points that could be used in new formulations of substance use disorders. [ABSTRACT FROM AUTHOR]

Background: While the validity of self-reported consumption based on blood alcohol concentration (BAC) has been found to be high in emergency room (ER) samples, little research exists on the estimated number of drinks consumed given a BAC level. Such data would be useful in establishing a dose–response relationship between drinking and risk (e.g., of injury) in those studies for which the number of drinks consumed is not available but BAC is. Methods: Several methods were used to estimate the number of drinks consumed in the 6 hours prior to injury based on BAC obtained at the time of ER admission of n = 1,953 patients who self-reported any drinking 6 hours prior to their injury and who arrived to the ER within 6 hours of the event, from the merged Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injury across 16 countries. Results: The relationship between self-reported consumption and averaged BAC within each consumption level appeared to be fairly linear up to about 7 drinks and a BAC of approximately 100 mg/dl. Above about 7 reported drinks, BAC appeared to have no relationship with drinking, possibly representing longer consumption periods than only the 6 hours before injury for those reporting higher quantities consumed. Both the volume estimate from the bivariate BAC to self-report relationship as well as from a Widmark calculation using BAC and time from last drink to arrival to the ER indicated a somewhat weak relationship to actual number of self-reported drinks. Conclusions: Future studies may benefit from investigating the factors suspected to be driving the weak relationships between these measures, including the actual time over which the reported alcohol was consumed and pattern of drinking over the consumption period. [ABSTRACT FROM AUTHOR]

Aims To replicate the finding that there is a single dimension trait in alcohol use disorders and to test whether the usual 5+ drinks for men and 4+ drinks for women and other measures of alcohol consumption help to improve alcohol use disorder criteria in a series of diverse patients from emergency departments (EDs) in four countries. Design Cross-sectional surveys of patients aged 18 years and older that reflected consecutive arrival at the ED. The Composite International Diagnostic Interview Core was used to obtain a diagnosis of DSM-IV alcohol dependence and alcohol abuse; quantity and frequency of drinking and drunkenness as well as usual number of drinks consumed during the last year. Setting Participants were 5195 injured and non-injured patients attending seven EDs in four countries: Argentina, Mexico, Poland and the United States (between 1995–2001). Findings Using exploratory factor analyses alcohol use disorders can be described as a single, unidimensional continuum without any clear-cut distinction between the criteria for dependence and abuse in all sites. Results from item response theory analyses showed that the current DSM-IV criteria tap people in the middle–upper end of the alcohol use disorder continuum. Alcohol consumption (amount and frequency of use) can be used in all EDs with the current DSM-IV diagnostic criteria to help tap the middle–lower part of this continuum. Even though some specific diagnostic criteria and some alcohol consumption variables showed differential item function across sites, test response curves were invariant for ED sites and their inclusion would not impact the final (total) performance of the diagnostic system. Conclusions DSM-IV abuse and dependence form a unidimensional continuum in ED patients regardless of country of survey. Alcohol consumption variables, if added, would help to tap patients with more moderate severity. The DSM diagnostic system for alcohol use disorders showed invariance and performed extremely well in these samples. [ABSTRACT FROM AUTHOR]

Aims To determine the relative risk (RR) of non-fatal injury associated with alcohol consumption in a series of emergency departments (EDs), possible effect modifiers and the impact of contextual variables on differences across sites. Design The case–crossover method was used to obtain RR estimates of the effect of alcohol on non-fatal injuries. Meta-analysis was used to evaluate the consistency and magnitude of RR across sites, and the extent to which contextual variables explain differences in effect sizes. Participants Probability samples of 11 536 injured patients attending 28 EDs studies in 16 countries (1984–2002). The majority of the sample was male (65%) and > 30 years old (53%). Measurements Exposed cases where those that consumed alcohol 6 hours prior to the injury. Usual alcohol consumption served as the control period. Findings Drinking within 6 hours prior to the injury was reported by 21% of the sample. The estimated (random) pooled relative risk for patients who reported alcohol use within 6 hours prior to injury was 5.69 (95% confidence interval = 4.04–8.00), ranging from 1.05 in Canada to 35.00 in South Africa. Effect size was not homogeneous across studies, as societies with riskier consumption patterns had a higher relative risk for injury. Heavier drinkers also showed lower RR. Conclusions Acute alcohol was a risk factor for non-fatal injuries in most sites. Policy measures addressed to the general population are recommended, especially in societies with riskier consumption patterns. [ABSTRACT FROM AUTHOR]