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Background: The present paper describes the results of a rating study performed by a group of European Union (EU) drug experts using the multi-criteria decision analysis model for evaluating drug harms. Methods: Forty drug experts from throughout the EU scored 20 drugs on 16 harm criteria. The expert group also assessed criteria weights that would apply, on average, across the EU. Weighted averages of the scores provided a single, overall weighted harm score (range: 0–100) for each drug. Results: Alcohol, heroin and crack emerged as the most harmful drugs (overall weighted harm score 72, 55 and 50, respectively). The remaining drugs had an overall weighted harm score of 38 or less, making them much less harmful than alcohol. The overall weighted harm scores of the EU experts correlated well with those previously given by the UK panel. Conclusion: The outcome of this study shows that the previous national rankings based on the relative harms of different drugs are endorsed throughout the EU. The results indicates that EU and national drug policy measures should focus on drugs with the highest overall harm, including alcohol and tobacco, whereas drugs such as cannabis and ecstasy should be given lower priority including a lower legal classification.

AbstractIntroductionFoetal alcohol spectrum disorders (FASD) are a set of preventable conditions where the foetus is exposed to alcohol in utero and as a result suffers adverse consequences. To develop a public health strategy related to FASD, it is important to first establish what is known by the public about this condition. This study aimed to assess the current level of knowledge about FASD in the UK general population.MethodsA mixed methodology study was conducted using a 17‐item questionnaire and focus group sessions. Four focus groups were held with an average of 10 people in each group. Semi‐structured questions and thematic analysis of interviews alongside quantitative analysis of the questionnaire data was completed. The research was approved by an National Health service (NHS) research ethical committee.ResultsA total of 674 people responded to the questionnaire and a majority (86.7%) had heard about FASD, with most receiving their information from the media (26.2%) or from their work (27.7%). Four broad themes emerged. Overall these were: a general lack of knowledge about the subject; information about the subject needed to be personally relevant; there was a need for further education; and there was a lack of clarity in the current guidance on alcohol use in pregnancy.Discussion and conclusionsCurrently there appears to be a superficial level of knowledge about FASD in the UK general public. More detailed work in subgroups, such as young women, to identify their specific needs may be necessary before targeted public health and educational interventions can be developed to meet the needs of the general public.

Locusts differ from ordinary grasshoppers in their ability to swarm over long distances and are among the oldest migratory pests. The ecology and biology of locusts make them among the most devastating pests worldwide and hence the calls for actions to prevent the next outbreaks. The most destructive of all locust species is the desert locust (Schistocerca gregaria). Here, we review the current locust epidemic 2020 outbreak and its causes and prevention including the green technologies that may provide a reference for future directions of locust control and food security. Massive locust outbreaks threaten the terrestrial environments and crop production in around 100 countries of which Ethiopia, Somalia and Kenya are the most affected. Six large locust outbreaks are reported for the period from 1912 to 1989 all being closely related to long-term droughts and warm winters coupled with occurrence of high precipitation in spring and summer. The outbreaks in East Africa, India and Pakistan are the most pronounced with locusts migrating more than 150 km/day during which the locusts consume food equivalent to their own body weight on a daily basis. The plague heavily affects the agricultural sectors, which is the foundation of national economies and social stability. Global warming is likely the main cause of locust plague outbreak in recent decades driving egg spawning of up to 2-400,000 eggs per square meter. Biological control techniques such as microorganisms, insects and birds help to reduce the outbreaks while reducing ecosystem and agricultural impacts. In addition, green technologies such as light and sound stimulation seem to work, however, these are challenging and need further technological development incorporating remote sensing and modelling before they are applicable on large-scales. According to the Food and Agriculture Organization (FAO) of the United Nations, the 2020 locust outbreak is the worst in 70 years probably triggered by climate change, hurricanes and heavy rain and has affected a total of 70,000 ha in Somalia and Ethiopia. There is a need for shifting towards soybean, rape, and watermelon which seems to help to prevent locust outbreaks and obtain food security. Furthermore, locusts have a very high protein content and is an excellent protein source for meat production and as an alternative human protein source, which should be used to mitigate food security. In addition, forestation of arable land improves local climate conditions towards less precipitation and lower temperatures while simultaneously attracting a larger number of birds thereby increasing the locust predation rates.

The maxillofacial region is by far the most frequently selected target in assaults on adults. There is a causal link between alcohol intoxication and injury. Therefore, oral and maxillofacial surgery is, in effect, the lead speciality for those injured in violence and has a responsibility to orchestrate holistic care that takes into account mental health needs. Recent years have also seen a determined effort by oral and maxillofacial surgeons to get involved in wider issues of prevention, exemplified by the national UK BAOMS Facial Injuries Awareness Week. Multi-agency prevention, not just with mental health professionals in the case of individual patients, but also with emergency medicine, public health, local government, the police and the voluntary sector is key to success. Given the potential complexity of collaborations like this, it is important to understand what works in multi-agency prevention. This paper reviews successful interventions: their rationale and how oral and maxillofacial surgeons can contribute to local injury prevention.

Although neurokinin 1 receptor antagonists prevent ethanol (EtOH)-induced gastric lesions, the mechanisms by which EtOH releases substance P (SP) and SP damages the mucosa are unknown. We hypothesized that EtOH activates transient receptor potential vanilloid 1 (TRPV1) on sensory nerves to release SP, which stimulates epithelial neurokinin 1 receptors to generate damaging reactive oxygen species (ROS). SP release was assayed in the mouse stomach, ROS were detected using dichlorofluorescein diacetate, and neurokinin 1 receptors were localized by immunofluorescence. EtOH-induced SP release was prevented by TRPV1 antagonism. High dose EtOH caused lesions, and TRPV1 or neurokinin 1 receptor antagonism and neurokinin 1 receptor deletion inhibited lesion formation. Coadministration of low, innocuous doses of EtOH and SP caused lesions by a TRPV1-independent but neurokinin 1 receptor-dependent process. EtOH, capsaicin, and SP stimulated generation of ROS by superficial gastric epithelial cells expressing neurokinin 1 receptors by a neurokinin 1 receptor-dependent mechanism. ROS scavengers prevented lesions induced by a high EtOH dose or a low EtOH dose plus SP. Gastric lesions are caused by an initial detrimental effect of EtOH, which is damaging only if associated with TRPV1 activation, SP release from sensory nerves, stimulation of neurokinin 1 receptors on epithelial cells, and ROS generation.

Quantitative aspects of the potentiation of GABA and muscimol by benzodiazepines and barbiturates are reviewed, taking account of both electrophysiological and receptor binding data. It has been a consistent finding that barbiturates cause a greater maximal potentiation than do benzodiazepines. The steroid anaesthetic alphaxalone and some naturally occurring steroids were compared as potentiators of electrophysiological responses to muscimol. From the relative potencies, important structural features of the steroid molecule for this effect have been identified. The possibility of the barbiturates and the steroids having a common mode of action as potentiators of GABA and muscimol is discussed, together with the idea that this action may involve perturbation of membrane lipids rather than a barbiturate/steroid receptor site. The GABA-potentiating effect of ethanol may also be barbiturate-like but potentiations by chlormethiazole and ketamine appear to involve different mechanisms. It is predicted that any endogenous potentiators of GABA would be unlikely to have more than a modest effect.

This '10 Questions' contribution provides an overview of thermal comfort in relation to ageing and the way the indoor environment can contribute to and improve well-being and health of older adults to age in-place. The number of older people is increasing rapidly and these demographical changes put a large stress on the health care system. Furthermore, as most older people wish to age-in-place, adequate ageing-in-place strategies become significantly important. Housing impacts health, therefore appropriate and comfortable housing is a key determinant to facilitate older people to age-in-place. One of the aspects of concern is thermal comfort; however, the thermal requirements of older people differ from those of young adults. They are also relatively vulnerable to thermal conditions outside the generally accepted range. This '10 Questions' contribution addresses issues related to thermal comfort and ageing and argues that the current models for assessing thermal comfort are not sufficiently accurate to be used for older adults. It also discusses approaches to facilitate ageing-in-place including the use of smart home technologies. The paper is based on extensive literature review of numerous relevant studies relating to thermal comfort, physiological differences between older and younger people, the relationship between thermal environment, comfort and health, as well as housing design and smart home technologies for older people. (C) 2017 Elsevier Ltd. All rights reserved.

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour;P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol2017;38:1430–1434