AimsTo 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

BackgroundSARS-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.MethodsData 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.ResultsAcross 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.ConclusionsOur 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.

Selecting medical equipment is a complex multidisciplinary task requiring mathematical tools, considering associated uncertainties. This paper offers an in-depth study of multiple-criteria decision analysis (MCDA) methods to identify the most appropriate ones for performing management tasks in resource-limited settings. The chosen articles were divided into three topics: evaluation of projects and equipment, selection of projects and equipment, and development of medical devices. Three methods (analytic hierarchy process [AHP], multi-attribute utility theory and elimination and choice expressing reality) were selected for detailed analyses of their application for medical equipment management. Twenty-one work using MCDA, artificial neural networks, human factors engineering, and value analysis were analysed in the framework of medical equipment management. The important aspects of the procedure were described, highlighting their advantages and disadvantages. It was determined that the AHP approach corresponds to all defined criteria for selecting large medical equipment. Managing large medical equipment using MCDA will reduce uncertainties, and provide a rational selection and purchase of the most efficient equipment in resource-limited settings. The direction for improving the AHP method was determined.

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.