Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

AIMS - To examine how the changes in women's relationship to alcohol during the 1960s appear in narratives of situated drinking occasions. DATA - Newly collected autobiographies written by women born between 1918 and 1951 are analysed using theories by William Labov on narrative construction and Kenneth Burke on the rhetoric of motives. RESULTS - The historically restrictive attitude to women at all drinking is present in the oldest women's narratives, while the liberalisation of attitudes to alcohol that took place in the 1960s likewise marks the narratives told by the younger women, even though they when writing are of pension able age. With the writers' diminishing age, the norms framing the narratives have changed, from sobriety among the oldest women to controlled moderation among the younger. And yet, the narratives also demonstrate a stable pattern of questioning women's drinking, although the focus has shifted from tasting alcohol at all to the state of becoming intoxicated. CONCLUSIONS - A controlling norm remains in place, which the women have internalised and made their own. The mitigating circumstances and the neutralising explanations that are presented throughout indicate that the women are conscious of the narratives' deviation from the prevailing norm, and show that women take a risk in drinking alcohol. When a woman drinks she risks her femininity.

Purpose – The purpose of this paper is to contribute to theory of hybrid organizations, with particular regard to state-owned enterprises (SOEs) and their ability to contribute to sustaining value pluralism in the public sector.

Design/methodology/approach – The paper offers a qualitative case concerning ongoing performance management reforms in the corporate governance of SOEs in Sweden, which is analyzed using theory on valuation and evaluation.

Findings – It is found that the number of non-financial values is reduced with reference to categorization. Attempts are made to change the perception of the potential value conflict at hand between financial and non-financial missions by adding a number of neutralizing “meta values” such as transparency and efficiency to the performance language in use. There is a risk of mission drift as a clear hierarchization of values, prioritizing financial values, is created and sustained in “investment teams.” Processes, standards and dialogues are all dominated by an economic logic despite formal aspirations to balance the values at stake. The few remaining non-financial values are translated into economic language aiming for a commensuration of the performance of the different missions. In addition, the ambition of the public policy assignment may be further reduced by de-coupling.

Originality/value – The paper suggests a novel approach to hybrid organizations in general and SOEs in particular when exploring how the values underlying complex missions are configured in “value work” performed by government officials in Swedish government offices. Such analyses of value work in the micro-practice of hybrids offer a more fine-grained understanding of organizational dilemmas that are commonly acknowledged, but more seldom explained in empirical detail.

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes

Background: The trend in the number of new problem drug users per year (incidence) is the most important measure for studying the diffusion of problem drug use. Due to sparse data sources and complicated statistical models, estimation of incidence of problem drug use is challenging. The aim of this study is to widen the palette of available methods and data types for estimating incidence of problem drug use over time, and for identifying the trends. Methods: This study presents a new method of incidence estimation, applied to people who inject drugs (PWID) in Oslo. The method took into account the transition between different phases of drug use progression - active use, temporary cessation, and permanent cessation. The Horwitz-Thompson estimator was applied. Data included 16 cross-sectional samples of problem drug users who reported their onset of injecting drug use. We explored variation in results for selected probable scenarios of parameter variation for disease progression, as well as the stability of the results based on fewer years of cross-sectional samples. Results: The method yielded incidence estimates of problem drug use, over time. When applied to people in Oslo who inject drugs, we found a significant reduction of incidence of 63% from 1985 to 2008. This downward trend was also present when the estimates were based on fewer surveys (five) and in the results of sensitivity analysis for likely scenarios of disease progression. Conclusion: This new method, which incorporates temporarily inactive problem drug users, may become a useful tool for estimating the incidence of problem drug use over time. The method may be less data intensive than other methods based on first entry to treatment and may be generalized to other groups of substance users. Further studies on drug use progression would improve the validity of the results.

Alcohol misuse is a complex systemic problem. The aim of this study was to explore the feasibility of using a transparent and participatory agent-based modelling approach to develop a robust decision support tool to test alcohol policy scenarios before they are implemented in the real world. A consortium of Australia's leading alcohol experts was engaged to collaboratively develop an agent-based model of alcohol consumption behaviour and related harms. As a case study, four policy scenarios were examined. A 19.5 +/- 2.5% reduction in acute alcohol-related harms was estimated with the implementation of a 3 a.m. licensed venue closing time plus 1 a.m. lockout; and a 9 +/- 2.6% reduction in incidence was estimated with expansion of treatment services to reach 20% of heavy drinkers. Combining the two scenarios produced a 33.3 +/- 2.7% reduction in the incidence of acute alcohol-related harms, suggesting a synergistic effect. This study demonstrates the feasibility of participatory development of a contextually relevant computer simulation model of alcohol-related harms and highlights the value of the approach in identifying potential policy responses that best leverage limited resources.

Foucault's work has inspired studies examining how subject positions are constructed for citizens of the welfare state that encourage them to adopt the subject position of active and responsible people or consumers. Yet these studies are often criticised for analysing these subject positions as coherent constructions without considering how their construction varies from one situation to another. This paper develops the concept of subject position in relation to the theory of justification and the concept of modality in order to achieve a more sensitive and nuanced analysis of the politics of welfare in public debates. The theory of justification places greater weight on actors' competence in social situations. It helps to reveal how justifications and critiques of welfare policies are based on the skilful contextual combination of diverse normative bases. The concept of modality, in turn, makes it possible to elaborate how subject positions in justifications and critiques of welfare policies become associated with specific kinds of values. We demonstrate the approach by using public debates on children's day care in Finland. The analysis illustrates how subject positions are justified in relation to different kinds of worlds and made persuasive by connecting them to commonly desirable rights, responsibilities, competences or abilities.

Under år 2008 fördes cirka 424 miljoner cigaretter in i Sverige från utlandet i samband med svenskars utlandsresor. I jämförelse med år 2007 har ingen förändring skett. Antalet köpta smuggelcigaretter har däremot ökat mellan 2007 och 2008 från 144 miljoner till 440 miljoner dvs. med cirka 205 procent. Köp av privatimporterade cigaretter, det vill säga köp av cigaretter som privatpersoner lagligt fört in i landet och sålt vidare utan kommersiellt syfte, uppgick år 2008 till cirka 134 miljoner vilket i jämförelse med år 2007 är en ökning med cirka 6 procent. Sammantaget så ökade därmed den oregistrerade cigarettkonsumtionen under 2008 med cirka 44 procent i jämförelse med 2007 (998 miljoner mot 694 miljoner). Den registrerade (i Sverige beskattade) cigarettförsäljningen minskade under 2008 samtidigt som den oregistrerade cigarettkonsumtionens andel av den totala cigarettkonsumtionen (det vill säga den registrerade och den oregistrerade sammantaget), ökade från 9,5 procent under 2007 till 14 procent för 2008. Den totala cigarettkonsumtionen fortsätter dock att minska under 2008 och var ca 2,7 procent lägre än 2007 och 7,7 procent lägre än 2006. Denna utveckling får stöd i andra uppgifter som visar att andelen dagligrökare minskat under samma period. I denna rapport skattades också den oregistrerade snuskonsumtionen för år 2008 vilken uppgick till cirka 30,8 miljoner dosor varav 17 miljoner var resandeinförda (främst från Finland) och cirka 9,7 miljoner hade beställts via Internet. Köp av smuggelsnus uppgick till cirka 4 miljoner dosor. Detta är i jämförelse med år 2007 en total ökning med cirka 320 procent (30,8 miljoner mot 7,3 miljoner).

This article summarizes the contents of Alcohol: No Ordinary Commodity (2nd edn). The first part of the book describes why alcohol is not an ordinary commodity, and reviews epidemiological data that establish alcohol as a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. This section also documents how international beer and spirits production has been consolidated recently by a small number of global corporations that are expanding their operations in Eastern Europe, Asia, Africa and Latin America. In the second part of the book, the scientific evidence for strategies and interventions that can prevent or minimize alcohol-related harm is reviewed critically in seven key areas: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drink-driving countermeasures, restrictions on marketing, education and persuasion strategies, and treatment and early intervention services. Finally, the book addresses the policy-making process at the local, national and international levels and provides ratings of the effectiveness of strategies and interventions from a public health perspective. Overall, the strongest, most cost-effective strategies include taxation that increases prices, restrictions on the physical availability of alcohol, drink-driving countermeasures, brief interventions with at risk drinkers and treatment of drinkers with alcohol dependence.

Drug Policy and the Public Good presents the accumulated scientific knowledge of direct relevance to the development of drug policy on local, national, and international levels. The book explores both illicit drug use and non-medical use of prescription medications within a public health perspective. A conceptual basis for a rational drug policy is presented, along with new epidemiological data on the global dimensions of drug misuse, significant trends in drug epidemics, and the global burden of disease attributable to drug misuse. The markets for both illicit and legally prescribed psychoactive substances are described, showing that these two sources of drug supply are becoming increasingly connected in many countries. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; treatment interventions and harm reduction approaches; attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; decriminalization and penal approaches; and control of the legal market through prescription drug regimes. The final chapters discuss the trend toward legalization of some psychoactive substances in different parts of the world and describe the need for a new approach to drug policy that is evidence-based, realistic, and coordinated. The evidence reviewed in this book suggests that an integrated and balanced approach to evidence-informed drug policy is more likely to benefit the public good than are uncoordinated efforts to reduce drug supply and demand.

The second edition of Drug Policy and the Public Good presents up-to-date evidence relating to the development of drug policy at local, national and international levels. The book explores both illicit drug use and non-medical use of prescription medications from a public health perspective. The core of the book is a critical review of the scientific evidence in five areas of drug policy: (1) primary prevention programs in schools and other settings; (2) treatment interventions and harm reduction approaches; (3) attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; (4) penal approaches, decriminalization and other alternatives; and (5) control of the legal market through prescription drug regimens. It also discusses the trend towards legalization of some psychoactive substances in some countries and the need for a new approach to drug policy that is evidence-based, realistic and coordinated. The accumulated evidence provides important information about effective and ineffective policies. Shifting the emphasis towards a public health approach should reduce the extent of illicit drug use, prevent the escalation of new epidemics and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties.

Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence.

http://www.who.int/substance_abuse/publications/treatment/en/index.html