Background Preventing nicotine use onset among children and youth is an important public health goal. One possible contributor that has received little empirical investigation is caffeine use. The goal of this study was to examine the possible contribution of caffeine to nicotine onset during early adolescence. Methods We used data from the Young Mountaineer Health Study Cohort. Survey data were collected from 1,349 (response rate: 80.7%) 6 th grade students (mean age at baseline 11.5 years) in 20 middle schools in West Virginia during the fall of 2020 and spring of 2021. We limited our analyses to students reporting never having used any form of nicotine at baseline. Logistic regression was employed in analyses. Results Approximately 8% of participants reported having used nicotine at least once between baseline and the follow-up, and 4.7% reported solely using electronic nicotine delivery systems (ENDS) and no other forms of nicotine. In multivariable analyses, we controlled for many environmental, social, and behavioral variables known to influence nicotine use such as alcohol use, peer substance use, and perceived access to nicotine. We formulated our main independent variable, caffeine consumption, as continuous deciles. Any nicotine use, as well as ENDS use only at follow-up, were modeled as dependent variables. Caffeine was significantly associated with nicotine use in both models with ORs of 1.15 (1.04–1.27) and 1.13 (1.00–1.28). Conclusions Caffeine consumption among 6 th grade non-nicotine users was associated with nicotine use at approximately 6-months follow-up.

This chapter provides an overview of the general principles and miscellaneous topics of clinical pharmacology that are relevant to pain medicine. This involves the World Health Organization (WHO) analgesic ladder which is mainly used for acute and cancer pain. Placebo and nocebo effects and their effect on clinical outcomes and treatment in pain medicine, as well as the principles of pre-emptive and preventative analgesia in acute pain, are described. Screening tools and management principles for patients with a substance use disorder are also included. Last, but not least, serotonin syndrome and its presentation are explained.

Alcohol use impairs psychosocial and neurocognitive development and increases youth vulnerability to academic failure, substance use disorder and other mental health problems. Early adolescent alcohol use onset is of particular concern, forecasting substance abuse in later adolescence and adulthood. Evidence to date suggests that youth in rural areas are especially vulnerable to contextual and community factors that contribute to early onset of alcohol use. The objective of the Young Mountaineer Health Study (YMHS) is to investigate the influence of contextual and health behavior variables on early onset of alcohol use among middle school-aged youth in resource-poor Appalachian rural communities. This is a program of prospective cohort studies of ~2,200 middle school youth from a range of twenty rural, small town, and small city (< 30k) public schools in West Virginia. Students participate in 6 waves of data collection (2 per year), over the course of middle school (6th- 8th grades, fall and spring). Based on an organizational arrangement which includes a team of local data collection leaders, supervising contact agents in schools, and an “honest broker” system to de-identify data linked via school IDs, we have been able to collect novel forms of data (self-report, teacher-report, census linked area data, and archival school records) while ensuring high rates of participation by a large majority of youth in each participating school. To date, three waves of student survey data, two waves of teacher data, and a selection of archival school records have been collected. Student survey Wave 1: N = 1,349 (response rate = 80.7%), Wave 2: N = 1,649 (response rate = 87.0%), and Wave 3: N = 1,909 (response rate = 83.1%). The COVID-19 pandemic had a negative impact on the sampling frame size, resulting in a reduced number of eligible students, particularly during the fall of 2020. Nevertheless, our team structure and incentive system has proven vitally important in mitigating a potentially far greater negative impact of the pandemic on our data collection processes. The YMHS will employ a large dataset to test pathways linking rural community disadvantage to alcohol misuse among early adolescents. Further, the program will test hypotheses regarding contextual factors (e.g., parenting practices, neighborhood collective efficacy) that protect youth from community disadvantage, and explore alcohol antecedents in the onset of nicotine, marijuana, and other drug use. So far, data collection efforts have been successful despite interruptions caused by the COVID-19 pandemic. Data quality checking, preliminary analyses, and manuscript preparations are currently under way. N/A

Preventing or delaying the onset of alcohol use among children and youth is an important public health goal. One possible factor in alcohol use onset among early adolescents is caffeine. The aim of this study was to assess the possible contribution of caffeine to the onset of alcohol use during early adolescence. We used data from the Young Mountaineer Health Study Cohort. Survey data were collected from 1349 (response rate: 80.7%) 6th grade students (mean age at baseline 11.5 years) in 20 middle schools in West Virginia during the fall of 2020, and again approximately 6 months later in spring of 2021. We limited our analyses to students reporting never having used any form of alcohol at baseline. Logistic regression was employed in multivariable analyses and both Odds Ratios and Relative Risks reported. At follow-up, almost 14% of participants reported having consumed alcohol at least once and 57% used caffeine of 100 mg + daily. In multivariable analyses we controlled for social and behavioral variables known to impact tobacco use. Caffeine use was operationalized as a three-level factor: no use, <100 mg per day, and 100 + mg per day, with the latter being the approximate equivalent of the minimum of a typical cup of coffee or can of energy drink. Caffeine use of 100 mg + per day was significantly related to alcohol use at 6-months follow-up (OR: 1.79, RR: 1.56, p = .037). We conclude that caffeine consumption among 11-12-year-old adolescents may be a factor in early onset of alcohol use.

This chapter provides an overview of the general principles and miscellaneous topics of clinical pharmacology that are relevant to pain medicine. This involves the World Health Organization (WHO) analgesic ladder which is mainly used for acute and cancer pain. Placebo and nocebo effects and their effect on clinical outcomes and treatment in pain medicine, as well as the principles of pre-emptive and preventative analgesia in acute pain, are described. Screening tools and management principles for patients with a substance use disorder are also included. Last, but not least, serotonin syndrome and its presentation are explained.

Objectives Caffeine is a habit-forming substance consumed daily by the majority of pregnant women. Accordingly, it is important that women receive sound evidence-based advice about potential caffeine-related harm. This narrative review examines evidence of association between maternal caffeine consumption and negative pregnancy outcomes, and assesses whether current health advice concerning maternal caffeine consumption is soundly based. Methods Database searches using terms linking caffeine and caffeinated beverages to pregnancy outcomes identified 1261 English language peer-reviewed articles. Screening yielded a total of 48 original observational studies and meta-analyses of maternal caffeine consumption published in the past two decades. The articles reported results for one or more of six major categories of negative pregnancy outcomes: miscarriage, stillbirth, low birth weight and/or small for gestational age, preterm birth, childhood acute leukaemia, and childhood overweight and obesity. Results Of 42 separate sets of findings reported in 37 observational studies, 32 indicated significantly increased caffeine-related risk and 10 suggested no or inconclusive associations. Caffeine-related increased risk was reported with moderate to high levels of consistency for all pregnancy outcomes except preterm birth. Of 11 studies reporting 17 meta-analyses, there was unanimity among 14 analyses in finding maternal caffeine consumption to be associated with increased risk for the four outcome categories of miscarriage, stillbirth, low birth weight and/or small for gestational age, and childhood acute leukaemia. The three remaining meta-analyses were also unanimous in reporting absence of a reliable association between maternal caffeine consumption and preterm birth. No meta-analyses were identified for childhood overweight and obesity, although four of five original observational studies reported significant associations linking maternal caffeine consumption to that outcome category. Conclusions The substantial majority finding from observational studies and meta-analyses is that maternal caffeine consumption is reliably associated with major negative pregnancy outcomes. Reported findings were robust to threats from potential confounding and misclassification. Among both observational studies and meta-analyses, there were frequent reports of significant dose–response associations suggestive of causation, and frequent reports of no threshold of consumption below which associations were absent. Consequently, current evidence does not support health advice that assumes 'moderate' caffeine consumption during pregnancy is safe. On the contrary, the cumulative scientific evidence supports pregnant women and women contemplating pregnancy being advised to avoid caffeine.

Background Adolescent caffeine consumption has been linked to aggressive behaviors, although no longitudinal tests have been reported to date. The purpose of this study was to test the longitudinal relations between daily adolescent caffeine consumption and aggressive behaviors. Methods Two waves of survey data collected 12 months apart in the spring of 2018 and 2019, from the 2004 birth cohort in the Icelandic LIFECOURSE study, were analyzed using structural equation modeling (N = 2,278). Both direct and mediated models were employed. Results Caffeine use at time 1 (T1) was associated with aggressive behavior at time 2 (T2) (β = .12, p < .001) independent of aggressive behavior at T1. A considerable added relation was observed between caffeine at T1 and aggressive behavior at T2 via indirect (i.e., mediated) effects of aggressive behavior at T1 (standardized β = .20, p < .001). Over 64% of the standardized total effect (β = .31) observed between caffeine at T1 and aggressive behavior at T2 was due to mediation. Conclusion Adolescent caffeine consumption forecasts aggressive behaviors. Caffeine use at T1 increased the likelihood of self-reported aggressive behaviors 12 months later irrespective of level of reported aggressive behavior at T1 while controlling for common confounders.

The session, held in September 2021, is an introduction to the work of Society and Leaning Research Priority Area (RPA), in which we examine the nature and role of the RPA as well as the ways in which it supports research in the university. The largest part of the event is an opportunity for staff to share a slide on their research, including the focus of the work, ongoing and potential projects, and opportunities for others to get involved.

Despite the immense value of scientific knowledge, academic publishing has long pursued an ethos of sharing rather than trade for profit.

Open access has long been an ideal of academic publishing. Yet, contrary to initial expectations, cost of access to published scientific knowledge increased following the advent of the Internet and electronic processing. An analysis of the ethicality of current arrangements in academic publishing shows that monetization and the sequestering of scientific knowledge behind paywalls breach the principle of fairness and damage public interest. Following decades of failed effort to redress the situation, there are ethical grounds for consumers of scientific knowledge to invoke the right of collective civil disobedience, including support for pirate open access. Could this be the best option available to consumers of scientific knowledge for removing paywalls to knowledge that rightly belongs in the public domain?

Open access has long been an ideal of academic publishing. Yet, contrary to initial expectations, cost of access to published scientific knowledge increased following the advent of the Internet and electronic processing. An analysis of the ethicality of current arrangements in academic publishing shows that monetization and the sequestering of scientific knowledge behind paywalls breach the principle of fairness and damage public interest. Following decades of failed effort to redress the situation, there are ethical grounds for consumers of scientific knowledge to invoke the right of collective civil disobedience, including support for pirate open access. Could this be the best option available to consumers of scientific knowledge for removing paywalls to knowledge that rightly belongs in the public domain?

Disclosing conflict of interest is widely believed to mitigate bias and harm from industry entanglement in healthcare research, education and practice. However, evidence is lacking of disclosure-related mitigation. Radical and extensive severing of industry ties to health care is necessary to curtail industry-related bias and harm.

I declare that I have no conflicts interest in relation to the contents of this article.

BACKGROUND AND AIMS:Despite the negative consequences associated with caffeine use among children and youth, its use is increasingly widespread among middle school students. Cross-sectional studies reveal links between caffeine and other substance use. The potential for caffeine use to confer increased vulnerability to substance use, however, has not been investigated using prospective designs. We hypothesized that caffeine use at baseline would be associated positively with increased alcohol use, drunkenness, smoking and e-cigarette use.DESIGN:Prospective cohort study with 12 months separating baseline from follow-up.SETTING:West Virginia, USA.PARTICIPANTS:Middle school students (6th and 7th grades; n = 3932) in three West Virginia (WV) counties provided data at baseline and follow-up 12 months later.MEASUREMENTS:Youth self-reported their use of caffeine from multiple sources (e.g. soda, energy drinks, coffee and tea), cigarette smoking, electronic cigarette use, alcohol use and drunkenness.FINDINGS:Cross-lagged path models for individual substance use categories provided a good fit to the data. Controlling for demographic variables and other substance use at baseline, caffeine at time 1 (T1) was associated positively with T2 cigarette smoking (β = 0.27, P = 0.001), e-cigarette use (β = 0.21, P = 0.001), alcohol use (β = 0.17, P = 0.001) and drunkenness (β = 0.15, P = 0.001). Conversely, non-significant relations emerged between three of four substances at T1 and caffeine at T2. Positive relations were found between e-cigarette use at T1 and caffeine use at T2 (β = 0.07, P = 0.006). These findings were supported by an omnibus model with all substances included. Specifically, significant relations were observed between caffeine at T1 and all substance use outcomes at T2, whereas no significant relations were observed between substance use and caffeine over time.CONCLUSIONS:Caffeine may promote early use of other types of substances among middle school-aged adolescents.

OBJECTIVE:Most adolescents regularly consume caffeine. Whereas observational studies have suggested that coffee may be cardio-protective, pharmacological experimentation with adults shows that caffeine at dietary doses increases blood pressure, thereby implicating regular caffeine consumption as a potential source of harm for cardiovascular health. The present study was in response to the dearth of caffeine research among younger consumers. It was hypothesised that compared to the consumption of little or no caffeine, adolescents who habitually consume caffeine have overall higher blood pressure and increased vascular resistance. METHOD:Using a quasi-experimental design, continuous measurements of blood pressure, cardiac output, and total peripheral resistance were taken non-invasively from adolescents (n = 333) aged 14-15 years and 18-19 years who reported "low", "moderate", or "high" levels of caffeine intake. Measurements were conducted when participants generally had negligible or low systematic caffeine levels while at rest, during stress, and during recovery from stress. RESULTS:Whereas habitual caffeine consumption did not predict blood pressure level, higher caffeine intake was associated with modestly increased vascular resistance during all phases of the experiment (i.e., at rest, during stress, and during recovery from stress). CONCLUSIONS:Present findings are important because they suggest that early exposure to caffeine may lead to persistent increases in vascular resistance, which in turn is an acknowledged risk factor for the development of hypertension. These results highlight the need for further studies of adolescents to determine the robustness of any persistent caffeine-related hemodynamic effects, and the implications such effects could have for long-term cardiovascular health.

Public financing to incentivise private sector innovation in antimicrobial pharmaceuticals is believed by many to be necessary to defeat growing threats from antimicrobial resistance. Large cash incentives from the public sector are said to be essential to stimulate 'normal' market forces capable of unleashing much-needed innovation. However, there is little evidence to suggest that lack of innovation in drug development is peculiar to antimicrobials or that current deficits in the supply of antimicrobials is due to unique inefficiencies in the antimicrobial market. Neither the history of drug development in general nor of antimicrobial innovation in particular supports economic interventions intended to stimulate private sector supply of new antimicrobials. On the contrary, public underwriting of the private sector, which by definition is compelled to prioritise profit, risks dire consequences for future global health.

Background: There is a large corpus of observational evidence claiming that coffee is health protective and a similarly large corpus of experimental psychopharmacological evidence to suggest that habitual caffeine consumption may be harmful to health. Aim: The purpose of this study was to examine the disjunction between observational and experimental findings with specific reference to the implications of coffee/caffeine consumption for elevated blood pressure, cardiovascular disease, type 2 diabetes and neurodegenerative disease. Method: Illustrative recent major reviews alleging health protective effects from coffee consumption were examined in light of findings from relevant experimental studies of caffeine. Findings: Decades-long coffee consumption is but one of countless lifestyle variables that may benefit or harm health. Contradictions concerning the implications of coffee/caffeine consumption for health between observational and experimental research are attributable mostly to poor control over potential confounders in observational studies. Conclusion: When considered in the context of experimental evidence concerning caffeine’s known pharmacological actions, there is reason to be sceptical about observational findings alleging health-protective effects from coffee consumption. Long-term randomised trials are needed to end the enduring interpretative disjunction between observational and experimental evidence concerning coffee/caffeine consumption and health.

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The Internet has triggered transformational change in the dissemination of science in the form of a global transition to open access (OA) publishing. Heavy investment favoring Gold over Green OA has been associated with increased total publication costs, inequality of opportunity to publish, and concerns about integrity in science reporting. Notwithstanding current fluidity because of ongoing competition for market share between supporters of the major alternative publishing strategies, emerging trends indicate the need for material and human resources to be redirected away from Gold and toward Green OA. Doing so will reduce total publication costs, increase equality of access for authors and readers, and remove the financial incentives that have encouraged poor and corrupt publishing practices.