Background Alcohol-attributable costs to society are captured by cost-of-illness studies, however estimates are often not comparable, e.g. due to the omission of relevant cost components. In this contribution we (1) summarize the societal costs attributable to alcohol use, and (2) estimate the total costs under the assumption that all cost components are considered. Methods A systematic review and meta-analyses were conducted for studies reporting costs from alcohol consumption for the years 2000 and later, using the EMBASE and MEDLINE databases. Cost estimates were converted into 2019 international dollars (Int$) per adult and into percentage of gross domestic product (GDP). For each study, weights were calculated to correct for the exclusion of cost indicators. Results Of 1708 studies identified, 29 were included, and the mean costs of alcohol use amounted to 817.6 Int$ per adult (95% confidence interval [CI] 601.8–1033.4), equivalent to 1.5% of the GDP (95% CI 1.2–1.7%). Adjusting for omission of cost components, the economic costs of alcohol consumption were estimated to amount to 1306 Int$ per adult (95% CI 873–1738), or 2.6% (95% CI 2.0–3.1%) of the GDP. About one-third of costs (38.8%) were incurred through direct costs, while the majority of costs were due to losses in productivity (61.2%). Discussion The identified cost studies were mainly conducted in high-income settings, with high heterogeneity in the employed methodology. Accounting for some methodological variations, our findings demonstrate that alcohol use continues to incur a high level of cost to many societies. Registration PROSPERO #CRD42020139594.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with significant dyspnea and limited exercise capacity. This systematic review aimed to synthesize evidence of exercise interventions during pulmonary rehabilitation that aim to improve exercise capacity, dyspnea, and health-related quality of life (HRQL) in IPF patients. Methods: Searches were performed in MEDLINE, Embase, CENTRAL, SPORTDiscus, PubMed and PEDro from inception to January 2019 using search terms for: (I) participants: ‘IPF or interstitial lung disease’; (II) interventions: ‘aerobic training or resistance training or respiratory muscle training’; and (III) outcomes: ‘exercise capacity or dyspnea or health-related quality of life’. Two reviewers independently screened titles, abstracts and full texts to identify eligible studies. Methodological quality of studies was assessed using the Downs and Black checklist and meta-analyses were performed. Results: Of 1,677 articles identified, 14 were included (four randomized controlled trials and 10 prospective pre-post design studies) that examined 362 patients receiving training and 95 control subjects. Exercise capacity was measured with the 6-minute walk distance, peak oxygen consumption, peak work rate, or endurance time for constant work rate cycling, which increased after exercise [aerobic exercise; aerobic and breathing exercises; aerobic and inspiratory muscle training (IMT) exercises] compared to the control groups. Dyspnea scores improved after aerobic and breathing exercises. HRQL also improved after aerobic exercise training alone or combined with breathing exercises. Aerobic training alone or combined with IMT or breathing exercises improved exercise capacity. Conclusions: Breathing exercises appears to complement exercise training towards improved dyspnea and HRQL in patients with IPF.

This contribution gives an overview on estimating the economic impact of substance use (SU) and substance use disorders (SUDs) from a societal perspective.In this Expert Review, we first discuss th...