New and Updated Cochrane Systematic Reviews

A six-session intervention for harmful alcohol use was piloted via a 24-hour alcohol and other drug (AOD) helpline, assessing feasibility of telephone-delivered treatment. The intervention, involving practice elements from Motivational Interviewing, Cognitive-Behavioral Therapy, and node-link mapping, was evaluated using a case file audit (n = 30) and a structured telephone interview one month after the last session (n = 22). Average scores on the Alcohol Use Disorder Identification Test (AUDIT) dropped by more than 50%, and there were significant reductions in psychological distress. Results suggest that, even among dependent drinkers, a telephone intervention offers effective and efficient treatment for those unable or unwilling to access face-to-face treatment. Publication type: Journal: Article Source: EMBASE 12.Title: Economic analysis of costs for patients with end stage liver disease over the last year of life. Citation: BMJ supportive & palliative care, Mar 2015, vol. 5, no. 1, p. 110. (March 2015) Author(s): Gola, A, Davis, S, Greenslade, L, Hopkins, K, Low, J, Marshall, A, Thorburn, D, Vickerstaff, V, Jones, L Abstract: Liver disease is the third largest cause of death in the UK in people under the age of 65. With predicted increases in alcohol consumption, viral hepatitis and obesity, it is anticipated that the economic burden on the healthcare system will continue to rise. To evaluate costs of hospital admissions for patients with end-stage liver disease over the 12 months prior to death obtained from hospital records and case-note audit. The analysis includes all costs incurred during the admission, such as bed and board, nursing, specialist consultations, medications, investigations and surgery. We also compared costs of care for a cohort with terminal hospital admission and costs of care for those who spent the last days at a hospice. The mean cost per patient in the twelve months prior to death was £18,458, (SD=15,267), the mean total cost per hospital admission was £6,863 (SD=£6,631), the mean cost for individual admissions that ended in the patient's death i.e. the terminal admission, was £9,615 (SD=£8,443). Comparatively, for the patients who had a terminal admission at a hospice, the mean cost per terminal admission was £4,598 (SD=£5,818). There was no statistically significant difference in costs between patients with and without alcohol-related liver disease. Our analysis underlines the significant economic burden placed on the healthcare system by patients with end stage liver disease. On average, compared to costs associated with hospice death, costs for hospital deaths were double. With rates of liver disease set to increase, government policy needs to address challenges for future funding of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. Source: Medline 13.Title: Efficacy of supplementation with vitamin B6 vitamin B12 and folate in patients with alcoholic liver disease Citation: Hepatology International, March 2015, vol./is. 9/1 SUPPL. 1(S127), 1936-0533 (March 2015) Author(s): Ko S.Y., Kim J.H., Choe W.H., Kwon S.Y., Ahn H.S., Kim K.P., Chae H.B. Language: English Abstract: Background and aims: Although three essential B-vitamins (vitamin B6, vitamin B12, and folate) play a critical role in the methionine metabolic cycle related to the pathogenesis of experimental alcoholic liver disease (ALD), the effectiveness of B-vitamin supplementation is not known in clinical situation. The aims of this study were to identify changes between serum levels of methionine metabolites after 4 weeks of B-vitamin supplementation and determine the relationship between aberrant methionine metabolic cycle and B-vitamin supplementation in patients with ALD. Methods: At baseline, serum levels of liver function biochemical parameters, B-vitamins (vitamin B6, vitamin B12, and folate), and methionine metabolites (homocysteine, S-adenosylhomocysteine) were measured in 20 ALD patients and 20 healthy subjects. Among these 20 ALD patients, 10 patients (Group A) received 4-week Bvitamin supplementation, which included vitamin B6, vitamin B12, and folate. The other 10 patients (Group B) received 4-week B-vitamin supplementation without folate. Methionine metabolite levels, homocysteine and Sadenosylhomocysteine, were measured using stable isotope dilution liquid mass spectrometry. Results: Two groups of ALD patients showed an overall improvement in liver function biochemical parameters and B-vitamin levels after 4 weeks of B-vitamin supplementation. Serum homocysteine and Sadenosylhomocysteine levels tended to show reduction in the Group A patients after 4 weeks of B-vitamin supplementation, which included folate (P = 0.209 for HCY and P = 0.038 for SAH). Conclusions: Short-term abstinence and B-vitamin supplementation including folate may help improve nutritional status and methionine metabolite levels related to the aberrant methionine metabolic pathway. Efficacy of B-vitamin supplementation may require the regimen including folate supplementation. Publication type: Journal: Conference Abstract Source: EMBASE 14.Title: Explaining reactions to normative information about alcohol consumption: A test of an extended social identity model Citation: International Journal of Drug Policy, April 2015, vol./is. 26/4(388-395), 0955-3959;1873-4758 (01 Apr 2015) Author(s): Livingstone A.G., McCafferty S. Language: English Abstract: Background: To test the role of group identification and the perceived importance of alcohol consumption to a group identity in shaping reactions to normative information about alcohol consumption. Methods: The study had a 2 (behaviour: identity-defining/alcohol vs. non-identity defining/caffeine). x. 2 (norm: low vs. heavy consumption) between-subjects factorial design. Group identification and personal attitudes towards alcohol/caffeine consumption were included as measured predictors. Participants were 83 undergraduate students (44 female, 38 male, one unspecified) at a University in Scotland. Predictor and outcome variables included questionnaire measures of group (student) identification, personal attitudes to alcohol/caffeine consumption, the perceived importance of alcohol/caffeine consumption to group identity, and behavioral intentions to consume alcohol/caffeine. Results: Personal attitude and group identification moderated the impact of norm information on consumption intentions, but only for alcohol consumption, and not caffeine consumption. For alcohol, norm information did affect intended consumption (ps. <.034), with the crucial exception of high identifiers who had favourable personal attitudes towards alcohol consumption. Instead, these individuals resist norm information (ps = .458 and.174), showing no decrease in intentions in the face of norm information that emphasised relatively 'low' levels of consumption. Conclusions: The impact of norm information on alcohol consumption intentions depends on Background: To test the role of group identification and the perceived importance of alcohol consumption to a group identity in shaping reactions to normative information about alcohol consumption. Methods: The study had a 2 (behaviour: identity-defining/alcohol vs. non-identity defining/caffeine). x. 2 (norm: low vs. heavy consumption) between-subjects factorial design. Group identification and personal attitudes towards alcohol/caffeine consumption were included as measured predictors. Participants were 83 undergraduate students (44 female, 38 male, one unspecified) at a University in Scotland. Predictor and outcome variables included questionnaire measures of group (student) identification, personal attitudes to alcohol/caffeine consumption, the perceived importance of alcohol/caffeine consumption to group identity, and behavioral intentions to consume alcohol/caffeine. Results: Personal attitude and group identification moderated the impact of norm information on consumption intentions, but only for alcohol consumption, and not caffeine consumption. For alcohol, norm information did affect intended consumption (ps. <.034), with the crucial exception of high identifiers who had favourable personal attitudes towards alcohol consumption. Instead, these individuals resist norm information (ps = .458 and.174), showing no decrease in intentions in the face of norm information that emphasised relatively 'low' levels of consumption. Conclusions: The impact of norm information on alcohol consumption intentions depends on group-based factors such as group identification and the perceived importance of alcohol to a group identity. When both of these factors are high, and an individual also personally favours the behaviour, the potential for norm-based interventions to fail is increased. Publication type: Journal: Article Source: EMBASE 15.Title: How to prevent alcoholic liver disease Citation: Experimental and Molecular Pathology, April 2015, vol./is. 98/2(304-307), 0014-4800;1096-0945 (April 01, 2015) Author(s): French S.W. Language: English Abstract: Betaine supplements of alcoholic beverages are proposed to prevent the development of alcoholic liver disease in patients that abuse alcohol. This recommendation is based on the observation of studies where it has been shown in binge drinking and chronic ethanol feeding animal models that betaine prevents liver injury resulting from high blood alcohol levels. The basic observation is that betaine added to ethanol being ingested increases the elimination rate of blood alcohol, which prevents the blood alcohol levels (BALs) from reaching high levels. The mechanism of how betaine does this is postulated to be that betaine causes the increase in the elimination rate by increasing the metabolic rate which generates NAD the rate limiting cofactor of alcohol oxidation by ADH. Betaine does this most likely by supporting the methylation of norepinephrine to form epinephrine by phenylethanolamine N-methyltransferase. Epinephrine is 5 to 10-fold more active than norepinephrine in increasing the metabolic rate. Publication type: Journal: Article Source: EMBASE 16.Title: Is local alcohol outlet density related to alcohol-related morbidity and mortality in Scottish cities? Citation: Health and Place, May 2015, vol./is. 33/(172-180), 1353-8292;1873-2054 (May 01, 2015) Author(s): Richardson E.A., Hill S.E., Mitchell R., Pearce J., Shortt N.K. Language: English Abstract: Alcohol consumption may be influenced by the local alcohol retailing environment. This study is the first to examine neighbourhood alcohol outlet availability (onand off-sales outlets) and alcohol-related health outcomes in Scotland. Alcohol-related hospitalisations and deaths were significantly higher in neighbourhoods with higher outlet densities, and off-sales outlets were more important than on-sales outlets. The relationships held for most age groups, including those under the legal minimum drinking age, although were not significant for the youngest legal drinkers (18-25 years). Alcohol-related deaths and hospitalisations were higher in more income-deprived neighbourhoods, and the gradient in deaths (but not hospitalisations) was marginally larger in neighbourhoods with higher off-sales outlet densities. Efforts to reduce alcohol-related harm should consider the potentially important role of the alcohol retail environment Publication type: Journal: Article Source: EMBASE 17.Title: Kiosk versus In-person screening for alcohol and drug use in the emergency department: Patient preferences and disclosure Citation: Western Journal of Emergency Medicine, March 2015, vol./is. 16/2(220-228), 1936-900X;1936-9018 (01 Mar 2015) Author(s): Hankin A., Haley L., Baugher A., Colbert K., Houry D. Language: English Abstract: Introduction: Annually eight million emergency department (ED) visits are attributable to alcoholuse. Screening ED patients for at-risk alcohol and substance use is an integral component ofscreening, brief intervention, and referral to treatment programs, shown to be effective at reducingsubstance use. The objective is to evaluate ED patients' acceptance of and willingness to disclosealcohol/substance use via a computer kiosk versus an in-person interview. Methods: This was a cross-sectional, survey-based study. Eligible participants included thosewho presented to walk-in triage, were English-speaking, >18 years, were clinically stable andable to consent. Patients had the opportunity to access the kiosk in the ED waiting room, andwere approached for an in-person survey by a research assistant (9am-5pm weekdays). Bothsurveys used validated assessment tools to assess drug and alcohol use. Disclosure statistics andpreferences were calculated using chi-square tests and McNemar's test. Results: A total of 1,207 patients were screened: 229 in person only, 824 by kiosk, and 154 byboth in person and kiosk. Singlemodality participants were more likely to disclose hazardousdrinking (p=0.003) and high-risk drug use (OR=22.3 [12.3-42.2]; p<0.0001) via kiosk. Participantswho had participated in screening via both modalities were more likely to reveal high-risk drug useon the kiosk (p=0.003). When asked about screening preferences, 73.6% reported a preference foran in-person survey, which patients rated higher on privacy and comfort. Conclusion: ED patients were significantly more likely to disclose at-risk alcohol and substance use toa computer kiosk than an interviewer. Paradoxically patients stated a preference for in-person screening,despite reduced disclosure to a human screener. Publication type: Journal: Article Source: EMBASE Full text: Available Western Journal of Emergency Medicine at Western Journal of Emergency Medicine 18.Title: Online health check for reducing alcohol intake among employees: A feasibility study in six workplaces across england Citation: PLoS ONE, March 2015, vol./is. 10/3, 1932-6203 (23 Mar 2015) Author(s): Khadjesari Z., Newbury-Birch D., Murray E., Shenker D., Marston L., Kaner E. Language: English Abstract: Background Most hazardous and harmful drinkers are of working age and do not seek help with their drinking. Occupational health services are uniquely placed to universally screen employees across the range of socioeconomic and ethnic groups. The aim was to explore the feasibility and acceptability of offering electronic screening and brief intervention for alcohol misuse in the context of a health check in six different workplace settings. Methods and Findings Employees were recruited from six workplaces across England, including three local authorities, one university, one hospital and one petro-chemical company. A total of 1,254 (8%) employees completed the health check and received personalised feedback on their alcohol intake, alongside feedback on smoking, fruit and vegetable consumption and physical activity. Most participants were female (65%) and of 'White British' ethnicity (94%), with a mean age of 43 years (SD 11). Participants were mostly in Intermediate occupations (58%), followed by Higher managerial / professional (39%) and Routine and manual occupations (2%). A quarter of participants (25%) were drinking at hazardous levels (33% male, 21% female), which decreased with age. Sixty-four percent (n=797) of participants completed online follow-up at three months. Most participants were supportive of workplaces offering employees an online health check (95%), their preferred format was online (91%) and many were confident of the confidentiality of their responses (60%). Whilst the feedback reminded most participants of things they already knew (75%), some were reportedly motivated to change their behaviour (13%). Conclusions Online health screening and personalised feedback appears feasible and acceptable, but challenges include low participation rates, potentially attracting 'worried well' employees rather than those at greatest health risk, and less acceptance of the approach among older employees and those from ethnic minority backgrounds and routine or manual occupations. Publication type: Journal: Article Source: EMBASE Full text: Available ProQuest at PLoS ONE Full text: Available ProQuest at PLoS One 19.Title: Oral Care in Hepatology Nursing: Nurses’ Knowledge and Education. Citation: Gastroenterology Nursing, 01 January 2015, vol./is. 38/1(22-30), 1042895X Author(s): Ladegaard Groenkjaer, Lea Language: English Abstract: This study aimed, for the first time, to explore hepatology nurses’ knowledge and education in the oral care and oral health assessments of patients with liver cirrhosis. Liver cirrhosis can be associated with lifestyles and behaviors that contribute to oral neglect and untreated oral inflammation. This inflammation can represent foci for systemic infections, with increases in morbidity and mortality rates. A questionnaire consisting of 26 closedand open-ended questions was used to determine among heptalogy nurses the extent of knowledge, education, and current practices in oral healthcare among hepatology nurses. The study involved a sample of 94 nurses employed in different gastroenterology and hepatology units, with a response rate of 73%. The results indicated that respondents lacked substantial oral care education, both in connection with their initial training and after qualifying as nurses. The respondents had inadequate knowledge of basic oral health, the equipment used for oral care, and medications’ adverse effects on oral health. These results indicate a need for educational updates in cooperation with dentists and for the promotion of specific oral assessment guides in patients with liver cirrhosis. Publication type: journal article Source: CINAHL 20.Title: Personalized Feedback Based on a Drink-Pouring Exercise May Improve Knowledge of, and Adherence to, Government Guidelines for Alcohol Consumption Citation: Alcoholism: Clinical and Experimental Research, February 2015, vol./is. 39/2(317-323), 0145-6008;15300277 (01 Feb 2015) Author(s): De Visser R.O. Language: English Abstract: Background: Although most people are aware of government guidelines for alcohol consumption, few have accurate knowledge of these and fewer still use these guidelines to monitor their drinking. Most people also lack accurate knowledge of the alcohol content of the drinks they consume. The aim of the study reported here was to examine whether or not personalized feedback on alcohol consumption based on performance in a drink-pouring task and self-reported alcohol intake would improve university students' knowledge of alcohol consumption guidelines and reduce their alcohol intake. Methods: A quasi-randomized control trial with a 2-month follow-up was conducted with 200 students aged 18 to 37 in the south of England. Participants were allocated to a "pour + feedback" group that completed a drink-pouring task and received personalized feedback, a "pour only" group that completed the drink-pouring task but did not receive feedback, and a control group. Results: At follow-up, participants in the "pour + feedback" group had significantly better knowledge of government guidelines, and significantly lower weekly alcohol intake when compared to the "control" and "pour only" groups. Conclusions: Further refinement of the drink-pouring intervention and feedback is reported in this paper, and assessment of their impact in various populations may lead to better understanding of which elements of personalized feedback have the greatest influence on young people's alcohol use. Publication type: Journal: Article Source: EMBASE 21.Title: Pharmacotherapy for alcohol use disorder: Current and emerging therapies Citation: Harvard Review of Psychiatry, March 2015, vol./is. 23/2(122-133), 1067-3229;1465-7309 (18 Mar 2015) Author(s): Swift R.M., Aston E.R. Language: English Abstract: Alcohol use disorder is a heterogeneous illness with a complex biology that is controlled by many genes and gene-by-environment interactions. Several efficacious, evidence-based treatments currently exist for treating and managing alcohol use disorder, including a number of pharmacotherapies that target specific aspects of biology that initiate and maintain dangerous alcohol misuse. This article reviews the neurobiological and neurobehavioral foundation of alcohol use disorder, the mechanisms of action and evidence for the efficacy of currently approved medications for treatment, and the literature on other emerging pharmacotherapies. Publication type: Journal: Review Source: EMBASE 22.Title: Population pharmacokinetics of oxazepam in patients with alcohol use disorder Citation: Fundamental and Clinical Pharmacology, April 2015, vol./is. 29/(62), 0767-3981 (April 2015) Author(s): Imbert B., Marsot A., Liachenko N., Bazin M., Simon N. Language: English Abstract: Introduction: According to the guidelines, benzodiazepines are the reference medication to treat alcohol withdrawal syndrome. The doses of oxazepam used in this population may reach up to 300 mg per day, significantly higher than usual doses. Its optimal use in these patients requires further pharmacokinetic informations. The objective of this study was to investigate the pharmacokinetics of high doses of oxazepam in alcohol dependent patients treated for alcohol withdrawal syndrome. Material and methods: 63 outpatients (weight: 71.1 kg [45.0118.0]; Age: 47.6 years [31-67]) were studied. Total mean dose of 96.0 mg (20-300) per day was administered by oral route. Therapeutic drug monitoring allowed the measurement of 96 plasma concentrations. The following covariates were evaluated: demographic data (age, body weight, height, sex) and biological data (creatinine, AST, ALT, PAL, GGT). Pharmacokinetic analysis was performed by using a non-linear mixed-effect population model. Results: Data were modelled with a one-compartment pharmacokinetic model. The population typical mean (95% Confidence interval (90% CI)) values for clearance (CL), apparent volume of distribution (V) and resorption time (D1) were 6.8 L/h (3.9-8.0 L/h), 159 L (98.0-282 L) and 2 h (Fixed), respectively. The interindividual variability of CL and V, and residual variability (90% CI) were 74% (44-96%), 69% (40-89%) and 32% (20-41%), respectively. The elimination half-life was 16 h (range 3-42). Discussion/Conclusion: Oxazepam exhibited a linear pharmacokinetic with a proportional relationship from 20 to 300 mg per day, the dose range currently used in alcohol dependent patients treated for alcohol withdrawal syndrome. We did not find any evidence of drug accumulation with these doses [1-4]. Publication type: Journal: Conference Abstract Source: EMBASE 23.Title: Portrayal of alcohol intoxication on youtube Citation: Alcoholism: Clinical and Experimental Research, March 2015, vol./is. 39/3(496-503), 0145-6008;1530-0277 (01 Mar 2015) Author(s): Primack B.A., Colditz J.B., Pang K.C., Jackson K.M. Language: English Abstract: Background: We aimed to characterize the content of leading YouTube videos related to alcohol intoxication and to examine factors associated with alcohol intoxication in videos that were assessed positively by viewers. Methods: We systematically captured the 70 most relevant and popular videos on YouTube related to alcohol intoxication. We employed an iterative process to codebook development which resulted in 42 codes in 6 categories: video characteristics, character socio demographics, alcohol depiction, degree of alcohol use, characteristics associated with alcohol, and consequences of alcohol. Results: There were a total of 333,246,875 views for all videos combined. While 89% of videos involved males, only 49% involved females. The videos had a median of 1,646 (interquartile range [IQR] 300 to 22,969) "like" designations and 33 (IQR 14 to 1,261) "dislike" designations each. Liquor was most frequently represented, followed by beer and then wine/champagne. Nearly one-half (44%) of videos contained a brand reference. Humor was juxtaposed with alcohol use in 79% of videos, and motor vehicle use was present in 24%. There were significantly more likes per dislike, indicating more positive sentiment, when there was representation of liquor (29.1 vs. 11.4, p = 0.008), brand references (32.1 vs. 19.2, p = 0.04), and/or physical attractiveness (67.5 vs. 17.8, p < 0.001). Conclusions: Internet videos depicting alcohol intoxication are heavily viewed. Nearly, half of these videos involve a brand-name reference. While these videos commonly juxtapose alcohol intoxication with characteristics such as humor and attractiveness, they infrequently depict negative clinical outcomes. The popularity of this site may provide an opportunity for public health intervention. Publication type: Journal: Article Source: EMBASE 24.Title: Reasons why people change their alcohol consumption in later life: Findings from the Whitehall II Cohort Study Citation: PLoS ONE, March 2015, vol./is. 10/3, 1932-6203 (10 Mar 2015) Author(s): Britton A., Bell S. Language: English Abstract: Purpose Harmful alcohol consumption among the ageing population is an important public health issue. Very few studies ask drinkers why they change their consumption in later life. The aim of this paper was to determine whether a group of people aged over 60 years increased or decreased their alcohol consumption over the past decade and to determine the reasons for their change. We also examined whether the responses varied by age, sex and socioeconomic position (SEP). Subjects and Methods Data were taken from 6,011 participants (4,310 men, 1,701 women, age range 61 to 85 years) who completed questionnaires at phase 11 (2012-2013) of the Whitehall II Cohort Study. Results Over half the study members reported a change in alcohol consumption over the past decade (40% decreased, 11% increased). The most common reasons given for decreases were as a health precaution and fewer social occasions. Common reasons for increases were more social occasions and fewer responsibilities. The lowest SEP group was less likely to increase consumption compared to high SEP (RR 0.57, 95% CI 0.40 to 0.81). Women were more likely to increase consumption in response to stress/depression than men (RR1.53, 95% CI 1.04 to 2.25). Compared to high SEP, the lowest SEP group was less likely to reduce as a health precaution (RR 0.61, 95% CI 0.38 to 0.76). Conclusions Alcohol consumption in late life is not fixed. Reasons for change vary by age, sex and SEP. Such information could be used to tailor intervention strategies to reduce harmful consumption. Publication type: Journal: Article Source: EMBASE Full text: Available ProQuest at PLoS ONE Full text: Available ProQuest at PLoS One 25.Title: Relations of negative and positive work experiences to employee alcohol use: Testing the intervening role of negative and positive work rumination Citation: Journal of Occupational Health Psychology, April 2015, vol./is. 20/2(148-160), 1076-8998;1939-1307 (01 Apr 2015) Author(s): Frone M.R. Language: English Abstract: This study tested a model linking work experiences to employee alcohol use. The model extended past research in 3 ways. First, it incorporated both negative and positive work experiences. Second, it incorporated a previously unexplored cognitive intervening process involving negative and positive work rumination. Third, it incorporated several important dimensions of alcohol use (heavy use, workday use, and after-work use). Data were collected from a national probability sample of 2,831 U.S. workers. Structural equation modeling revealed that the conceptual model provided an excellent fit to the data. Negative work experiences were positively related to negative work rumination, which was positively related to heavy alcohol use, workday alcohol use, and after work alcohol use. Positive work experiences were positively related to positive work rumination, which was negatively related to heavy alcohol use and after work alcohol use, but was unrelated to workday alcohol use. The study also provided initial support for the psychometric properties and construct validity of the newly developed Negative and Positive Work Rumination Scale (NAPWRS). Publication type: Journal: Article Source: EMBASE Full text: Available Journal of occupational health psychology at Journal of Occupational Health Psychology 26.Title: Screening and brief intervention delivery in the workplace to reduce alcohol-related harm: A pilot randomized controlled trial. Citation: International Journal of Nursing Studies, 01 January 2015, vol./is. 52/1(39-48), 00207489 Author(s): Watson, Hazel, Godfrey, Christine, McFadyen, Angus, McArthur, Katherine, Stevenson, Marisa, Holloway, Aisha Language: English Abstract: Aim: To explore the feasibility and cost effectiveness of screening and delivery of a brief intervention for hazardous drinking employees. Methods: A pilot randomised controlled trial of a brief intervention delivered by an Occupational Health nurse versus no delivery of brief intervention (control group) conducted in a Local Authority Council (LCA) in the United Kingdom. Changes in quality of life and economic indicators were measured by the EQ5D. Results: 627 employees were screened of whom 163 (26.01%) fulfilled the inclusion criteria with a total of 57 (35%) agreeing to participate. No significant differences were found between the groups for baseline demographics or levels/patterns of alcohol consumption. A statistically significant effect was found in the mean AUDIT scores over time (F = 8.96, p = 0.004) but not for group (F = 0.017, p = 0.896), and no significant interaction was found (F = 0.148, p = 0.702). The cost of each intervention was calculated at £12.48, the difference in service costs was calculated at £344.50 per person; that is there was a net saving of health and other care costs in the intervention group compared to the control group. The QALYs fell in both intervention and control groups, the difference -0.002 (-0.010) yields a net advantage of the intervention of 0.008 QALYs. Conclusion: The main results from this pilot study suggest that alcohol brief interventions delivered in the workplace may offer the potential to reduce alcohol-related harm and save public sector resources. A fully powered multi-centre trial is warranted to contribute to the current evidence base and explore further the potential of alcohol brief interventions in the workplace. In a full trial the recruitment method may need to be re-considered. Publication type: journal article Source: CINAHL 27.Title: The pharmacogenetics of alcohol use disorder Citation: Alcoholism: Clinical and Experimental Research, March 2015, vol./is. 39/3(391-402), 0145-6008;1530-0277 (01 Mar 2015) Author(s): Jones J.D., Comer S.D., Kranzler H.R. Language: English Abstract: Background: Annually, the use and abuse of alcohol contributes to millions of deaths and billions of dollars in societal costs. To determine the impact of genetic variation on the susceptibility to the disorder and its response to treatment, studies have been conducted to assess the contribution of a variety of candidate genetic variants. These variants, which we review here, were chosen based upon their observed or hypothesized functional relevance to alcohol use disorder (AUD) risk or to the mechanism by which medications used to treat the disorder exert their effects. Methods: This qualitative review examines studies in which candidate polymorphisms were tested as moderator variables to identify pharmacogenetic effects on either the subjective response to alcohol or the outcomes of pharmacotherapy. Results: Although findings from these studies provide evidence of a number of clinically relevant pharmacogenetic effects, the literature is limited and there are conflicting findings that require resolution. Conclusions: Pharmacogenetic studies of AUD treatment that use greater methodological rigor and better statistical controls, such as corrections for multiple testing, may help to resolve inconsistent findings. These procedures could also lead to the discovery of more robust and clinically meaningful moderator effects. As the field evolves through methodological standardization and the use of larger study samples, pharmacogenetic research has the potential to inform clinical care by enhancing therapeutic effects and personalizing treatments. These efforts Background: Annually, the use and abuse of alcohol contributes to millions of deaths and billions of dollars in societal costs. To determine the impact of genetic variation on the susceptibility to the disorder and its response to treatment, studies have been conducted to assess the contribution of a variety of candidate genetic variants. These variants, which we review here, were chosen based upon their observed or hypothesized functional relevance to alcohol use disorder (AUD) risk or to the mechanism by which medications used to treat the disorder exert their effects. Methods: This qualitative review examines studies in which candidate polymorphisms were tested as moderator variables to identify pharmacogenetic effects on either the subjective response to alcohol or the outcomes of pharmacotherapy. Results: Although findings from these studies provide evidence of a number of clinically relevant pharmacogenetic effects, the literature is limited and there are conflicting findings that require resolution. Conclusions: Pharmacogenetic studies of AUD treatment that use greater methodological rigor and better statistical controls, such as corrections for multiple testing, may help to resolve inconsistent findings. These procedures could also lead to the discovery of more robust and clinically meaningful moderator effects. As the field evolves through methodological standardization and the use of larger study samples, pharmacogenetic research has the potential to inform clinical care by enhancing therapeutic effects and personalizing treatments. These efforts may also provide insights into the mechanisms by which medications reduce heavy drinking or promote abstinence in patients with an AUD. Publication type: Journal: Review Source: EMBASE 28.Title: Violence, self-harm and drug or alcohol misuse in adolescents admitted to hospitals in england for injury: A retrospective cohort study Citation: BMJ Open, 2015, vol./is. 5/2, 2044-6055 (2015) Author(s): Herbert A., Gilbert R., Gonzalez-Izquierdo A., Li L. Language: English Abstract: Objectives: Of adolescents in the general population in England, we aimed to determine (1) the proportion that has an emergency admission to hospital for injury related to adversity (violence, self-harm or drug or alcohol misuse) and (2) the risk of recurrent emergency admissions for injury in adolescents admitted with adversity-related injury compared with those admitted with accident-related injury only. Design: We used longitudinally linked administrative hospital data (Hospital Episode Statistics) to identify participants aged 10 -19 years with emergency admissions for injury (including day cases lasting more than 4 h) in England in 1998-2011. We used the Office for National Statistics mid-year estimates for population denominators. Results: Approximately 4.3% (n=141 248) of adolescents in the general population (n=3 254 046) had one or more emergency admissions for adversityrelated injury (girls 4.6%, boys 4.1%), accounting for 50% of all emergency admissions for injury in girls and 29.1% in boys. Admissions for self-harm or drug or alcohol misuse commonly occurred in the same girls and boys. Recurrent emergency admissions for injury were more common in adolescents with adversity-related injury (girls 17.3%, boys 16.5%) than in those with accident-related injury only (girls 4.7%, boys 7.4%), particularly for adolescents with adversityrelated injury related to multiple types of adversity (girls 21.1%, boys 24.2%). Conclusions: Hospital-based interventions should be developed to reduce the risk of future injury in adolescents admitted for adversity-related injury. Publication type: Journal: Article Source: EMBASE Full text: Available Highwire Press at BMJ Open 29.Title: Violence, self-harm and drug or alcohol misuse in adolescents admitted to hospitals in England for injury: a retrospective cohort study. Citation: BMJ open, Jan 2015, vol. 5, no. 2, p. e006079. (2015) Author(s): Herbert, Annie, Gilbert, Ruth, González-Izquierdo, Arturo, Li, Leah Abstract: Of adolescents in the general population in England, we aimed to determine (1) the proportion that has an emergency admission to hospital for injury related to adversity (violence, self-harm or drug or alcohol misuse) and (2) the risk of recurrent emergency admissions for injury in adolescents admitted with adversity-related injury compared with those admitted with accident-related injury only. We used longitudinally linked administrative hospital data (Hospital Episode Statistics) to identify participants aged 10-19 years with emergency admissions for injury (including day cases lasting more than 4 h) in England in 1998-2011. We used the Office for National Statistics mid-year estimates for population denominators. Approximately 4.3% (n=141 248) of adolescents in the general population (n=3 254 046) had one or more emergency admissions for adversity-related injury (girls 4.6%, boys 4.1%), accounting for 50% of all emergency admissions for injury in girls and 29.1% in boys. Admissions for self-harm or drug or alcohol misuse commonly occurred in the same girls and boys. Recurrent emergency admissions for injury were more common in adolescents with adversity-related injury (girls 17.3%, boys 16.5%) than in those with accident-related injury only (girls 4.7%, boys 7.4%), particularly for adolescents with adversity-related injury related to multiple types of adversity (girls 21.1%, boys 24.2%). Hospital-based interventions should be developed to reduce the risk of future injury in adolescents admitted for adversity-related injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. Source: Medline Full text: Available Highwire Press at BMJ Open 30.Title: Worsening of Health and a Cessation or Reduction in Alcohol Consumption to Special Occasion Drinking Across Three Decades of the Life Course Citation: Alcoholism: Clinical and Experimental Research, January 2015, vol./is. 39/1(166-174), 0145-6008;1530-0277 (01 Jan 2015) Author(s): Ng Fat L., Cable N., Shelton N. Language: English Abstract: Background: Ex-drinkers suffer from worse health than drinkers; however, whether a worsening of health is associated with a change in drinking status from early adulthood has not been previously investigated. We assess whether a worsening of health is associated with a cessation in consumption or reduction to special occasion drinking from early adulthood to middle age. Methods: Multinomial logistic regression assessing whether a change in self-reported limiting longstanding illness (LLI) was associated with ceasing alcohol consumption, or a reduction to special occasion drinking compared with being a persistent drinker from age 23 in separate models at ages 33, 42, and 50. All models adjusted for sex, poor psychosocial health, education, marital status, and children in the household. Sample included participants from Great Britain followed longitudinally in the National Child Development Study from ages 23 to 33 (N = 5,529), 42 (N = 4,787), and 50 (N = 4,476). Results: Developing an LLI from the previous wave was associated with ceasing alcohol consumption at ages 33 (odds ratio [ORs] = 2.71, 95% confidence interval [CI] = 1.16-4.93), 42 (OR = 2.44, 95%CI = 1.24-4.81), and 50 (OR = 3.33, 95%CI = 1.56-7.12) and a reduction to special occasion drinking at ages 42 (OR = 2.04, 95%CI = 1.40-2.99) and 50 (OR = 2.04, 95%CI = 1.183.53). Having a persistent LLI across 2 waves increased the odds of ceasing consumption at ages 42 (OR = 3.22, 95%CI = 1.06-9.77) and 50 (OR = 4.03, 95%CI = 1.72-9.44) and reducing consumption to special occasion drinking at ages 33 (OR = 3.27, 95%CI = 1.34-8.01) and 42 (OR = 2.25, 95%CI = 1.23-4.50). Persistent drinkers at older ages had the best overall health suffering less from previous poor health compared with those who reduced or ceased consumption at an earlier time point. Conclusions: Developing an LLI was associated with a cessation in alcohol consumption and a reduction in consumption to special occasion drinking from early adulthood. Persistent drinkers who drank at least till 50 were the healthiest overall. Health selection is likely to influence nondrinking across the life course. Publication type: Journal: Article Source: EMBASE 31.Title: Zonisamide, topiramate, and levetiracetam efficacy and neuropsychological effects in alcohol use disorders Citation: Journal of Clinical Psychopharmacology, February 2015, vol./is. 35/1(34-42), 0271-0749;1533-712X (01 Feb 2015) Author(s): Knapp C.M., Ciraulo D.A., Sarid-Segal O., Richardson M.A., Devine E., Streeter C.C., Oscar-Berman M., Surprise C., Colaneri L., Putnam M., Waters M., Richambault C. Language: English Abstract: The anticonvulsant topiramate not only decreases ethanol consumption in alcohol dependence (AD) but also may produce several adverse events including cognitive impairment. Zonisamide is a structurally related anticonvulsant that is a promising agent for the treatment of AD and may have greater tolerability than topiramate. This study evaluated the effects of zonisamide (400 mg/d) on alcohol consumption and its neurotoxic effects in subjects with AD. A double-blind placebo-controlled clinical trial was conducted using 2 comparator anticonvulsant drugs, topiramate (300 mg/d) and levetiracetam (2000 mg/d), which does not impair cognition. Study medications were administered for 14 weeks, including a 2-week taper period. Medication adherence was facilitated using Brief Behavioral Compliance Enhancement Treatment. The neurotoxicity of the study drugs was assessed using neuropsychological tests and the AB-Neurotoxicity Scale. Compared with placebo, both zonisamide and topiramate produced significant reductions in the drinks consumed per day, percent days drinking, and percent days heavy drinking. Only the percent days heavy drinking was significantly decreased in the levetiracetam group. The topiramate cell was the only group that had a significant increase on themental slowing subscale of the Neurotoxicity Scale compared with placebo at study weeks 11 and 12. Topiramate and zonisamide both producedmodest reductions in verbal fluency and working memory. These findings indicate that zonisamidemay have efficacy in the treatment ofAD, with effect sizes similar to topiramate. Both of these drugs produced similar patterns of cognitive impairment, although only the topiramate group reported significant increases in mental slowing. Publication type: Journal: Article Source: EMBASE Full text: Available Ovid at Journal of Clinical Psychopharmacology