Can screening and brief intervention lead to population-level reductions in alcohol-related harm?

A distinction is made between the clinical and public health justifications for screening and brief intervention (SBI) against hazardous and harmful alcohol consumption. Early claims for a public health benefit of SBI derived from research on general medical practitioners' (GPs') advice on smoking cessation, but these claims have not been realized, mainly because GPs have not incorporated SBI into their routine practice. A recent modeling exercise estimated that, if all GPs in England screened every patient at their next consultation, 96% of the general population would be screened over 10 years, with 70-79% of excessive drinkers receiving brief interventions (BI); assuming a 10% success rate, this would probably amount to a population-level effect of SBI. Thus, a public health benefit for SBI presupposes widespread screening; but recent government policy in England favors targeted versus universal screening, and in Scotland screening is based on new registrations and clinical presentation. A recent proposal for a national screening program was rejected by the UK National Health Service's National Screening Committee because 1) there was no good evidence that SBI led to reductions in mortality or morbidity, and 2) a safe, simple, precise, and validated screening test was not available. Even in countries like Sweden and Finland, where expensive national programs to disseminate SBI have been implemented, only a minority of the population has been asked about drinking during health-care visits, and a minority of excessive drinkers has been advised to cut down. Although there has been research on the relationship between treatment for alcohol problems and population-level effects, there has been no such research for SBI, nor have there been experimental investigations of its relationship with population-level measures of alcohol-related harm. These are strongly recommended. In this article, conditions that would allow a population-level effect of SBI to occur are reviewed, including their political acceptability. It is tentatively concluded that widespread dissemination of SBI, without the implementation of alcohol control measures, might have indirect influences on levels of consumption and harm but would be unlikely on its own to result in public health benefits. However, if and when alcohol control measures were introduced, SBI would still have an important role in the battle against alcohol-related harm

Inclusive meson production in peripheral collisions of ultrarelativistic heavy ions

There exist several proposals to use Weizs\"{a}cker-Williams photons generated by ultrarelativistic heavy ions to produce exotic particles in $\gamma\gamma$ fusion reactions. To estimate the background conditions for such reactions we analyze various mechanisms of meson production in very peripheral collisions of ultrarelativistic heavy ions at RHIC and LHC energies. Besides $\gamma\gamma$ fusion they include also electromagnetic $\gamma A$ interactions and strong nucleon-nucleon interactions in grazing $AA$ collisions. All these processes are characterised by low multiplicities of produced particles. $\gamma A$ and $AA$ events are simulated by corresponding Monte Carlo codes, RELDIS and FRITIOF. In each of these processes a certain fraction of pions is produced close to the mid-rapidity region that gives a background for the $\gamma\gamma$ events. The possibility of selecting mesons produced in $\gamma\gamma$ fusion events via different $p_t$ cut procedures is demonstrated.Comment: 27 pages with 4 eps-figures included, uses axodraw.sty Tab.2 and 3 correcte

Carbon dioxide sequestration by direct mineral carbonation with carbonic acid

The Albany Research Center (ARC) of the U.S. Dept. of Energy (DOE) has been conducting a series of mineral carbonation tests at its Albany, Oregon, facility over the past 2 years as part of a Mineral Carbonation Study Program within the DOE. Other participants in this Program include the Los Alamos National Laboratory, Arizona State University, Science Applications International Corporation, and the DOE National Energy Technology Laboratory. The ARC tests have focused on ex-situ mineral carbonation in an aqueous system. The process developed at ARC utilizes a slurry of water mixed with a magnesium silicate mineral, olivine [forsterite end member (Mg2SiO4)], or serpentine [Mg3Si2O5(OH)4]. This slurry is reacted with supercritical carbon dioxide (CO2) to produce magnesite (MgCO3). The CO2 is dissolved in water to form carbonic acid (H2CO3), which dissociates to H+ and HCO3 -. The H+ reacts with the mineral, liberating Mg2+ cations which react with the bicarbonate to form the solid carbonate. The process is designed to simulate the natural serpentinization reaction of ultramafic minerals, and for this reason, these results may also be applicable to in-situ geological sequestration regimes. Results of the baseline tests, conducted on ground products of the natural minerals, have been encouraging. Tests conducted at ambient temperature (22 C) and subcritical CO2 pressures (below 73 atm) resulted in very slow conversion to the carbonate. However, when elevated temperatures and pressures are utilized, coupled with continuous stirring of the slurry and gas dispersion within the water column, significant reaction occurs within much shorter reaction times. Extent of reaction, as measured by the stoichiometric conversion of the silicate mineral (olivine) to the carbonate, is roughly 90% within 24 hours, using distilled water, and a reaction temperature of 185?C and a partial pressure of CO2 (PCO2) of 115 atm. Recent tests using a bicarbonate solution, under identical reaction conditions, have achieved roughly 83% conversion of heat treated serpentine and 84% conversion of olivine to the carbonate in 6 hours. The results from the current studies suggest that reaction kinetics can be improved by pretreatment of the mineral, catalysis of the reaction, or some combination of the two. Future tests are intended to examine a broader pressure/temperature regime, various pretreatment options, as well as other mineral groups

Carbon dioxide sequestration by direct aqueous mineral carbonation

Carbon dioxide sequestration by an ex-situ, direct aqueous mineral carbonation process has been investigated over the past two years. This process was conceived to minimize the steps in the conversion of gaseous CO2 to a stable solid. This meant combining two separate reactions, mineral dissolution and carbonate precipitation, into a single unit operation. It was recognized that the conditions favorable for one of these reactions could be detrimental to the other. However, the benefits for a combined aqueous process, in process efficiency and ultimately economics, justified the investigation. The process utilizes a slurry of water, dissolved CO2, and a magnesium silicate mineral, such as olivine [forsterite end member (Mg2SiO4)], or serpentine [Mg3Si2O5(OH)4]. These minerals were selected as the reactants of choice for two reasons: (1) significant abundance in nature; and (2) high molar ratio of the alkaline earth oxides (CaO, MgO) within the minerals. Because it is the alkaline earth oxide that combines with CO2 to form the solid carbonate, those minerals with the highest ratio of these oxides are most favored. Optimum results have been achieved using heat pretreated serpentine feed material, sodium bicarbonate and sodium chloride additions to the solution, and high partial pressure of CO2 (PCO2). Specific conditions include: 155?C; PCO2=185 atm; 15% solids. Under these conditions, 78% conversion of the silicate to the carbonate was achieved in 30 minutes. Future studies are intended to investigate various mineral pretreatment options, the carbonation solution characteristics, alternative reactants, scale-up to a continuous process, geochemical modeling, and process economics

High-field Phase Diagram and Spin Structure of Volborthite Cu3V2O7(OH)2/2H2O

We report results of 51V NMR experiments on a high-quality powder sample of volborthite Cu3V2O7(OH)2/2H2O, a spin-1/2 Heisenberg antiferromagnet on a distorted kagome lattice. Following the previous experiments in magnetic fields $B$ below 12 T, the NMR measurements have been extended to higher fields up to 31 T. In addition to the two already known ordered phases (phases I and II), we found a new high-field phase (phase III) above 25 T, at which a second magnetization step has been observed. The transition from the paramagnetic phase to the antiferromagnetic phase III occurs at 26 K, which is much higher than the transition temperatures from the paramagnetic to the lower field phases I (B < 4.5 T) and II (4.5 < B < 25 T). At low temperatures, two types of the V sites are observed with different relaxation rates and line shapes in phase III as well as in phase II. Our results indicate that both phases II and III exhibit a heterogeneous spin state consisting of two spatially alternating Cu spin systems, one of which exhibits anomalous spin fluctuations contrasting with the other showing a conventional static order. The magnetization of the latter system exhibits a sudden increase upon entering into phase III, resulting in the second magnetization step at 26 T.We discuss the possible spin structure in phase III.Comment: 9 pages, 12 figure

Perioperative Research into Memory (PRiMe): Cognitive impairment following a severe burn injury and critical care admission, part 1

Introduction An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. Methods A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks. Results 15 patients (11M, 4F; 41 ± 14 years; TBSA 38.4% ± 18.5) and comparators (11M, 4F; 40 ± 13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1 ± 8.2, control 38.7 ± 3.2, p = 0.0004) and cognitive function (patient composite z-score 0.01, IQR −0.11 to 0.33, control 0.13, IQR 0.47–0.73, p = 0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p = 0.002). Cognitive function negatively correlated with burn severity (rBaux score, p = 0.04). QoL strongly correlated with depressive symptoms (Rho = −0.67, p = 0.009) but not cognitive function. Conclusions Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment