Improvements in readiness to change and drinking in primary care patients with unhealthy alcohol use: a prospective study

BACKGROUND. The course of alcohol consumption and cognitive dimensions of behavior change (readiness to change, importance of changing and confidence in ability to change) in primary care patients are not well described. The objective of the study was to determine changes in readiness, importance and confidence after a primary care visit, and 6-month improvements in both drinking and cognitive dimensions of behavior change, in patients with unhealthy alcohol use. METHODS. Prospective cohort study of patients with unhealthy alcohol use visiting primary care physicians, with repeated assessments of readiness, importance, and confidence (visual analogue scale (VAS), score range 1–10 points). Improvements 6 months later were defined as no unhealthy alcohol use or any increase in readiness, importance, or confidence. Regression models accounted for clustering by physician and adjusted for demographics, alcohol consumption and related problems, and discussion with the physician about alcohol. RESULTS. From before to immediately after the primary care physician visit, patients (n = 173) had increases in readiness (mean +1.0 point), importance (+0.2), and confidence (+0.5) (all p < 0.002). In adjusted models, discussion with the physician about alcohol was associated with increased readiness (+0.8, p = 0.04). At 6 months, many participants had improvements in drinking or readiness (62%), drinking or importance (58%), or drinking or confidence (56%). CONCLUSION. Readiness, importance and confidence improve in many patients with unhealthy alcohol use immediately after a primary care visit. Six months after a visit, most patients have improvements in either drinking or these cognitive dimensions of behavior change.Swiss National Science Foundation; Fondation Suisse de Recherche sur I'Alcool; Robert Wood Johnson Foundation (Generalist Faculty Physician Scholar Award

Ultra-brief intervention for problem drinkers: research protocol

Background: Helping the large number of problem drinkers who will never seek treatment is a challenging issue. Public health initiatives employing educational materials or mass media campaigns have met with mixed success. However, clinical research has developed effective brief interventions to help problem drinkers. This project will employ an intervention that has been validated in clinical settings and then modified into an ultra-brief format suitable for use as a public health intervention. The major objective of this study is to conduct a randomized controlled trial to establish the effectiveness of an ultra-brief, personalized feedback intervention for problem drinkers. Methods/design: Problem drinkers recruited on a baseline population telephone survey conducted in a major metropolitan city in Canada will be randomized to one of three conditions - a personalized feedback pamphlet condition, a control pamphlet condition, or a no intervention control condition. In the week after the baseline survey, households in the two pamphlet conditions will be sent their respective pamphlets. Changes in drinking will be assessed post intervention at three-month and six-month follow-ups. Drinking outcomes will be compared between experimental conditions using Structural Equation Modeling. The primary hypothesis is that problem drinkers from households who receive the personalized feedback pamphlet intervention will display significantly improved drinking outcomes at three and six-month follow-ups as compared to problem drinkers from households in the no intervention control condition. Secondary hypotheses will test the impact of the intervention on help seeking, and explore the mediating or moderating role of perceived drinking norms, perceived alcohol risks and the problem drinker's social reasons for drinking. Discussion: This trial will provide information on the effectiveness of a pamphlet-based personalized feedback intervention for problem drinkers in a community setting. Trial registration: ClinicalTrials.gov registration #NCT00688584.This study is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Grant #R01 AA015680-01A2

Measurement of ϒ production in pp collisions at √s = 2.76 TeV

The production of ϒ(1S), ϒ(2S) and ϒ(3S) mesons decaying into the dimuon final state is studied with the LHCb detector using a data sample corresponding to an integrated luminosity of 3.3 pb−1 collected in proton–proton collisions at a centre-of-mass energy of √s = 2.76 TeV. The differential production cross-sections times dimuon branching fractions are measured as functions of the ϒ transverse momentum and rapidity, over the ranges pT &#60; 15 GeV/c and 2.0 &#60; y &#60; 4.5. The total cross-sections in this kinematic region, assuming unpolarised production, are measured to be σ (pp → ϒ(1S)X) × B ϒ(1S)→μ+μ− = 1.111 ± 0.043 ± 0.044 nb, σ (pp → ϒ(2S)X) × B ϒ(2S)→μ+μ− = 0.264 ± 0.023 ± 0.011 nb, σ (pp → ϒ(3S)X) × B ϒ(3S)→μ+μ− = 0.159 ± 0.020 ± 0.007 nb, where the first uncertainty is statistical and the second systematic

Investigation of a Brief Teaching Encounter Using Standardized Patients: Teaching Residents Alcohol Screening and Intervention

OBJECTIVE: To investigate a brief teaching intervention using standardized patients (SPs) trained to improve residents' detection and advising of problem drinkers. DESIGN: Pretest-posttest design assessing resident behavior and skills. SUBJECTS: Nineteen internal medicine residents in a University Hospital General Internal Medicine Clinic. INTERVENTION: Announced SPs were interviewed by residents and presented to faculty who provided brief instruction on the National Institute on Alcohol Abuse and Alcoholism guidelines for screening and brief counseling of problem drinkers. MEASURE: Unannounced SPs assessed resident behavior and skills. RESULTS: Following the teaching intervention, 2 times more residents screened for alcohol use and nearly 3 times more residents did brief counseling. Residents reported that the intervention was informative and valuable. CONCLUSION: A single, 1-hour teaching intervention lead to a 2- to 3-fold increase in resident detection and advising of problem drinkers. SPs provide effective teaching encounters and a useful measure of resident behavior

Model-independent measurement of mixing parameters in D-0 -> K-S(0)pi(+)pi(-) decays

The first model-independent measurement of the charm mixing parameters in the decay D-0 -> K-S(0)pi(+)pi(-) is reported, using a sample of pp collision data recorded by the LHCb experiment, corresponding to an integrated luminosity of 1.0 fb(-1) at a centre-of-mass energy of 7 TeV. The measured values are x = (0.86 +/- 0.53 +/- 0.17) x 10(-2), y = (+0.03 +/- 0.46 +/- 0.13) x 10(-2), where the first uncertainties are statistical and include small contributions due to the external input for the strong phase measured by the CLEO collaboration, and the second uncertainties are systematic

Observation of the B (s) (0) -> aEuro parts per thousand J/psi I center dot I center dot decay

The B (s) (0) -> aEuro parts per thousand J/psi I center dot I center dot decay is observed in pp collision data corresponding to an integrated luminosity of 3 fb(-1) recorded by the LHCb detector at centre-of-mass energies of 7 TeV and 8 TeV. This is the first observation of this decay channel, with a statistical significance of 15 standard deviations. The mass of the B (s) (0) meson is measured to be 5367.08 +/- 0.38 +/- 0.15 MeV/c(2). The branching fraction ratio a?not sign(B (s) (0) -> aEuro parts per thousand J/psi I center dot I center dot)/a?not sign(B (s) (0) -> aEuro parts per thousand J/psi I center dot) is measured to be 0.0115 +/- A 0.0012 (-aEuro parts per thousand 0.0009) (+ 0.0005) . In both cases, the first uncertainty is statistical and the second is systematic. No evidence for non-resonant B (s) (0) -> aEuro parts per thousand J/psi I center dot K (+) K (-) or B (s) (0) -> aEuro parts per thousand J/psi K (+) K (-) K (+) K (-) decays is found