***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Veterans who served in Operation Enduring Freedom ( OEF ) and Operation Iraqi Freedom ( OIF ) commonly experience alcohol misuse and symptoms of posttraumatic stress disorder ( PTSD ) following their return from deployment to a war zone . We conducted a r and omized clinical trial to evaluate the efficacy of a newly developed , 8-module , self-management web intervention ( VetChange ) based on motivational and cognitive-behavioral principles to reduce alcohol consumption , alcohol-related problems , and PTSD symptoms in returning combat veterans . METHOD Six hundred participants , recruited through targeted Facebook ads , were r and omized to either an Initial Intervention Group ( IIG ; n = 404 ) or a Delayed Intervention Group ( DIG ; n = 196 ) that waited 8 weeks for access to VetChange . Primary outcome measures were Drinks per Drinking Day , Average Weekly Drinks , Percent Heavy Drinking Days , and PTSD symptoms . Intent-to-treat analyses compared changes in outcome measures over time between IIG and DIG as well as within-group changes . RESULTS IIG participants demonstrated greater reductions in drinking ( p < .001 for each measure ) and PTSD symptoms ( p = .009 ) between baseline and end-of-intervention than did DIG participants between baseline and the end of the waiting period . DIG participants showed similar improvements to those in IIG following participation in VetChange .  Alcohol problems were also reduced within each group between baseline and 3-month follow-up . CONCLUSIONS Results indicate that VetChange is effective in reducing drinking and PTSD symptoms in OIF/OEF veterans . Further studies of VetChange are needed to assess web-based recruitment and retention methods and to determine VetChange 's effectiveness in demographic and clinical sub- population s of returning veterans OBJECTIVE Brief intervention for patients with unhealthy alcohol use  is a prevention priority in the United States , but most eligible patients do not receive it . This study evaluated an electronic alcohol-counseling clinical reminder at a single Veterans Affairs general medicine clinic . METHOD The systems-level intervention evaluated in this study consisted of making the clinical reminder , which facilitated medical record documentation of brief intervention among patients who screened positive for unhealthy alcohol use , available to providers on one ( of two ) r and omly selected hallways . Secondary electronic data were extracted for all patients who visited the clinic ( October 1 , 2002 , to September 30 , 2005 ) . The proportion of patients with clinical -reminder use was evaluated among patients who screened positive for unhealthy drinking and were assigned to intervention hallway providers ( " descriptive cohort " ) . Adjusted logistic regression evaluated the association between the intervention and resolution of unhealthy drinking at follow-up among all screen-positive patients who completed a second Alcohol Use Disorders Identification Test Consumption question naire 18 months or longer after the first ( " outcomes cohort " ) . RESULTS Eligible patients ( N= 22,863 ) included 10,392 controls and 12,471 in the intervention group . Fifteen percent ( 398 of 2,640 ) of descriptive cohort patients with unhealthy drinking had clinical -reminder use , which varied by severity ( 14 % [ n = 302 of 2,165 ] with mild/moderate and 20 % [ n = 96 of 475 ] with severe unhealthy drinking , p = .001 ) . Only 39 % ( 156 of 398 ) of patients with clinical -reminder use had documented brief intervention ; advice to abstain was most common . Access to the clinical reminder was not significantly associated with resolution of unhealthy drinking in 1,358 patients in the outcomes cohort . CONCLUSIONS Availability of a clinical reminder to facilitate brief intervention did not , alone , result in substantial use of the clinical reminder . More active implementation efforts may be needed to get brief interventions onto the agenda of busy primary care providers BACKGROUND Little is known about the factors associated with leaving the armed forces , or what predicts subsequent employment success for veterans . It is likely that there is a complex interaction of adverse social outcomes and mental health status in this group . METHOD Analysis of existing data from the King 's Military Cohort , a large , r and omly selected , longitudinal cohort of service personnel , many of whom have now left the armed forces . The sample consisted of 8195 service personnel who served in the armed forces in 1991 ; a third deployed to the Gulf ( 1990 - 91 ) , a third deployed to Bosnia ( 1992 - 97 ) and the final third an ' Era ' control group in the Armed Forces in 1991 but not deployed . RESULTS The majority of service leavers do well after leaving and are in full-time employment . Those with poor mental health during service were more likely to leave and had a greater chance of becoming unemployed after leaving . Mental health problems appear to remain static for veterans after leaving . Veterans of the Gulf War enjoyed more favourable employment outcomes , provided that they came home well . CONCLUSIONS Only a minority of veterans fare badly after service , even amongst those with active tours of duty behind them . Veterans with mental health problems during service seem to be at higher risk of social exclusion after leaving and therefore these individuals represent an especially vulnerable group of the veteran population OBJECTIVE The purpose of this study was to test the efficacy of 2 brief interventions for alcohol misuse in a sample of combat veterans of the wars in Iraq and Afghanistan . METHOD Participants were 68 combat veterans ( 91.2 % male ; 64.7 % White , 27.9 % Black ) with a mean age of 32.31 years ( SD = 8.84 ) who screened positive for hazardous drinking in a Veterans Affairs Medical Center primary care clinic using the Alcohol Use Disorders Identification Test ( Babor , Higgins-Biddle , Saunders , & Monteiro , 2001 ) . More than half of the sample ( 57.4 % ) met criteria for posttraumatic stress disorder ( PTSD ; based on the Clinician-Administered PTSD Scale ; Blake et al. , 1995 ) . Eligible veterans who elected to participate completed a baseline assessment and were r and omized to receive 1 of 2 interventions ( personalized feedback delivered with or without a motivational interviewing counseling session ) . Both interventions included information on hazardous drinking , PTSD symptoms , depression , and coping . Follow-up assessment s were conducted at 6 weeks and 6 months post-intervention . RESULTS Both conditions result ed in statistically significant reductions in quantity and frequency of alcohol use as well as frequency of binge drinking and alcohol-related consequences . Within-group effect sizes ( ds ) were in the small to medium range ( .21-.55 ) for quantity and frequency of alcohol use . There were no statistically significant Condition × Time interactions , suggesting that both interventions were similarly effective . PTSD and non-PTSD veterans responded equally well to both interventions , but veterans with PTSD assigned to feedback plus motivational interviewing reported greater reductions in weekly drinking at the 6-week follow-up . CONCLUSIONS These findings suggest that brief interventions for alcohol misuse may be effective for reducing drinking , even in an Operation Enduring Freedom/Operation Iraqi Freedom veteran population with a high degree of PTSD AIMS To examine patterns of drinking in the UK Armed Forces , how they vary according to gender and other demographics , and to make comparisons with the general population . DESIGN Large cross-sectional postal question naire study ( response rate 60 % ) . SETTING United Kingdom . PARTICIPANTS A r and om representative sample of the regular UK Armed Forces who were in service in March 2003 ( n = 8686 ; 7937 men , 749 women ) . Comparisons were made with the general population of Great Britain . MEASUREMENTS Alcohol consumption was assessed using the  Alcohol Use Disorders Identification Test ( AUDIT ) .  FINDINGS Sixty-seven per cent of men and 49 % of women in the UK Armed Forces had an AUDIT score of 8 + ( defined as hazardous drinking ) , compared to 38 % of men and 16 % of women in the general population . In both sexes , for all ages , the military have a higher prevalence of hazardous drinking . Binge drinking was associated with being younger , being in the Army , being single , being a smoker and being white . Among military men , heavy drinking ( AUDIT score 16 + ) was associated with holding a lower rank , being younger , being single , being in the Naval Service or Army , being deployed to Iraq , not having children , being a smoker , having a combat role and having a parent with a drink or drug problem . CONCLUSIONS Excessive alcohol consumption is more common in the UK Armed Forces than in the general population . There are certain socio-demographic characteristics associated with heavy drinking within the military ; for example , young age , being single and being a smoker , which may allow the targeting of preventive interventions OBJECTIVE This study sought to examine whether a web-delivered brief alcohol intervention ( BAI ) is effective for reducing alcohol misuse in U.S. military veterans presenting to primary care . METHOD Veterans ( N = 167 ) screening positive for alcohol misuse during a routine primary care visit were r and omized to receive a BAI plus treatment as usual ( TAU ) or TAU alone . An assessment of alcohol-related outcomes was conducted at baseline and 3 and 6 months after treatment . RESULTS Veterans in both study conditions showed a significant reduction in alcohol quantity and frequency and alcohol-related problems at 6-month follow-up . No differential treatment effects on outcomes were observed between the two treatment groups . CONCLUSIONS This study is the first to explore whether a web-delivered BAI using normative feedback is effective for veterans with alcohol misuse . Our findings suggest that BAIs using normative feedback may not have any additional benefit beyond TAU for older veterans with high rates of comorbid mental health concerns R. Lorraine Collins State University of New York at Stony Brook George A. Parks and G. Alan Marlatt University of Washington Two studies were conducted to assess variables related to the social determinants of alcohol consumption . In Study 1 , moderate- and heavy-drinking male under- graduates  were paired with confederates who behaved in a sociable or unsociable manner while modeling either light or heavy consumption . Modeling occurred in the sociable conditions but not in the unsociable conditions , where subjects tended to drink heavily . In Study 2 , a similar group of subjects was exposed to one of three social status conditions crossed with light versus heavy consumption . The results indicated a modeling effect in all social status conditions . These studies provide further support for the existence of a modeling effect that can be disrupted by a lack of rapport between drinking partners . This latter finding has implication s for the etiology of problem drinking because it suggests that increased alcohol consumption may serve as a strategy for coping with aversive social interactions . Initial research on the effect of modeled consumption rates on social drinking ( Caudill & Marlatt , 1975 ) suggested that heavy-drink- ing men tended to match the consumption of their drinking partner whether his con- sumption was heavy or light . Subsequent examinations of this phenomenon replicated these findings in laboratory analogue drinking tasks such as the taste-rating task ( Cooper , Waterhouse , & Sobell , 1979 ; Hendricks , So- bell , & Cooper , 1978 ; Lied & Marlatt , 1979 ; Watson & Sobell , 1982 ) , natural bar setting s ( Reid , 1978 ) , and seminaturalistic bar setting s ( Caudill & Lipscomb , 1980 ) . Much of the research concerning the mod- eling of alcohol consumption has focused on manipulating characteristics of the model , including the nature of the social interaction between the model and the subject . The effects of manipulating social interaction are unclear . In the Caudill and Marlatt study , model 's drinking rate ( light vs. heavy ) and OBJECTIVE Research has shown that U.S. military veterans are at risk relative to the general adult population for excessive alcohol consumption , and veterans of the wars in Afghanistan and Iraq ( Operation Enduring Freedom [ OEF ] , Operation Iraqi Freedom [ OIF ] , and Operation New Dawn [ OND ] ) particularly so . The purpose of this study was to examine the efficacy of a brief personalized drinking feedback intervention tailored for veterans . METHOD All veterans who presented to the OEF/OIF/OND Seamless Transition Clinic at the Harry S. Truman Memorial Veterans ' Hospital ( Columbia , MO ) were eligible to participate . Participants were 325 veterans ( 93 % male ; 82 % White , 75 % Army , M(age ) = 32.20 years ) who were r and omly assigned to one of two conditions : personalized drinking feedback ( PDF ) or educational information ( EDU ) . Those in the PDF condition received personalized information about their alcohol use , including social norms comparisons , risks associated with reported drinking levels , and a summary of their alcohol-related problems . Follow-up assessment s were completed at 1 and 6 months after intervention ( response rates = 93 % and 86 % , respectively ) . RESULTS Results indicated a significant ( p < .05 ) Omnibus Group × Time effect for estimated peak blood alcohol concentration , although tests of simple main effects did not indicate between-group differences at the individual follow-up points . Among baseline abstainers , those in the PDF condition were more likely than those in the EDU condition to remain an abstainer at 6-month follow-up ( p < .05 ) . CONCLUSIONS These findings provide preliminary support for the efficacy of a brief , inexpensive alcohol prevention/intervention for young adult military veterans STUDY OBJECTIVE Opportunistic brief in-person emergency department ( ED ) interventions can be effective at reducing hazardous alcohol use in young adult drinkers , but require re sources frequently unavailable 
    Output:
    
The findings suggest some evidence for effectiveness of self-administered web-based interventions , involving personalised feedback over a number of sessions , and system-level electronic clinical reminders .
Delivery of interventions by a clinician during motivational interviews was most effective for those with post-traumatic stress disorder symptoms .