***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 BACKGROUND Heavy drinking is one of the leading causes of morbidity and mortality in young men .  Brief motivational intervention ( BMI ) has shown promising results for young people , but has never been tested in young men in the community who volunteered to receive an intervention . METHODS We evaluated the effectiveness of  BMI  in reducing alcohol use  among heavy episodic users and in maintaining low-risk drinking among nonheavy episodic users . Participants were French-speaking young men attending the m and atory Swiss army conscription process . They were offered the opportunity to receive a 20-minute BMI , and those interested were r and omized into an intervention group ( BMI immediately ) or into a control group ( BMI after the 6-month follow-up assessment , in a waiting list design ) . Analyses were conducted separately for heavy and nonheavy episodic users ( separated using baseline heavy episodic use frequency ) as the hypotheses tested were different between both groups ( primary vs. secondary prevention intervention ) . RESULTS From a pool of 6,085 young men invited to receive BMI , 727 ( 11.9 % ) showed up and 572 were included in the study ( after exclusions related to organizational aspects of the conscription process ) . Among nonheavy episodic users , there was a protective effect of BMI on weekly alcohol use ( p < 0.05 ) . Among heavy episodic users , there were no significant effects of BMI . CONCLUSIONS About 12 % of young men were interested in addressing their drinking within the BMI framework , suggesting that there is some need for easily accessible alcohol intervention . The present intervention did have a preventive effect among low-risk young drinkers in helping them maintain their patterns of alcohol use . An explanation for the lack of effectiveness among heavy episodic users might be that those individuals interested in BMI had patterns of more severe alcohol use , thereby making change more difficult OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity BACKGROUND Strong evidence exists for the efficacy of screening and brief intervention for reducing  hazardous drinking .  However , problems have been highlighted with respect to its implementation in health-care systems , not least of which is a reluctance of some doctors to discuss alcohol proactively with their patients . AIMS To determine the efficacy of a novel web-based screening and brief intervention ( e-SBI ) to reduce hazardous drinking . DESIGN A double-blind r and omized controlled trial . SETTING A university student health service . PARTICIPANTS A total of 167 students ( 17 - 26 years ) were recruited in the reception area and completed a 3-minute web-based screen including the Alcohol Use Disorder Identification Test ( AUDIT ) question naire . Of these , 112 tested positive , and 104 ( 52 females ) who consented to follow-up were included in the trial . MEASUREMENTS Drinking frequency , typical occasion quantity , total volume , heavy episode frequency ( females > 80 g ethanol , males > 120 g ethanol ) , number of personal problems , an academic problems score . INTERVENTION Participants were r and omized to 10 - 15 minutes of web-based assessment and personalized feedback on their drinking ( intervention , n = 51 ) or to a leaflet-only control group ( n = 53 ) . FINDINGS Mean baseline AUDIT scores for control and intervention groups were 16.6 ( SD = 6.0 ) and 16.6 ( SD = 5.7 ) . At 6 weeks , participants receiving e-SBI reported significantly lower total consumption ( geometric mean ratio = 0.74 ; 95 % confidence interval : 0.56 - 0.96 ) , lower heavy episode frequency ( 0.63 ; 0.42 - 0.92 ) and fewer personal problems ( 0.70 ; 0.54 - 0.91 ) . At 6 months personal problems remained lower ( 0.76 ; 0.60 - 0.97 ) , although consumption did not differ significantly . At 6 months , academic problems were lower in the intervention group relative to controls ( 0.72 ; 0.51 - 1.02 ) . CONCLUSIONS e-SBI reduced  hazardous drinking among university students , to an extent similar to that found for practitioner-delivered brief interventions in the general population . e-SBI offers promise as a strategy to reduce alcohol-related harm in a way that is non-intrusive , appealing to the target group , and capable of being incorporated into primary care . Research is required to replicate the findings , to determine the duration of intervention effects , and to investigate the mechanisms by which the intervention operates 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 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 Objective : Young-adult American veterans are at risk for problematic alcohol use . However , they are unlikely to seek care and may drop out from lengthy , multicomponent treatments when they do get care . This r and omized controlled trial tested a very brief alcohol intervention delivered over the Internet to reach the population of young-adult veterans to help reduce their drinking . Method : Veterans ( N = 784 ) were recruited from Facebook and r and omized to either a control condition or a personalized normative feedback ( PNF ) intervention seeking to correct drinking perceptions of gender-specific veteran peers . Results : At immediate postintervention , PNF participants reported greater reductions in their perceptions of peer drinking and intentions to drink over the next month , compared with control participants . At 1-month follow-up , PNF participants reduced their drinking behavior and related consequences to a significantly greater extent than controls . Specifically , PNF participants drank 3.4 fewer drinks per week , consumed 0.4 fewer drinks per occasion , binge drank on 1.0 fewer days , and experienced about 1.0 fewer consequences than control participants in the month after the inter 
    Output:
    
Based on these findings , existing BAIs do not seem to be efficacious in reducing  alcohol use in military population s , despite some encouraging results from one electronic intervention which was of extensive duration