***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: BACKGROUND The Brief Motivational Intervention ( BMI ) is an effective treatment for alcohol misuse but has not been adequately tested for use in helplines for alcoholics . The main objective of this study was to evaluate the efficacy of a  telephone-based BMI  for Brazilians seeking help with alcohol use cessation . METHODS A r and omized , controlled trial was performed with Brazilian subjects . Participants were r and omly assigned to either the minimal intervention group ( i.e. , given reference material s ) or the BMI group .  Alcohol abstinence was evaluated in a 6-month follow-up telephone counseling session . The analysis was based on the intention to treat ( ITT ) . RESULTS Of the 5,896 drug users who called the helpline , 700 ( 12 % ) used alcohol , 637 of whom enrolled in this study . At 6-month follow-up , 70 % of the BMI group had stopped consuming alcohol compared to 41 % in the control group ( odds ratio = 1.5 ; 95 % confidence interval = 1.2 - 1.9 ; p = 0.001 ) . CONCLUSIONS A helpline-based BMI helps alcohol users achieve abstinence Background In 2008 the World Health Organization ( WHO ) reported that South Africa had the highest tuberculosis ( TB ) incidence in the world . This high incidence rate is linked to a number of factors , including HIV co-infection and alcohol use disorders . The diagnosis and treatment package for TB and HIV co-infection is relatively well established in South Africa . However , because alcohol use disorders may present more insidiously , making it difficult to diagnose , those patients with active TB and misusing alcohol are not easily cured from TB . With this in mind , the primary purpose of this cluster r and omized controlled trial is to provide screening for alcohol misuse and to test the efficacy of brief interventions in reducing alcohol intake in those patients with active TB found to be misusing alcohol in primary health care clinics in three provinces in South Africa . Methods / Design Within each of the three selected health districts with the highest TB burden in South Africa , 14 primary health care clinics with the highest TB caseloads will be selected . Those agreeing to participate will be stratified according to TB treatment caseload and the type of facility ( clinic or community health centre ) . Within strata from 14 primary care facilities , 7 will be r and omly selected into intervention and 7 to control study clinics ( 42 clinics , 21 intervention clinics and 21 control clinics ) . At the clinic level systematic sampling will be used to recruit newly diagnosed TB patients . Those consenting will be screened for alcohol misuse using the AUDIT . Patients who screen positive for alcohol misuse over a 6-month period will be given either a brief intervention based on the Information-Motivation-Behavioural Skills ( IMB ) Model or an alcohol use health education leaflet . A total sample size of 520 is expected . Discussion The trial will evaluate the impact of alcohol screening and brief interventions for patients with active TB in primary care setting s in South Africa . The findings will impact public health and will enable the health ministry to formulate policy related to comprehensive treatment for TB and alcohol misuse , which will result in reduction in alcohol use and ultimately improve the TB cure rates . Trial registration numberPACTR : AIMS To assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country . METHODS A r and omized controlled trial in a public-sector clinic in Delft , a township in the Western Cape , South Africa recruited 403 patients who were r and omized to either single-session , nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list , and followed up at 3 months . RESULTS Although rates of at-risk alcohol use and drug use did not differ by treatment arm at follow-up , patients assigned to the Brief Motivational Intervention had significantly reduced scores on ASSIST ( Alcohol , Smoking and Substance Involvement Screening Test ) for alcohol-the most prevalent substance . CONCLUSION Brief Motivational Intervention may be effective at reducing at-risk alcohol use in the short term among low-income young adult primary care patients ; additional research is needed to examine long-term outcomes Seven hundred and thirty one men admitted to medical wards were interviewed to identify problem drinkers who had not received previous treatment for alcoholism and who had some social support . One hundred and sixty one met the diagnostic criteria ; 156 agreed to a follow up interview and were allocated to one of two groups . One group received a session of counselling about their drinking habits from a nurse while the other received only routine medical care . Both groups reported a reduction in alcohol consumption when interviewed 12 months later , but the counselled group had a significantly better outcome than the control group . It is concluded that systematic screening for alcohol consumption and related problems should become a routine part of medical assessment and that advice on drinking habits is effective if given before irreversible physical or psychosocial problems have developed The aim of this study was to assess the effectiveness of Screening and Brief Intervention ( SBI ) for alcohol problems among university students in South Africa . The study design for this efficacy study is a r and omized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting . The unit of r and omization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus . University students were screened for alcohol problems , and those identified as hazardous or harmful drinkers were r and omized into an experimental or control group . The experimental group received one brief counseling session on alcohol risk reduction , while the control group received a health education leaflet . Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 ( 21.1 % ) tested positive for the Alcohol Use Disorder Identification Test ( AUDIT ) ( score 8 or more ) . Among the 147 ( 96.7 % ) university students who also attended the 12-month follow-up session , the intervention effect on the AUDIT score was −1.5 , which was statistically significant ( P = 0.009 ) . Further , the depression scores marginally significantly decreased over time across treatment groups , while other substance use ( tobacco and cannabis use ) , self-rated health status and Posttraumatic Stress Disorder ( PTSD ) scores did not change over time across treatment groups . The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa . The short duration of the brief intervention makes it a realistic c and i date for use in a university setting Background High prevalence rates of hazardous and harmful alcohol use have been found in a hospital outpatient setting in South Africa . Hospital setting s are a particularly valuable point of contact for the delivery of brief interventions because of the large access to patient population s each year . With this in mind , the primary purpose of this r and omized controlled trial is to provide screening for alcohol misuse and to test the effectiveness of brief interventions in reducing alcohol intake among hospital out patients in South Africa . Methods The study design for this effectiveness study is a r and omized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous or harmful drinkers in a hospital setting . Out patients were screened for alcohol problems , and those identified as hazardous or harmful drinkers were r and omized into an experimental or control group . The experimental group received one brief counselling session on alcohol risk reduction , while the control group received a health education leaflet . Results Of the 1419 screened for alcohol misuse who agreed to participate in the trial 392 ( 27.6 % ) screened positive for hazardous or harmful use on the Alcohol Use Disorder Identification Test ( AUDIT ) ( score 7/8 - 19 ) and 51 ( 3.6 % ) had an AUDIT score of 20 or more . Among the 282 ( 72 % ) hospital out patients who also attended the 12-month follow-up session , the time effects on the AUDIT scores were significant [ F ( 1,195 = 7.72 ) , P < 0.01 ] but the intervention effect on the AUDIT score was statistically not significant [ F ( 1,194 = 0.06 ) , P < 0.804 ] . Conclusion Given the lack of difference in outcome between control and intervention group , alcohol screening and the provision of an alcohol health education leaflet may in itself cause reduction in drinking . Trial registration At-risk alcohol use is increasing among women and it has been linked to important harm to their health . However , the effectiveness of brief intervention ( BI ) among women is unclear . Research on the most effective components of those interventions in the female population is necessary , especially in low and middle income countries . The aim of this study was to evaluate the impact of a BI , carried out among women in a household community setting , on their alcohol consumption . Participants were enrolled through a household survey , using a probabilistic sample of 905 adult women in the city of Juiz de Fora , Brazil . The 61 ( 6.7 % ) women who screened positive for at-risk drinking ( AUDIT score ≥ 8) were r and omly allocated to one of two groups : the Intervention Group ( n=32 ) , which received one single session of BI carried out in the household setting after screening , or the Control Group ( n=29 ) which did not receive BI . After three months , 46 ( 75.4 % ) participants completed the follow-up interview ( 23 in each group ) . All participants received an informative leaflet , and the Intervention Group received a 15 - 40 minute BI , which provided information on the adverse consequences of alcohol and strategies to help moderate consumption . Participants of both groups decreased their alcohol consumption after three months . The intervention group decreased the mean AUDIT score from 12.4 to 9.4 , while the control group reduced from 10.6 to 7.5 . Preliminary analyzes using general linear modelling indicate that there was no difference between the Intervention Group and the Control Group in relation to the main outcome ( total AUDIT score ) . Although no difference was found between groups , the results of this study are not conclusive and may reflect the small sample size of the trial . More studies are needed to better estimate the effectiveness of BI among women in a household setting Background The leading mental health causes of the global burden of disease are depression in women and alcohol use disorders in men . A major hurdle to the implementation of evidence -based psychological treatments in primary care in developing countries is the non-availability of skilled human re sources . The aim of these trials is to evaluate the effectiveness and cost-effectiveness of two psychological treatments developed for the treatment of depression and alcohol use disorders in primary care in India . Methods / design This study protocol is for parallel group , r and omized controlled trials ( Healthy Activity Program for moderate to severe depression , Counselling for Alcohol Problems for harmful and dependent drinking ) in eight primary health centres in Goa , India . Adult primary care attendees will be screened with the Patient Health Question naire for  depression  and , in men only , the Alcohol Use Disorders Identification Test for drinking problems . Screen-positive attendees will be invited to participate ; men who screen positive for both disorders will be invited to participate in the Counselling for Alcohol Problems trial . Those who consent will be allocated in a 1:1 ratio to receive either the respective psychological treatment plus enhanced usual care or enhanced usual care only using a computer generated allocation sequence , stratified by primary health centre and , for depression , by sex . The enhanced usual care comprises providing primary health centre doctors with context ualized World Health Organization guidelines and screening results . Psychological treatments will be delivered by lay counsellors , over a maximum period of three months . Primary outcomes are severity of disorder and remission rates at three months post-enrolment and , for the Counselling for Alcohol Problems trial , drinking and the impact of drinking on daily lives . Secondary outcomes include severity of disorder and remission rates at 12 months , disability scores , suicidal behaviour and economic impact , and cost-effectiveness at three and 12 months .  500 participants with depression and 400 participants with harmful drinking will be recruited . Primary analyses will be intention-to-treat . Discussion These trials may offer a new approach for the treatment of moderate-severe depression and drinking problems in primary care that is potentially scalable as it relies on delivery by a single pool of lay counsellors . Trial registration Both trials are registered with the International Society for the Registration of Clinical Trials ( Healthy Activity Programme registration number IS RCT N95149997 ; Counselling for Alcohol Problems registration number IS RCT N76465238 ) Background The aim of this study was to conduct a cluster r and omized control trial to assess the efficacy of screening and brief intervention ( SBI ) for conjoint alcohol and tobacco use among hospital out- patients . Method In all 620 hospital out- patients who screened positive for both tobacco and alcohol moderate risk in four hospitals were r and omized into 2 control and 1 intervention condition using the hospital as a unit of r and omization ( 2 intervention and 2 control hospitals ) to 405 patients in the two control groups ( tobacco only intervention , n = 199 , and alcohol only intervention , n = 206 ) and 215 in the intervention group . The intervention or control consisted of three counselling sessions . Results Results of the interaction ( Group × Time ) effects using GEE indicated that there were statistically significant differences between the three study groups over the 6-month follow-up on the ASSIST tobacco score ( Wald χ2 = 8.43 , P = 0.004 ) , and past week tobacco 
    Output:
    
Conclusion This systematic review of RCTs on alcohol brief intervention conducted in middle-income countries suggests that brief intervention can help reduce self-reported hazardous or harmful alcohol use  in primary -care population