human
***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: Motivational Interviewing ( MI ) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs . Some questions have been raised as to the effectiveness of MI in severely distressed population s. This study aims to assess the effectiveness of MI in a population of homeless , unemployed , and substance dependent veterans who are being wait-listed for entry into a residential treatment program . Seventy-five veterans placed on a wait-list were r and omized to receive a single MI or st and ard ( Std ) intake interview . Outcomes assessed were entry , and length of stay ( LOS ) . Secondary outcomes assessed included program completion and rates of graduation . Readiness to change and self-efficacy were assessed before and after the interview . Significantly more participants entered the program in the MI group ( 95 % ) than in the Std group ( 71 % ) . Although those in the MI group remained in the program longer , and had higher program completion and graduation rates , these differences were not statistically significant . No significant between-group or within-group differences were found in readiness or self-efficacy . This study demonstrates that a single , easily administered intervention can increase program entry . Also based on the study findings , further research into the question of whether MI can increase program retention , in a severely distressed population , is warranted Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objective To evaluate the effectiveness of different brief intervention strategies at reducing  hazardous or harmful drinking in primary care . The hypothesis was that more intensive intervention would result in a greater reduction in hazardous or harmful drinking . Design Pragmatic cluster r and omised controlled trial . Setting Primary care practice s in the north east and south east of Engl and and in London . Participants 3562 patients aged 18 or more routinely presenting in primary care , of whom 2991 ( 84.0 % ) were eligible to enter the trial : 900 ( 30.1 % ) screened positive for hazardous or harmful drinking and 756 ( 84.0 % ) received a brief  intervention .  The sample was predominantly male ( 62 % ) and white ( 92 % ) , and 34 % were current smokers . Interventions Practice s were r and omised to three interventions , each of which built on the previous one : a patient information leaflet control group , five minutes of structured brief advice , and 20 minutes of brief lifestyle counselling . Delivery of the patient leaflet and brief advice occurred directly after screening and brief lifestyle counselling in a subsequent consultation . Main outcome measures The primary outcome was patients ’ self reported hazardous or harmful drinking status as measured by the alcohol use disorders identification test ( AUDIT ) at six months . A negative AUDIT result ( score < 8) indicated non-hazardous or non-harmful drinking . Secondary outcomes were a negative AUDIT result at 12 months , experience of alcohol related problems ( alcohol problems question naire ) , health utility ( EQ-5D ) , service utilisation , and patients ’ motivation to change drinking behaviour ( readiness to change ) as measured by a modified readiness ruler . Results Patient follow-up rates were 83 % at six months ( n=644 ) and 79 % at 12 months ( n=617 ) . At both time points an intention to treat analysis found no significant differences in AUDIT negative status between the three interventions . Compared with the patient information leaflet group , the odds ratio of having a negative AUDIT result for brief advice was 0.85 ( 95 % confidence interval 0.52 to 1.39 ) and for brief lifestyle counselling was 0.78 ( 0.48 to 1.25 ) . A per protocol analysis confirmed these findings . Conclusions All patients received simple feedback on their screening outcome . Beyond this input , however , evidence that brief advice or brief lifestyle counselling provided important additional benefit in reducing hazardous or harmful drinking compared with the patient information leaflet was lacking . Trial registration Current Controlled Trials IS RCT N06145674 OBJECTIVE The current pilot study examined the preliminary efficacy of a brief intervention ( BI ) for at-risk drinking in an employee assistance program . METHOD Clients ( N = 107 ) entering the employee assistance program ( EAP ) for mental health services were screened and met criteria for at-risk drinking . EAP therapists were r and omly assigned to deliver either the BI plus EAP services as usual ( SAU ) or SAU only . Participants in the final analyses consisted of 44 BI + SAU ( 30 women , 14 men ) and 30 SAU ( 21 women , 9 men ) EAP clients who completed a 3-month follow-up . RESULTS Results suggested that participants in the BI + SAU group had significant reductions in peak blood alcohol concentration , peak quantity , and alcohol-related consequences compared with the SAU group . Men in the BI + SAU group had greater reductions in alcohol-related problems compared with men in the SAU group . Groups did not differ by number of total EAP sessions attended or rates of presenting problem resolution . CONCLUSIONS Results provide preliminary evidence to support the integration of alcohol screening and BI as a low-cost method of intervening with clients with at-risk drinking in the context of co-occurring presenting problems An interactive web-site-based intervention for reducing alcohol consumption was pilot tested . Participants were 145 employees of a work site in the Silicon Valley region of California , categorized as low or moderate risk for alcohol problems . All participants were given access to a web site that provided feedback on their levels of stress and use of coping strategies . Participants r and omized to the full individualized feedback condition also received individualized feedback about their risk for alcohol-related problems . Some evidence was found for greater alcohol reduction among participants who received full individualized feedback , although due to difficulties in recruiting participants , the sample size was inadequate for evaluating treatment effects on drinking . The results provide preliminary support for using an interactive web site to provide individualized feedback for persons at risk for alcohol problems . However , the low participation rate ( 2.7 % ) suggests that such an intervention must address the challenges of recruiting employees through their work site Aim . To evaluate the effectiveness of brief interventions ( BIs ) in reducing alcohol use among hazardous drinkers consulting their occupational doctors . Material s and methods . Design : R and omized controlled trial with 12-month follow-up , conducted between November 2004 and September 2006 . Setting : Fifteen French regional occupational medicine centers with 147 doctors and 157 assistants who were trained in BI and screening with the AUDIT question naire . Participants : We invited 33,488 individuals to fill out AUDIT . These patients were eligible if their scores were 6–12 for women and 7–12 for men , indicating hazardous drinking without dependence ( found in 7.1 % of respondents ) . Intervention : After r and omization , BIs ( informative advice using motivational approach , with 10-minute average duration ) were performed by the occupational doctors . The control group received information booklets from the doctors ’ assistants . Measurements : Situations were evaluated 12 months after inclusion . Outcome measures : AUDIT scores , self-reported alcohol consumption ( SRAC ) and biological assays . The main criteria were the differences observed between groups for SRAC , the AUDIT score at follow-up , and any reduction in score between inclusion and final assessment . Success of intervention , which was defined as an AUDIT score below the hazardous drinking threshold at follow-up , was considered to analyze the variables associated with the efficiency of intervention . Results . The analyzed sample included 787 persons , among whom 435 were met again 12 months later . In the BI group , we found a lower AUDIT score ( p = 0.01 ) , a higher reduction in reported consumptions ( –60 g/week versus −44g/week , p = 0.04 ) and in AUDIT scores ( p = 0.009 ) . In the control group , 44.8 % reduced their AUDIT scores below hazardous drinking thresholds , as compared to 51.6 % in the BI group ( p = 0.15 ) . Success was associated with a significant reduction in biological and clinical indices . Conclusions . Though the high attrition rate led to careful conclusions , BIs seem to be efficient in occupational medicine , in comparison with written information , which also seems to influence drinking behavior This study examined the effectiveness of a traditional face-to-face health education and e-mail health education on alcohol usage among male workers in comparison with a control group . Male workers at a manufacturing plant ( N=36 ) who had abnormal serum gamma-GTP were stratified by age and job types , then r and omized into three groups : face-to-face education , e-mail education , and the control . The subjects were assessed on their knowledge about and attitude towards drinking , reported alcohol consumption , and serum gamma-GTP before the start of education and 2 months later after comparison of the education . Paired t-test and repeated ANOVA were conducted to test the significance of changes pre and post the intervention and across groups . In the face-to-face group , knowledge ( p=0.001 ) , attitude ( p=0.026 ) , alcohol consumption ( p=0.003 ) and serum gamma-GTP showed significant improvement . In the e-mail group , only alcohol consumption showed marginal improvement ( p=0.077 ) . In the control group , no variables remarkably changed . These results indicate that the face-to-face health education was more effective than the e-mail program . We discuss why the face-to-face approach was superior to the e-mail approach in this study by referring to self-monitoring , goal setting processes and timely feedback . We concluded that further studies are warranted to identify the effect of health education using e-mails and other network tools in consideration of the above three factors Although it is commonly assumed that alcohol consumption has a significant impact on employee absenteeism , the nature of the alcohol-absence relationship remains poorly understood . Proposing that alcohol impairment likely serves as a key mechanism linking drinking and work absence , we posit that this relationship is likely governed less by the amount of alcohol consumed and more by the way it is consumed . Using a prospect i ve study design and a r and om sample of urban transit workers , we found that the frequency of heavy episodic drinking over the previous month is positively associated with the number of days of absence recorded in the subsequent 12-month period , whereas modal consumption ( a metric capturing the typical amount of alcohol consumed in a given period of time ) is not . In addition , consistent with both volitional treatments of absenteeism and social exchange theory , perceived coworker support was found to attenuate , and supervisory support to amplify , the link between the frequency of heavy episodic drinking and absenteeism A theory-based intervention aim ed at reducing corporate employees ' alcohol consumption in excess of guideline limits is presented . The intervention adopted an outcome mental simulation technique and was administered to a sample of corporate employees from three companies . A single-arm r and omized-controlled design was adopted . All participants completed baseline psychological measures and self-reported number of alcohol units consumed and binge-drinking occasions . Participants allocated to the intervention condition were presented with a mental simulation exercise . One month later , participants completed follow-up measures of the psychological variables and alcohol consumption . Results revealed a significant effect of the mental simulation intervention on number of units of alcohol consumed at follow-up . There was no effect of the intervention on frequency of binge-drinking occasions . There was no evidence for the mediation of the effect of mental simulations on alcohol consumption by the perceived behavioural control and motivation variables . Results support the efficacy of the mental simulation intervention in reducing alcohol consumption but not in reducing binge drinking or alcohol consumption in excess of guideline limits , among corporate employees . Results are discussed with respect to the importance of the mental simulation intervention to inform practice and the proposed processes by which mental simulations affect alcohol consumption The short-term results of a r and omized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented . Homeless adolescents ages 14 - 19 ( N = 285 ) recruited from drop-in centers at agencies and from street intercept were r and omly assigned to either a brief motivational enhancement ( ME ) group or 1 of 2 control groups . The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing . Follow-up interviews were conducted at 1 and 3 months postintervention . Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups . Treatment effects were not found with respect to alcohol or marijuana . Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged . Limitations of the study are discussed as are implication s for development of future substance use interventions for this high-risk group AIMS To examine the effectiveness of a brief intervention ( BI ) and cognitive behaviour therapy ( CBT ) for alcohol abuse . DESIGN A r and omized trial with clients r and omized within counsellors . SETTING Community-based drug and alcohol counselling in Australia . PARTICIPANTS Of all new clients attending counselling . 869 ( 82 % ) completed a computerized assessment at their first consultation . Four hundred and twenty-one ( 48 % ) were defined as eligible , of whom 295 ( 70 % ) consented and were allocated r and omly to an intervention . Of these , 13 3 ( 45 % ) were followed-up at 6 months post-test . INTERVENTIONS BI comprised the elements identified by the acronym FRAMES : feedback , responsibility , advice , menu , empathy , self-e 
    Output:
    
agent
***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: Motivational Interviewing ( MI ) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs . Some questions have been raised as to the effectiveness of MI in severely distressed population s. This study aims to assess the effectiveness of MI in a population of homeless , unemployed , and substance dependent veterans who are being wait-listed for entry into a residential treatment program . Seventy-five veterans placed on a wait-list were r and omized to receive a single MI or st and ard ( Std ) intake interview . Outcomes assessed were entry , and length of stay ( LOS ) . Secondary outcomes assessed included program completion and rates of graduation . Readiness to change and self-efficacy were assessed before and after the interview . Significantly more participants entered the program in the MI group ( 95 % ) than in the Std group ( 71 % ) . Although those in the MI group remained in the program longer , and had higher program completion and graduation rates , these differences were not statistically significant . No significant between-group or within-group differences were found in readiness or self-efficacy . This study demonstrates that a single , easily administered intervention can increase program entry . Also based on the study findings , further research into the question of whether MI can increase program retention , in a severely distressed population , is warranted Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objective To evaluate the effectiveness of different brief intervention strategies at reducing  hazardous or harmful drinking in primary care . The hypothesis was that more intensive intervention would result in a greater reduction in hazardous or harmful drinking . Design Pragmatic cluster r and omised controlled trial . Setting Primary care practice s in the north east and south east of Engl and and in London . Participants 3562 patients aged 18 or more routinely presenting in primary care , of whom 2991 ( 84.0 % ) were eligible to enter the trial : 900 ( 30.1 % ) screened positive for hazardous or harmful drinking and 756 ( 84.0 % ) received a brief  intervention .  The sample was predominantly male ( 62 % ) and white ( 92 % ) , and 34 % were current smokers . Interventions Practice s were r and omised to three interventions , each of which built on the previous one : a patient information leaflet control group , five minutes of structured brief advice , and 20 minutes of brief lifestyle counselling . Delivery of the patient leaflet and brief advice occurred directly after screening and brief lifestyle counselling in a subsequent consultation . Main outcome measures The primary outcome was patients ’ self reported hazardous or harmful drinking status as measured by the alcohol use disorders identification test ( AUDIT ) at six months . A negative AUDIT result ( score < 8) indicated non-hazardous or non-harmful drinking . Secondary outcomes were a negative AUDIT result at 12 months , experience of alcohol related problems ( alcohol problems question naire ) , health utility ( EQ-5D ) , service utilisation , and patients ’ motivation to change drinking behaviour ( readiness to change ) as measured by a modified readiness ruler . Results Patient follow-up rates were 83 % at six months ( n=644 ) and 79 % at 12 months ( n=617 ) . At both time points an intention to treat analysis found no significant differences in AUDIT negative status between the three interventions . Compared with the patient information leaflet group , the odds ratio of having a negative AUDIT result for brief advice was 0.85 ( 95 % confidence interval 0.52 to 1.39 ) and for brief lifestyle counselling was 0.78 ( 0.48 to 1.25 ) . A per protocol analysis confirmed these findings . Conclusions All patients received simple feedback on their screening outcome . Beyond this input , however , evidence that brief advice or brief lifestyle counselling provided important additional benefit in reducing hazardous or harmful drinking compared with the patient information leaflet was lacking . Trial registration Current Controlled Trials IS RCT N06145674 OBJECTIVE The current pilot study examined the preliminary efficacy of a brief intervention ( BI ) for at-risk drinking in an employee assistance program . METHOD Clients ( N = 107 ) entering the employee assistance program ( EAP ) for mental health services were screened and met criteria for at-risk drinking . EAP therapists were r and omly assigned to deliver either the BI plus EAP services as usual ( SAU ) or SAU only . Participants in the final analyses consisted of 44 BI + SAU ( 30 women , 14 men ) and 30 SAU ( 21 women , 9 men ) EAP clients who completed a 3-month follow-up . RESULTS Results suggested that participants in the BI + SAU group had significant reductions in peak blood alcohol concentration , peak quantity , and alcohol-related consequences compared with the SAU group . Men in the BI + SAU group had greater reductions in alcohol-related problems compared with men in the SAU group . Groups did not differ by number of total EAP sessions attended or rates of presenting problem resolution . CONCLUSIONS Results provide preliminary evidence to support the integration of alcohol screening and BI as a low-cost method of intervening with clients with at-risk drinking in the context of co-occurring presenting problems An interactive web-site-based intervention for reducing alcohol consumption was pilot tested . Participants were 145 employees of a work site in the Silicon Valley region of California , categorized as low or moderate risk for alcohol problems . All participants were given access to a web site that provided feedback on their levels of stress and use of coping strategies . Participants r and omized to the full individualized feedback condition also received individualized feedback about their risk for alcohol-related problems . Some evidence was found for greater alcohol reduction among participants who received full individualized feedback , although due to difficulties in recruiting participants , the sample size was inadequate for evaluating treatment effects on drinking . The results provide preliminary support for using an interactive web site to provide individualized feedback for persons at risk for alcohol problems . However , the low participation rate ( 2.7 % ) suggests that such an intervention must address the challenges of recruiting employees through their work site Aim . To evaluate the effectiveness of brief interventions ( BIs ) in reducing alcohol use among hazardous drinkers consulting their occupational doctors . Material s and methods . Design : R and omized controlled trial with 12-month follow-up , conducted between November 2004 and September 2006 . Setting : Fifteen French regional occupational medicine centers with 147 doctors and 157 assistants who were trained in BI and screening with the AUDIT question naire . Participants : We invited 33,488 individuals to fill out AUDIT . These patients were eligible if their scores were 6–12 for women and 7–12 for men , indicating hazardous drinking without dependence ( found in 7.1 % of respondents ) . Intervention : After r and omization , BIs ( informative advice using motivational approach , with 10-minute average duration ) were performed by the occupational doctors . The control group received information booklets from the doctors ’ assistants . Measurements : Situations were evaluated 12 months after inclusion . Outcome measures : AUDIT scores , self-reported alcohol consumption ( SRAC ) and biological assays . The main criteria were the differences observed between groups for SRAC , the AUDIT score at follow-up , and any reduction in score between inclusion and final assessment . Success of intervention , which was defined as an AUDIT score below the hazardous drinking threshold at follow-up , was considered to analyze the variables associated with the efficiency of intervention . Results . The analyzed sample included 787 persons , among whom 435 were met again 12 months later . In the BI group , we found a lower AUDIT score ( p = 0.01 ) , a higher reduction in reported consumptions ( –60 g/week versus −44g/week , p = 0.04 ) and in AUDIT scores ( p = 0.009 ) . In the control group , 44.8 % reduced their AUDIT scores below hazardous drinking thresholds , as compared to 51.6 % in the BI group ( p = 0.15 ) . Success was associated with a significant reduction in biological and clinical indices . Conclusions . Though the high attrition rate led to careful conclusions , BIs seem to be efficient in occupational medicine , in comparison with written information , which also seems to influence drinking behavior This study examined the effectiveness of a traditional face-to-face health education and e-mail health education on alcohol usage among male workers in comparison with a control group . Male workers at a manufacturing plant ( N=36 ) who had abnormal serum gamma-GTP were stratified by age and job types , then r and omized into three groups : face-to-face education , e-mail education , and the control . The subjects were assessed on their knowledge about and attitude towards drinking , reported alcohol consumption , and serum gamma-GTP before the start of education and 2 months later after comparison of the education . Paired t-test and repeated ANOVA were conducted to test the significance of changes pre and post the intervention and across groups . In the face-to-face group , knowledge ( p=0.001 ) , attitude ( p=0.026 ) , alcohol consumption ( p=0.003 ) and serum gamma-GTP showed significant improvement . In the e-mail group , only alcohol consumption showed marginal improvement ( p=0.077 ) . In the control group , no variables remarkably changed . These results indicate that the face-to-face health education was more effective than the e-mail program . We discuss why the face-to-face approach was superior to the e-mail approach in this study by referring to self-monitoring , goal setting processes and timely feedback . We concluded that further studies are warranted to identify the effect of health education using e-mails and other network tools in consideration of the above three factors Although it is commonly assumed that alcohol consumption has a significant impact on employee absenteeism , the nature of the alcohol-absence relationship remains poorly understood . Proposing that alcohol impairment likely serves as a key mechanism linking drinking and work absence , we posit that this relationship is likely governed less by the amount of alcohol consumed and more by the way it is consumed . Using a prospect i ve study design and a r and om sample of urban transit workers , we found that the frequency of heavy episodic drinking over the previous month is positively associated with the number of days of absence recorded in the subsequent 12-month period , whereas modal consumption ( a metric capturing the typical amount of alcohol consumed in a given period of time ) is not . In addition , consistent with both volitional treatments of absenteeism and social exchange theory , perceived coworker support was found to attenuate , and supervisory support to amplify , the link between the frequency of heavy episodic drinking and absenteeism A theory-based intervention aim ed at reducing corporate employees ' alcohol consumption in excess of guideline limits is presented . The intervention adopted an outcome mental simulation technique and was administered to a sample of corporate employees from three companies . A single-arm r and omized-controlled design was adopted . All participants completed baseline psychological measures and self-reported number of alcohol units consumed and binge-drinking occasions . Participants allocated to the intervention condition were presented with a mental simulation exercise . One month later , participants completed follow-up measures of the psychological variables and alcohol consumption . Results revealed a significant effect of the mental simulation intervention on number of units of alcohol consumed at follow-up . There was no effect of the intervention on frequency of binge-drinking occasions . There was no evidence for the mediation of the effect of mental simulations on alcohol consumption by the perceived behavioural control and motivation variables . Results support the efficacy of the mental simulation intervention in reducing alcohol consumption but not in reducing binge drinking or alcohol consumption in excess of guideline limits , among corporate employees . Results are discussed with respect to the importance of the mental simulation intervention to inform practice and the proposed processes by which mental simulations affect alcohol consumption The short-term results of a r and omized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented . Homeless adolescents ages 14 - 19 ( N = 285 ) recruited from drop-in centers at agencies and from street intercept were r and omly assigned to either a brief motivational enhancement ( ME ) group or 1 of 2 control groups . The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing . Follow-up interviews were conducted at 1 and 3 months postintervention . Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups . Treatment effects were not found with respect to alcohol or marijuana . Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged . Limitations of the study are discussed as are implication s for development of future substance use interventions for this high-risk group AIMS To examine the effectiveness of a brief intervention ( BI ) and cognitive behaviour therapy ( CBT ) for alcohol abuse . DESIGN A r and omized trial with clients r and omized within counsellors . SETTING Community-based drug and alcohol counselling in Australia . PARTICIPANTS Of all new clients attending counselling . 869 ( 82 % ) completed a computerized assessment at their first consultation . Four hundred and twenty-one ( 48 % ) were defined as eligible , of whom 295 ( 70 % ) consented and were allocated r and omly to an intervention . Of these , 13 3 ( 45 % ) were followed-up at 6 months post-test . INTERVENTIONS BI comprised the elements identified by the acronym FRAMES : feedback , responsibility , advice , menu , empathy , self-e 
    Output:
    