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: Research has demonstrated the efficacy of brief motivational interventions ( BMI ) and alcohol expectancy challenge ( AEC ) in reducing alcohol use and /or problems among college students . However , little is known about variables that may qualify the effectiveness of these approaches . The present analyses tested the hypothesis that need for cognition ( NFC ) , impulsivity/sensation seeking ( IMPSS ) and readiness to change ( RTC ) would moderate the effects of BMI and AEC .  Participants ( N = 335 ) were heavy drinking college students enrolled in a r and omized 2 x 2 factorial study of BMI and AEC .  Latent growth curve analyses indicated significant interactions for BMI x NFC and AEC x RTC on alcohol use but not problems . Simple slopes analyses were used to probe these relationships and revealed that higher levels of NFC at baseline were associated with a stronger BMI effect on drinking outcomes over time . Similarly , higher levels of baseline RTC were associated with stronger AEC effects on alcohol use . Future preventive interventions with this population may profit by considering individual differences and targeting approaches accordingly OBJECTIVE This study examined the effectiveness of three peer-facilitated brief alcohol interventions -small group motivational interviewing , motivationally enhanced peer theater , and an interactive alcohol-education program-with  students engaging in high-risk drinking who were referred for alcohol policy violations . METHOD Undergraduate students referred for alcohol policy violations ( N = 695 ) at a large northeastern public university were r and omized to one of the three conditions . Six-month follow-up data were collected on drinking frequency and quantity , negative consequences , use of protective behaviors , and perceptions of peers ' drinking norms . RESULTS There were no statistically significant overall pre-post effects or treatment effects . However , exploratory analyses indicated that decreases in perceived norms and increases in use of protective behavioral strategies were associated with reductions in alcohol use and alcohol-related problems at follow-up ( p < .01 ) . CONCLUSIONS The presence of nonsignificant pre-post or main effects is , in part , consistent with recent research indicating that sanctioned college students may immediately reduce drinking in response to citation and that brief interventions may not contribute to additional behavioral change . The presence of statistically significant correlations between alcohol use and related problems with corrections in norms misperceptions and increased use of protective behaviors at the individual level holds promise for both research and practice . The integration of elements addressing social norms and use of protective behaviors within brief cognitive-behavioral intervention protocol s delivered by trained peer facilitators warrants further study using r and omized clinical trials Alcohol use among college students has been associated with injunctive norms , which refer to the perceived acceptability of excessive drinking , and descriptive norms , which refer to perceptions of actual drinking . The purpose of this study was to examine the effect of a brief injunctive norms manipulation on both injunctive and descriptive norms about drinking alcohol and to explore differences in the malleability of norms across referent groups , sex , and gender role . Participants were 265 undergraduates ( 43 % male , 70 % freshmen ) who completed a web-based survey for course credit . A r and omly selected half was exposed to a page of information-based feedback about typical student injunctive norms . Relative to the control condition , the manipulation produced lower injunctive and descriptive norms related to typical students ' drinking but no change in either type of norm related to close friends . Femininity was associated with less permissive normative beliefs about the acceptability of excessive drinking whereas masculinity was associated with elevated perceptions of peer drinking , but neither sex nor gender role moderated the manipulation effect . We conclude that perceptions of peer approval of drinking are malleable with a very brief information-based manipulation Energy drink consumption has been anecdotally linked to the development of adverse cardiovascular effects in consumers , although clinical trials to support this link are lacking . The effects of Red Bull ® energy drink on cardiovascular and neurologic functions were examined in college-aged students enrolled at Winona State University . In a double-blind experiment where normal calorie and low calorie Red Bull ® were compared to normal and low calorie placebos , no changes in overall cardiovascular function nor blood glucose ( mg/dL ) were recorded in any participant ( n = 68 ) throughout a 2-h test period . However , in the second experiment , nine male and twelve female participants subjected to a cold pressor test ( CPT ) before and after Red Bull ® consumption showed a significant increase in blood sugar levels pre- and post Red Bull ® consumption . There was a significant increase in diastolic blood pressure of the male volunteers immediately after submersion of the h and in the 5 ° C water for the CPT . Under the influence of Red Bull ® , the increase in diastolic pressure for the male participants during the CPT was negated . There were no significant changes in the blood pressure of the female participants for the CPT with or without Red Bull ® . Finally , the CPT was used to evaluate pain threshold and pain tolerance before and after Red Bull ® consumption . Red Bull ® consumption was associated with a significant increase in pain tolerance in all participants . These findings suggest that Red Bull ® consumption ameliorates changes in blood pressure during stressful experiences and increases the participants ’ pain tolerance Abstract . Objective : The authors assessed short-term effectiveness of a Web-based alcohol education program on entering freshmen . Participants : 3,216 incoming first-year students were r and omized to a control or intervention group . Methods : Controls completed a survey and knowledge test the summer before college ; 4 to 6 weeks after arrival on campus , they completed a follow-up survey of behaviors and harms followed by an invitation to complete the online course . Intervention students completed the precourse survey and test , the online course , and final exam prior to coming to campus . This was followed by a survey 4 to 6 weeks after arrival on campus . Results : Although the intervention group showed significantly higher alcohol-related postcourse knowledge compared to the control group , protective behavior , risk-related behavior , high-risk drinking , and alcohol-related harm did not favor the intervention group , with the sole exception of playing drinking games . Conclusions : Alcohol knowledge alone was insufficient to mitigate alcohol-related high-risk behaviors in this student population OBJECTIVE Much research has documented extensive misperceptions of drinking norms and their negative effects in U.S. student population s. This study provides extensive research evidence documenting this phenomenon in Canadian higher education . METHODS Data were collected in a 2003 - 2004 survey of students ( N=5280 ) attending 11 institutions across Canada .  Surveys were administered either to a r and om sample of students through the mail or to students attending a diverse selection of classes . RESULTS Regardless of the actual drinking norm on each campus , students most commonly overestimated the alcohol consumption norms ( both quantity and frequency levels ) in every instance . Students ' perception of their campus drinking norm was the strongest predictor of the amount of alcohol personally consumed in comparison with the influence of all demographic variables . Perception of the norm was also a much stronger predictor of personal use than the actual campus norm for consumption on each campus or the actual norm for compliance with campus regulations . Among students who personally abstain or consume lightly , misperceptions of the student drinking norms contribute to alienation from campus life . CONCLUSION The data presented here on Canadian students extends the evidence that peer drinking norms are grossly misperceived and that these misperceptions produce a highly detrimental " reign of error " in the lives of college students . The data suggest that a broad range of students -- abstainers and light drinkers as well as moderate and heavy drinkers -- may benefit from implementing intervention strategies that can correct or reduce these misperceptions The current study was design ed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking . Participants ( N = 1,488 ) were r and omly assigned to feedback or assessment -only control conditions . Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall , with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls . In addition , abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants ( odds ratio = 2.02 ) , and feedback participants were significantly more likely to refrain from heavy episodic drinking ( odds ratio = 1.43 ) . Neither gender nor severity of baseline drinking moderated the efficacy of the intervention in these analyses , but more conservative analyses utilizing last-observation carryforward suggested women and abstainers benefited more from this prevention approach . Protective behaviors mediated intervention efficacy , with participants who received the intervention being more likely to use strategies such as setting limits and alternating alcohol with nonalcoholic beverages . Implication s of these findings for universal prevention of  college  drinking are discussed College students , particularly those who drink heavily , tend to overestimate the prevalence of heavy drinking among their peers . A self-regulation model predicts that feedback of undesirable deviation from normative st and ards would result in correction of behavior toward perceived norms . From a screening of 568 college students , sixty-four heavy drinkers were identified and offered the opportunity to participate in a survey study of drinking . Of these , twenty-six accepted and returned question naires with detailed information regarding their drinking practice s. These were r and omized to receive or not receive , by return mail , personal feedback of their drinking relative to population norms . At an independent follow-up interview , feedback subjects showed greater reduction in weekly consumption and typical intoxication levels , relative to controls . This simple feedback intervention , requiring no personal contact , may be a cost-effective strategy for reducing risky drinking OBJECTIVE Social influences to drink are important predictors of adolescent drinking . This study explored a social influence model of drinking among inner-city adolescents . We examined the role of family drinking and perceived drinking norms in predicting 1-year follow-up perceived social benefits of drinking and the relationship of perceived social benefits of drinking with 2-year follow-up adolescent drinking . METHOD Participants in the present study were from the control schools of a r and omized trial investigating the etiology and prevention of adolescent alcohol use . During a class period at baseline in seventh grade , participants completed a question naire that measured self-reported alcohol use and potential predictors . The panel sample consisted of 1,318 students from baseline ( seventh grade ) , 1-year follow-up ( eighth grade ) , and 2-year follow-up ( ninth grade ) . RESULTS Structural equation modeling found that both family drinking and perceived drinking norms affected the perceived benefits of drinking . In turn , the perceived benefits of drinking predicted subsequent drinking , controlling for earlier drinking . CONCLUSIONS These results illuminate the importance of the perceived benefits of drinking , as well as social influences to drink , in adolescent drinking . Therefore , they should be incorporated into alcohol prevention programs Background Excessive alcohol consumption amongst university students has received increasing attention . A social norms approach to reducing drinking behaviours has met with some success in the USA . Such an approach is based on the assumption that student 's perceptions of the norms of their peers are highly influential , but that these perceptions are often incorrect . Social norms interventions therefore aim to correct these inaccurate perceptions , and in turn , to change behaviours . However , UK studies are scarce and it is increasingly recognised that social norm interventions need to be supported by socio ecological approaches that address the wider determinants of behaviour . Objectives To describe the research design for an exploratory trial examining the acceptability , hypothesised process of change and implementation of a social norm marketing campaign design ed to correct misperceptions of normative alcohol use and reduce levels of misuse , implemented alongside a university wide alcohol harm reduction toolkit . It also assesses the feasibility of a potential large scale effectiveness trial by providing key trial design parameters including r and omisation , recruitment and retention , contamination , data collection methods , outcome measures and intracluster correlations . Methods / design The study adopts an exploratory cluster r and omised controlled trial design with halls of residence as the unit of allocation , and a nested mixed methods process evaluation . Four Welsh ( UK ) universities participated in the study , with residence hall managers consenting to implementation of the trial in 50 university owned campus based halls of residence . Consenting halls were r and omised to either a phased multi channel social norm marketing campaign addressing normative discrepancies ( n = 25 intervention ) or normal practice ( n = 25 control ) . The primary outcome is alcohol consumption ( units per week ) measured using the Daily Drinking Question naire . Secondary outcomes assess frequency of alcohol consumption , higher risk drinking , alcohol related problems and change in perceptions of alcohol-related descriptive and injunctive norms . Data will be collected for all 50 halls at 4 months follow up through a cross-sectional on line and postal survey of approximately 4000 first year students . The process evaluation will explore the acceptability and implementation of the social norms intervention and toolkit and hypothesised process of change including awareness , receptivity and normative changes . Discussion Exploratory trials such as this are essential to inform future definitive trials by providing crucial method ological parameters and guidance on design ing and implementing optimum interventions .Trial registration numberIS RCT N : IS RCT Aims This exploratory trial examines the feasibility of implementing a social norms marketing campaign to reduce student drinking in universities in Wales , and evaluating it using cluster r and omised trial methodology . Methods Fifty residence halls in 4 universities in Wales were r and omly assigned to intervention or control arms . Web and paper surveys were distributed to students within these halls ( n = 3800 ) , assessing exposure/contamination , recall of and evaluative responses to intervention messages , perceived drinking norms and personal drinking behaviour . Measures included the Drinking Norms Rating Form , the Daily Drinking Question naire and AUDIT-C. Results A response rate of 15 % ( n = 554 ) was achieved , varying substantially between sites .  Intervention posters  were seen by 80 % and 43 
    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: Research has demonstrated the efficacy of brief motivational interventions ( BMI ) and alcohol expectancy challenge ( AEC ) in reducing alcohol use and /or problems among college students . However , little is known about variables that may qualify the effectiveness of these approaches . The present analyses tested the hypothesis that need for cognition ( NFC ) , impulsivity/sensation seeking ( IMPSS ) and readiness to change ( RTC ) would moderate the effects of BMI and AEC .  Participants ( N = 335 ) were heavy drinking college students enrolled in a r and omized 2 x 2 factorial study of BMI and AEC .  Latent growth curve analyses indicated significant interactions for BMI x NFC and AEC x RTC on alcohol use but not problems . Simple slopes analyses were used to probe these relationships and revealed that higher levels of NFC at baseline were associated with a stronger BMI effect on drinking outcomes over time . Similarly , higher levels of baseline RTC were associated with stronger AEC effects on alcohol use . Future preventive interventions with this population may profit by considering individual differences and targeting approaches accordingly OBJECTIVE This study examined the effectiveness of three peer-facilitated brief alcohol interventions -small group motivational interviewing , motivationally enhanced peer theater , and an interactive alcohol-education program-with  students engaging in high-risk drinking who were referred for alcohol policy violations . METHOD Undergraduate students referred for alcohol policy violations ( N = 695 ) at a large northeastern public university were r and omized to one of the three conditions . Six-month follow-up data were collected on drinking frequency and quantity , negative consequences , use of protective behaviors , and perceptions of peers ' drinking norms . RESULTS There were no statistically significant overall pre-post effects or treatment effects . However , exploratory analyses indicated that decreases in perceived norms and increases in use of protective behavioral strategies were associated with reductions in alcohol use and alcohol-related problems at follow-up ( p < .01 ) . CONCLUSIONS The presence of nonsignificant pre-post or main effects is , in part , consistent with recent research indicating that sanctioned college students may immediately reduce drinking in response to citation and that brief interventions may not contribute to additional behavioral change . The presence of statistically significant correlations between alcohol use and related problems with corrections in norms misperceptions and increased use of protective behaviors at the individual level holds promise for both research and practice . The integration of elements addressing social norms and use of protective behaviors within brief cognitive-behavioral intervention protocol s delivered by trained peer facilitators warrants further study using r and omized clinical trials Alcohol use among college students has been associated with injunctive norms , which refer to the perceived acceptability of excessive drinking , and descriptive norms , which refer to perceptions of actual drinking . The purpose of this study was to examine the effect of a brief injunctive norms manipulation on both injunctive and descriptive norms about drinking alcohol and to explore differences in the malleability of norms across referent groups , sex , and gender role . Participants were 265 undergraduates ( 43 % male , 70 % freshmen ) who completed a web-based survey for course credit . A r and omly selected half was exposed to a page of information-based feedback about typical student injunctive norms . Relative to the control condition , the manipulation produced lower injunctive and descriptive norms related to typical students ' drinking but no change in either type of norm related to close friends . Femininity was associated with less permissive normative beliefs about the acceptability of excessive drinking whereas masculinity was associated with elevated perceptions of peer drinking , but neither sex nor gender role moderated the manipulation effect . We conclude that perceptions of peer approval of drinking are malleable with a very brief information-based manipulation Energy drink consumption has been anecdotally linked to the development of adverse cardiovascular effects in consumers , although clinical trials to support this link are lacking . The effects of Red Bull ® energy drink on cardiovascular and neurologic functions were examined in college-aged students enrolled at Winona State University . In a double-blind experiment where normal calorie and low calorie Red Bull ® were compared to normal and low calorie placebos , no changes in overall cardiovascular function nor blood glucose ( mg/dL ) were recorded in any participant ( n = 68 ) throughout a 2-h test period . However , in the second experiment , nine male and twelve female participants subjected to a cold pressor test ( CPT ) before and after Red Bull ® consumption showed a significant increase in blood sugar levels pre- and post Red Bull ® consumption . There was a significant increase in diastolic blood pressure of the male volunteers immediately after submersion of the h and in the 5 ° C water for the CPT . Under the influence of Red Bull ® , the increase in diastolic pressure for the male participants during the CPT was negated . There were no significant changes in the blood pressure of the female participants for the CPT with or without Red Bull ® . Finally , the CPT was used to evaluate pain threshold and pain tolerance before and after Red Bull ® consumption . Red Bull ® consumption was associated with a significant increase in pain tolerance in all participants . These findings suggest that Red Bull ® consumption ameliorates changes in blood pressure during stressful experiences and increases the participants ’ pain tolerance Abstract . Objective : The authors assessed short-term effectiveness of a Web-based alcohol education program on entering freshmen . Participants : 3,216 incoming first-year students were r and omized to a control or intervention group . Methods : Controls completed a survey and knowledge test the summer before college ; 4 to 6 weeks after arrival on campus , they completed a follow-up survey of behaviors and harms followed by an invitation to complete the online course . Intervention students completed the precourse survey and test , the online course , and final exam prior to coming to campus . This was followed by a survey 4 to 6 weeks after arrival on campus . Results : Although the intervention group showed significantly higher alcohol-related postcourse knowledge compared to the control group , protective behavior , risk-related behavior , high-risk drinking , and alcohol-related harm did not favor the intervention group , with the sole exception of playing drinking games . Conclusions : Alcohol knowledge alone was insufficient to mitigate alcohol-related high-risk behaviors in this student population OBJECTIVE Much research has documented extensive misperceptions of drinking norms and their negative effects in U.S. student population s. This study provides extensive research evidence documenting this phenomenon in Canadian higher education . METHODS Data were collected in a 2003 - 2004 survey of students ( N=5280 ) attending 11 institutions across Canada .  Surveys were administered either to a r and om sample of students through the mail or to students attending a diverse selection of classes . RESULTS Regardless of the actual drinking norm on each campus , students most commonly overestimated the alcohol consumption norms ( both quantity and frequency levels ) in every instance . Students ' perception of their campus drinking norm was the strongest predictor of the amount of alcohol personally consumed in comparison with the influence of all demographic variables . Perception of the norm was also a much stronger predictor of personal use than the actual campus norm for consumption on each campus or the actual norm for compliance with campus regulations . Among students who personally abstain or consume lightly , misperceptions of the student drinking norms contribute to alienation from campus life . CONCLUSION The data presented here on Canadian students extends the evidence that peer drinking norms are grossly misperceived and that these misperceptions produce a highly detrimental " reign of error " in the lives of college students . The data suggest that a broad range of students -- abstainers and light drinkers as well as moderate and heavy drinkers -- may benefit from implementing intervention strategies that can correct or reduce these misperceptions The current study was design ed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking . Participants ( N = 1,488 ) were r and omly assigned to feedback or assessment -only control conditions . Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall , with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls . In addition , abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants ( odds ratio = 2.02 ) , and feedback participants were significantly more likely to refrain from heavy episodic drinking ( odds ratio = 1.43 ) . Neither gender nor severity of baseline drinking moderated the efficacy of the intervention in these analyses , but more conservative analyses utilizing last-observation carryforward suggested women and abstainers benefited more from this prevention approach . Protective behaviors mediated intervention efficacy , with participants who received the intervention being more likely to use strategies such as setting limits and alternating alcohol with nonalcoholic beverages . Implication s of these findings for universal prevention of  college  drinking are discussed College students , particularly those who drink heavily , tend to overestimate the prevalence of heavy drinking among their peers . A self-regulation model predicts that feedback of undesirable deviation from normative st and ards would result in correction of behavior toward perceived norms . From a screening of 568 college students , sixty-four heavy drinkers were identified and offered the opportunity to participate in a survey study of drinking . Of these , twenty-six accepted and returned question naires with detailed information regarding their drinking practice s. These were r and omized to receive or not receive , by return mail , personal feedback of their drinking relative to population norms . At an independent follow-up interview , feedback subjects showed greater reduction in weekly consumption and typical intoxication levels , relative to controls . This simple feedback intervention , requiring no personal contact , may be a cost-effective strategy for reducing risky drinking OBJECTIVE Social influences to drink are important predictors of adolescent drinking . This study explored a social influence model of drinking among inner-city adolescents . We examined the role of family drinking and perceived drinking norms in predicting 1-year follow-up perceived social benefits of drinking and the relationship of perceived social benefits of drinking with 2-year follow-up adolescent drinking . METHOD Participants in the present study were from the control schools of a r and omized trial investigating the etiology and prevention of adolescent alcohol use . During a class period at baseline in seventh grade , participants completed a question naire that measured self-reported alcohol use and potential predictors . The panel sample consisted of 1,318 students from baseline ( seventh grade ) , 1-year follow-up ( eighth grade ) , and 2-year follow-up ( ninth grade ) . RESULTS Structural equation modeling found that both family drinking and perceived drinking norms affected the perceived benefits of drinking . In turn , the perceived benefits of drinking predicted subsequent drinking , controlling for earlier drinking . CONCLUSIONS These results illuminate the importance of the perceived benefits of drinking , as well as social influences to drink , in adolescent drinking . Therefore , they should be incorporated into alcohol prevention programs Background Excessive alcohol consumption amongst university students has received increasing attention . A social norms approach to reducing drinking behaviours has met with some success in the USA . Such an approach is based on the assumption that student 's perceptions of the norms of their peers are highly influential , but that these perceptions are often incorrect . Social norms interventions therefore aim to correct these inaccurate perceptions , and in turn , to change behaviours . However , UK studies are scarce and it is increasingly recognised that social norm interventions need to be supported by socio ecological approaches that address the wider determinants of behaviour . Objectives To describe the research design for an exploratory trial examining the acceptability , hypothesised process of change and implementation of a social norm marketing campaign design ed to correct misperceptions of normative alcohol use and reduce levels of misuse , implemented alongside a university wide alcohol harm reduction toolkit . It also assesses the feasibility of a potential large scale effectiveness trial by providing key trial design parameters including r and omisation , recruitment and retention , contamination , data collection methods , outcome measures and intracluster correlations . Methods / design The study adopts an exploratory cluster r and omised controlled trial design with halls of residence as the unit of allocation , and a nested mixed methods process evaluation . Four Welsh ( UK ) universities participated in the study , with residence hall managers consenting to implementation of the trial in 50 university owned campus based halls of residence . Consenting halls were r and omised to either a phased multi channel social norm marketing campaign addressing normative discrepancies ( n = 25 intervention ) or normal practice ( n = 25 control ) . The primary outcome is alcohol consumption ( units per week ) measured using the Daily Drinking Question naire . Secondary outcomes assess frequency of alcohol consumption , higher risk drinking , alcohol related problems and change in perceptions of alcohol-related descriptive and injunctive norms . Data will be collected for all 50 halls at 4 months follow up through a cross-sectional on line and postal survey of approximately 4000 first year students . The process evaluation will explore the acceptability and implementation of the social norms intervention and toolkit and hypothesised process of change including awareness , receptivity and normative changes . Discussion Exploratory trials such as this are essential to inform future definitive trials by providing crucial method ological parameters and guidance on design ing and implementing optimum interventions .Trial registration numberIS RCT N : IS RCT Aims This exploratory trial examines the feasibility of implementing a social norms marketing campaign to reduce student drinking in universities in Wales , and evaluating it using cluster r and omised trial methodology . Methods Fifty residence halls in 4 universities in Wales were r and omly assigned to intervention or control arms . Web and paper surveys were distributed to students within these halls ( n = 3800 ) , assessing exposure/contamination , recall of and evaluative responses to intervention messages , perceived drinking norms and personal drinking behaviour . Measures included the Drinking Norms Rating Form , the Daily Drinking Question naire and AUDIT-C. Results A response rate of 15 % ( n = 554 ) was achieved , varying substantially between sites .  Intervention posters  were seen by 80 % and 43 
    Output:
    