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OBJECTIVES: To examine the frequency and distribution of depressive symptoms among subjects with binge eating disorder (BED), bulimia nervosa (BN), and major depression. METHODS: This study examined depressive symptoms from the Hamilton Depression Scale in 122 BED, 142 BN, and 200 major depression subjects using discriminant function analysis. RESULTS: All three groups differed significantly on the Hamilton Depression Scale totals with major depressive disorder (MDD) subjects having the highest and BED subjects the lowest totals. Eighteen items differentiated MDD from the eating disorder groups. Three items-gastrointestinal (GI) somatic symptoms, paranoid symptoms, and obsessional symptoms-distinguished BED and BN. In each case these symptoms were more common in BN subjects. DISCUSSION: This study attempted to differentiate BN from BED on a basis other than eating behavior. The results provide limited support for the hypothesis that BN and BED can be distinguished on the basis of depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: The DIAMOND Project (Depression Is A MANageable Disorder), a nonrandomized controlled effectiveness trial, was intended to improve the long-term management of depression in primary care medical clinics. The project tested whether a quality improvement (QI) intervention could implement a systems approach-so that there would be more reliable and effective monitoring of patients with depression, leading to better outcomes. THE QUALITATIVE STUDY: A study was conducted in 1998-2000 to determine why a quality improvement intervention to improve depression care did not have a significant impact. Data consisted of detailed notes from observations of 12 project-related events (for example, team meetings and presentations) and open-ended interviews with a purposive sampling of 17 key informants. Thematic analytic methods were used to identify themes in the contextual data., Principal Findings: Overall, the project implementation was very limited. Five themes emerged: (1) The project received only lukewarm support from clinic and medical group leadership. (2) Clinicians did not perceive an urgent need for the new care system, and therefore there was a lack of impetus to change. (3) The improvement initiative was perceived as too complex by the physicians. (4) There was an inherent disconnect between the commitment of the improvement team and the unresponsiveness of most other clinic staff. (5) The doctor focus in clinic culture created a catch-22 dilemma-the involvement and noninvolvement of physicians were both problematic., Conclusion: Problems in both predisposing and enabling factors accounted for the ultimate failure of the DIAMOND quality improvement effort.

Nine focus groups were conducted with 75 staff nurses in three hospitals to determine the low participation rate of nurses in a smoking cessation programs directed at patients. Nurses felt that hospitalization was an appropriate time to offer quit-smoking advice to patients, particularly those with smoking related diseases. However, many felt advice should be given only to those receptive to it. The most common barriers to providing smoking cessation advice were lack of concrete techniques, or referral to provide and fear of alienating patients who were not receptive to hearing advice.

We surveyed the U.S. non-institutionalized population age 18+ on opinions regarding 23 alcohol control policies (N = 7,021). The cooperation rate among contacted households was 70% and the overall response rate was 54%. Results showed high levels of public support for most alcohol control policies. Over 80% support restrictions on alcohol use in public places, such as parks, beaches, concert venues, and on college campuses. Eighty-two percent support increased alcohol taxes, provided the funds are used for treatment or prevention programs. Over 60% support alcohol advertising and promotion restrictions, such as banning billboard advertising, banning promotion at sporting events, or banning liquor and beer advertising on television. Multivariate regression analyses indicated significant relationships between alcohol policy opinions and a variety of sociodemographic, political orientation, and behavioral measures. However, the absolute differences in alcohol policy support across groups is small. There is a strong base of support for alcohol control policies in the U.S., and such support is found among whites and ethnics of color, young and old, rich and poor, and conservatives, moderates, and liberals.

Objective: Luteinizing hormone (LH) pulse characteristics in depressed and normal women were compared to determine whether hypothalamic dysregulation in depression extends to the hypothalamic-pituitary-gonadal axis., Method: The subjects were 10 depressed and 13 normal comparison women admitted to a clinical research center. For each woman, an intravenous line was started and blood was withdrawn every 10 minutes for 8 hours. Blood samples were assayed for LH and LH pulse characteristics determined by using the computerized cluster algorithm of Veldhuis and Johnson., Results: The depressed women differed significantly from the comparison women in LH pulse amplitude, rhythmicity, and area under the curve., Conclusions: Major depressive disorder is associated with abnormal regulation of luteinizing hormone. Gonadotropin regulation may provide a hormonal link between major depressive disorder and impaired fertility.

Introduction: While effective policies exist to reduce alcohol-related harm, political will to enact them is low in many jurisdictions. We aimed to identify key barriers and strategies for strengthening political priority for alcohol policy reform., Methods: A framework synthesis was conducted, incorporating relevant theory, key informant interviews (n = 37) and a scoping review. Thematic analysis informed the development of a framework for understanding and influencing political priority for alcohol policy., Results: Twelve barriers and 14 strategies were identified at multiple levels (global, national and local). Major barriers included neoliberal or free trade ideology, the globalised alcohol industry, limited advocate capacity and the normalisation of alcohol harms. Strategies fell into two categories: sector-specific and system change initiatives. Sector-specific strategies primarily focus on influencing policymakers and mobilising civil society. Examples include developing a clear, unified solution, coalition building and effective framing. System change initiatives target structural change to reduce the power imbalance between industry and civil society, such as restricting industry involvement in policymaking and securing sustainable funding for advocacy. A key example is establishing an international treaty, similar to the Framework Convention on Tobacco Control, to support domestic policymaking., Discussion and Conclusions: Our findings provide a framework for understanding and advancing political priority for alcohol policy. The framework highlights that progress can be achieved at various levels and through diverse groups of actors. The importance of upstream drivers of policymaking was a key finding, presenting challenges for time-poor advocates, but offering potential facilitation through effective global leadership., (© 2023 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Objectives: Alcohol contributes to significant health, social and economic burdens worldwide, but evidence-based policy options can reduce the harm associated with alcohol use. The aim of this paper is to understand factors influencing public support for various alcohol policies in New South Wales (NSW), Australia, and to determine any change over time. Methods: An online survey of adults in NSW, in 2013 (n = 2482), 2016 (n = 1585) and 2019 (n = 1601), assessed support for alcohol policies. Multivariable logistic regression models examined the change in support over time, adjusting for demographics, alcohol consumption, smoking status and knowledge of alcohol as a risk factor for cancer. Results: Most participants (68-72%) supported policies preventing underage internet users from exposure to alcohol advertising, and banning alcohol sponsorship of underage music and sporting events. Fiscal policies and restrictions on the number of alcohol outlets were the least supported policies (<40% support). Compared with 2013, participants in 2016 and 2019 were less likely to support policies increasing price, applying a volumetric tax and reducing the number of alcohol outlets. In 2019, more than 55% of respondents were aware that alcohol was a cancer risk factor, and knowledge of that relationship was associated with an increased likelihood of support for alcohol policies. Conclusions: Support was greatest for alcohol harm-reduction policies that had less impact on an individual's drinking. Overall, support for alcohol policies in NSW is not increasing. Initiatives to raise awareness about the health consequences of alcohol use, together with effective alcohol policies, are needed to counter industry influence on decision makers and negative public discourse. [ABSTRACT FROM AUTHOR]

Background: The study objective was to analyse the implementation challenges experienced in carrying out the IMPROVE programme. This programme was designed to implement checklist-related improvement initiatives based on the national perioperative guidelines using a stepped-wedge trial design. A process analysis was carried out to investigate the involvement in the implementation activities.Methods: An involvement rating measure was developed to express the extent to which the implementation programme was carried out in the hospitals. This measure reflects the number of IMPROVE-implementation activities executed and the estimated participation in these activities in all nine participating hospitals. These data were compared with prospectively collected field notes.Results: Considerable variation between the hospitals was found with involvement ratings ranging from 0 to 6 (mean per measurement = 1.83 on a scale of 0-11). Major implementation challenges were respectively the study design (fixed design, time planning, long duration, repeated measurements, and data availability); the selection process of hospitals, departments and key contact person(s) (inadequately covering the entire perioperative team and stand-alone surgeons); the implementation programme (programme size and scope, tailoring, multicentre, lack of mandate, co-interventions by the Inspectorate, local intervention initiatives, intervention fatigue); and competitive events such as hospital mergers or the introduction of new IT systems, all reducing involvement.Conclusions: The process analysis approach helped to explain the limited and delayed execution of the IMPROVE-implementation programme. This turned out to be very heterogeneous between hospitals, with variation in the number and content of implementation activities carried out. The identified implementation challenges reflect a high complexity with regard to the implementation programme, study design and setting. The involvement of the target professionals was put under pressure by many factors. We mostly encountered challenges, but at the same time we provide solutions for addressing them. A less complex implementation programme, a less fixed study design, a better thought-out selection of contact persons, as well as more commitment of the hospital management and surgeons would likely have contributed to better implementation results.Trial Registration: Dutch Trial Registry: NTR3568 , retrospectively registered on 2 August 2012. [ABSTRACT FROM AUTHOR]

Objective: This research evaluated the South Carolina Alcohol Enforcement Team impact for reducing retail alcohol access to underage persons to decrease drinking and driving crashes among that population. Methods: The natural research experiment used interrupted time‐series (ITS) analyses of drinking and driving crashes involving under 21‐year‐old drivers from July 2006 through December 2016 (126‐month period = 4,782 Driving Under Influence [DUI] crashes for under 21‐year‐old drivers, µ = 38 crashes per month). Additional data analyzed included the monthly total number of retail compliance checks (total during 126‐month period = 64,954 compliance checks completed, µ = 515.5 checks per month), the average percentage of underage alcohol purchases (total completed during 126‐month period = 8,814 purchases, µ = 70 purchases per month), and a calculated measure of the percent of the population under 21 years old exposed to compliance checks each month. We used drinking and driving crashes for 21‐year‐old and over drivers as a control time series (total number over a 126‐month period = 52,180 DUI crashes for 21 and older drivers, µ = 414.1 crashes per month). Results: The results show a decline in drinking and driving crashes for drivers under 21 when compliance checks increase, and when compliance checks decline, traffic crashes increase. Stable Alcohol Enforcement Team implementation over 78 months produced an overall 18 to 29% decline in such crashes. A visual examination of the crash time series demonstrated that under‐21‐age‐driver crashes declined during the first wave of implementation and increased following a lag when enforcement declined, which provided additional empirical support for a South Carolina Alcohol Enforcement Team impact on retail alcohol availability. An ITS analysis of the prestable period compared to the stable period was statistically significant (T = −3.78, p < 0.001). A cross‐check of these results using single‐vehicle nighttime crashes using identical Autoregressive Integrated Moving Average models was also statistically significant (T = −8.18, p < 0.001). Conclusions: This longitudinal study provides strong evidence of sustained reductions in alcohol availability to underage youth can subsequently reduce alcohol‐related traffic crashes. Reductions found in this study continued over several years, considerably longer than any previous equivalent research has shown. [ABSTRACT FROM AUTHOR]

Background: Alcohol-related problems at professional sporting events are of increasing concern and alarming reports are often reported in international media. Although alcohol consumption increases the risk for interpersonal violence, it is viewed as a focal element of large football events. Sweden has a long tradition of high public support for strict alcohol-control policies. However, little is known about public opinions on alcohol intoxication and the support for interventions to decrease intoxication at football events. The current study explored the public opinion towards alcohol use, intoxication and alcohol policies at professional football matches in Sweden.Methods: A cross-sectional design was utilized and a random general population sample of 3503 adult Swedish residents was asked to participate in a web survey during 2016 (response rate 68%).Results: In total, 26% of the respondents supported alcohol sales at football events. Over 90% reported that obviously intoxicated spectators should be denied entrance or evicted from arenas. The support for regulations limiting alcohol availability varied with background factors such as gender, alcohol use and frequency of football event attendance.Conclusions: There is a strong public consensus for strategies and policies to reduce alcohol sales and intoxication levels at football matches. This public support has implications for our preventive efforts and will facilitate the implementation of strategies and policy changes. [ABSTRACT FROM AUTHOR]

Background Hospital admission provides a powerful opportunity to promote smoking cessation. We explored patients' and healthcare professionals' (HCP) views of a specialist smoking cessation service comprising systematic smoking ascertainment, default provision of pharmacotherapy and behavioural counselling at the bedside, and post-discharge follow-up, in a clinical trial in a United Kingdom teaching hospital. Methods Semi-structured interviews with 30 patients who were offered the intervention, and 27 HCPs working on intervention wards, were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results The shock of being admitted, and awareness that smoking may have contributed to the need for hospital admission, caused many patients to reassess their quit intentions. Most patients felt the service was too good an opportunity to pass up, because having long-term support and progress monitored was more likely to result in abstinence than trying alone. Had they not been approached, many patients reported that they would have attempted to quit alone, though some would have been discouraged from doing so by pharmacotherapy costs. Service delivery by a specialist advisor was favoured by patients and HCPs, largely because HCPs lacked time and expertise to intervene. HCPs reported that in usual practice, discussions about smoking were usually limited to ascertainment of smoking status. Timing of service delivery and improved co-ordination between service staff and inpatient ward staff were matters to address. Conclusions A hospital-based specialist smoking cessation service designed to identify smokers and initiate cessation support at the bedside was deemed appropriate by patients and HCPs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this article is to review existing research literature in order to trace changes in a level of public support for alcohol policies, their individual correlates and social/political determinants. Methods: Articles for the review were collected by SCOPUS browser which is a database of abstracts and number of citations. Articles were also searched by MEDLINE browser but the results overlapped with the results obtained by SCOPUS. In our search, we used the combination of the following words: (1) policy support and alcohol; (2) public opinion and alcohol policy and also (3) policy support and alcohol policy. In addition to a systematic review, a number of papers were included through opportunistic methods, such as searching in bibliographies and reference lists of relevant publications. Conclusions: Past decades of research on social support for alcohol control policies showed that the level of support either fluctuates or tends slowly to decline parallel with progressing economic liberalization. Nevertheless, supporters of restrictive alcohol policies still represent large proportion of the contemporary society and in combination with those satisfied with existing level of control - constitute large majority. Control measures targeting young people do enjoy more support which implicates diverting attention from strategies aimed at general adult population. [ABSTRACT FROM AUTHOR]

The article discusses research which examines how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of care in patients with diabetes and asthma. Results of the study reveal that practices with higher leadership scores had greater odds of performing medical screening. It concludes that operational practice leaders can facilitate practice changes that are associated with clinical improvement.

Background: Although collaborative team models (CTM) improve care processes and health outcomes, their diffusion poses challenges related to difficulties in securing their adoption by primary care clinicians (PCPs). The objectives of this study are to understand: (1) how the perceived characteristics of a CTM influenced clinicians' decision to adopt -or not- the model; and (2) the model's diffusion process. Methods: We conducted a longitudinal case study based on the Diffusion of Innovations Theory. First, diffusion curves were developed for all 175 PCPs and 59 nurses practicing in one borough of Paris. Second, semi-structured interviews were conducted with a representative sample of 40 PCPs and 15 nurses to better understand the implementation dynamics. Results: Diffusion curves showed that 3.5 years after the start of the implementation, 100% of nurses and over 80% of PCPs had adopted the CTM. The dynamics of the CTM's diffusion were different between the PCPs and the nurses. The slopes of the two curves are also distinctly different. Among the nurses, the critical mass of adopters was attained faster, since they adopted the CTM earlier and more quickly than the PCPs. Results of the semi-structured interviews showed that these differences in diffusion dynamics were mostly founded in differences between the PCPs' and the nurses' perceptions of the CTM's compatibility with norms, values and practices and its relative advantage (impact on patient management and work practices). Opinion leaders played a key role in the diffusion of the CTM among PCPs. Conclusion: CTM diffusion is a social phenomenon that requires a major commitment by clinicians and a willingness to take risks; the role of opinion leaders is key. Paying attention to the notion of a critical mass of adopters is essential to developing implementation strategies that will accelerate the adoption process by clinicians. Keywords: Primary care, Primary care physician, Nurses, Chronic disease, Collaboration, Health service research, Diffusion of innovation [ABSTRACT FROM AUTHOR]

Introduction and Aims. This study describes levels and predictors of community attitudes towards alcohol, support for structural alterations to the drinking context, and intention to increase participation in community sports clubs. Design and Methods. Cross-sectional data were obtained from the VicHealth Community Attitudes Survey on Healthy Sporting Environments, administered to a random sample of Victorian adults. Descriptive and multivariate logistic regression analysis was undertaken. Results. Very high support for removing alcohol sponsorship of community sport and for a levy on alcohol advertising was found. The groups most supportive of breaking the nexus between alcohol and community sport were female, older-aged and non-English-speaking citizens and those not involved in sport clubs. If alcohol sales at community sports clubs were reduced, participation may increase among population groups currently identified as least engaged with community sport. Discussion and Conclusions. An optimal climate exists for policy reforms to make community sporting environments healthier by reducing the ties with alcohol. If implemented, these reforms may lead to an increase and diversification of participants in community sport.[Tobin CL, Fitzgerald JL, Livingstone C, Thomson L, Harper TA. Support for breaking the nexus between alcohol and community sports settings: Findings from the VicHealth Community Attitudes Survey in Australia. Drug Alcohol Rev 2012;31:413-421] [ABSTRACT FROM AUTHOR]

I have documented the shift in youth alcoholic beverage preference from beer to distilled spirits between 2001 and 2009. I have assessed the role of distilled spirits industry marketing strategies to promote this shift using the Smirnoff brand marketing campaign as a case example. I conclude with a discussion of the similarities in corporate tactics across consumer products with adverse public health impacts, the importance of studying corporate marketing and public relations practices, and the implications of those practices for public health. [ABSTRACT FROM AUTHOR]

Background: There is no more effective intervention for secondary prevention of coronary heart disease than smoking cessation. Yet, evidence about the (cost-)effectiveness of smoking cessation treatment methods for cardiac inpatients that also suit nursing practice is scarce. This protocol describes the design of a study on the (cost-) effectiveness of two intensive smoking cessation interventions for hospitalised cardiac patients as well as first results on the inclusion rates and the characteristics of the study population. Methods/design: An experimental study design is used in eight cardiac wards of hospitals throughout the Netherlands to assess the (cost-)effectiveness of two intensive smoking cessation counselling methods both combined with nicotine replacement therapy. Randomization is conducted at the ward level (cross-over). Baseline and follow-up measurements after six and 12 months are obtained. Upon admission to the cardiac ward, nurses assess patients' smoking behaviour, ensure a quit advice and subsequently refer patients for either telephone counselling or face-to-face counselling. The counselling interventions have a comparable structure and content but differ in provider and delivery method, and in duration. Both counselling interventions are compared with a control group receiving no additional treatment beyond the usual care. Between December 2009 and June 2011, 245 cardiac patients who smoked prior to hospitalisation were included in the usual care group, 223 in the telephone counselling group and 157 in the face-to-face counselling group. Patients are predominantly male and have a mean age of 57 years. Acute coronary syndrome is the most frequently reported admission diagnosis. The ultimate goal of the study is to assess the effects of the interventions on smoking abstinence and their cost-effectiveness .Telephone counselling is expected to be more (cost-)effective in highly motivated patients and patients with high SES, whereas face-to-face counselling is expected to be more (cost-)effective in less motivated patients and patients with low SES. Discussion: This study examines two intensive smoking cessation interventions for cardiac patients using a multicentre trial with eight cardiac wards. Although not all eligible patients could be included and the distribution of patients is skewed in the different groups, the results will be able to provide valuable insight into effects and costs of counselling interventions varying in delivery mode and intensity, also concerning subgroups. Trial registration: Dutch Trial Register NTR2144 [ABSTRACT FROM AUTHOR]

Objective: This study analyzes posts to online news message boards covering driving under the influence (DUI) enforcement efforts to determine their usefulness for informing traffic safety program planning and public relations efforts aimed at mainstream drinking drivers. Methods: A series of Google searches were conducted using keywords designed to capture news stories regarding impaired driving enforcement efforts. For each search, the first 100 Web pages returned were reviewed and articles were included in analysis if they were from an independent news source and contained user comments. Coders captured data on 28 fields for each post, including tone in relation to enforcement, tone of interpersonal communication with other posters, and expressed feelings regarding drinking and driving. Results: Fifty-six news articles covering DUI enforcement efforts met study criteria, with 615 posts. The majority of posts (57%) were neutral on DUI enforcement; 24 percent (148) took a negative tone and 19 percent (115) positive. Posts that discussed checkpoints were 2.6 times more likely to take a negative tone toward enforcement than those that did not. Twenty-one percent of anti-enforcement posts challenged the idea that driving after drinking was necessarily dangerous. Of the 321 posts involving direct communication between posters, 67 percent involved disagreement with another post. Profanity or belittling comments appeared in 10 percent of posts. Conclusion: Public responses to DUI enforcement news articles provide insight into the beliefs and thought processes of those who oppose enforcement efforts or view drinking and driving as no big deal. Primary objections to enforcement focused on civil and personal rights issues, skepticism regarding law enforcement's motives and objectivity, and the belief that drinking driving is not a “real” crime. Online news message boards could be useful in informing campaigns and helping program planners frame media events and press releases to best appeal to the most at-risk segments of the driving public. [ABSTRACT FROM AUTHOR]

Introduction and Aims. The provision of smoking cessation care to surgical patients before admission can reduce post-operative complications and encourage long-term smoking cessation. Our aim was to show how a comprehensive computer-based smoking cessation intervention, developed to enhance smoking cessation care to surgical patients, addresses barriers to care provision. Design and Methods. Consultations with preoperative clinic staff and reviews of the scientific literature were conducted and identified the following barriers to the provision of effective smoking cessation care: a lack of organisational support, perceived patient objection, a lack of systems to identify smokers, a lack of staff time and skill, perceived inability to change care practices, a perceived lack of efficacy of cessation care and the cost of providing care. Based on positive findings of a pilot trial, a comprehensive computer-based smoking cessation intervention was implemented in a preoperative clinic. Data from previous evaluations of the intervention were used to assess the extent to which the intervention addressed clinician barriers to care. Results. The computer-based intervention was found to provide a means to accurately and systematically identify smokers; it required little clinical staff time or skill; it was considered an acceptable form of care by staff and patients; it was effective in encouraging patient cessation and it was inexpensive to deliver relative to other surgical costs. Furthermore, the computer-based intervention continues to operate in the preoperative clinic in the absence of ongoing research support. Discussion and Conclusions. The implementation of such a model of care should be considered by clinical services interested in reducing the smoking related morbidity and mortality of patients.[Wolfenden L, Wiggers J, Campbell E, Knight J, Kerridge R & Spigelman A. Providing comprehensive smoking cessation care to surgical patients: The case for computers. Drug Alcohol Rev 2009;28:60–65] [ABSTRACT FROM AUTHOR]

Objectives: On May 1, 1996, Ontario, Canada, amended the Liquor Licence Act to extend the hours of alcohol sales and service in licensed establishments from 1 to 2 a.m. The purpose of this study was to examine the effect of extended drinking hours on two cities in southwestern Ontario, Canada, one of which (London) would be affected by the alcohol control policy of extended drinking hours and the second city (Windsor) would be affected by two alcohol policies, extended drinking hours, and cross-border legal drinking age differences between Ontario and Michigan. Specifically, this study tested whether there were differences in impaired driving and assault charges in London and Windsor, Ontario, concomitant with the extended drinking hour amendment. Methods: A quasi-experimental design using interrupted time series was used to assess changes. The analyzed data sets were monthly police impaired driving and assault charges data for Ontario, for the 11-12 p.m., 12-1 a.m., 1-2 a.m., 2-3 a.m. and 3-4 a.m. time windows, for 4 years pre- and 3 years post-policy change. Results: Overall, London and Windsor exhibited significant overall reductions in impaired driving charges and no changes for assault charges aggregated over the 11 p.m.-4 a.m. time period after the drinking hours were extended. Within the different time windows, London showed significant decreases for the 1-2 a.m. Sunday-Wednesday and Thursday-Sunday time periods and a significant increase for the Sunday-Wednesday 3-4 a.m. time period, while Windsor demonstrated significant decreases in impaired driving charges for 1-2 a.m. Sunday-Wednesday and Thursday-Saturday time periods and significant increases for Sunday-Wednesday 2-3 and 3-4 a.m. and for Thursday-Saturday 2-3 a.m. For assault charges, no overall pre-post differences were found for the aggregated 11 p.m.-4 a.m. time period for either city. When the data were disaggregated by hour, a significant decrease was found in London for Thursday-Saturday 1-2 a.m. and significant increases for Sunday-Wednesday 2-3 a.m. and Thursday-Saturday 3-4 a.m. time periods, while no significant decreases were found in Windsor during the 1-2 a.m. time periods and one significant increase occurred during the Thursday-Saturday 2-3 a.m. time period. Conclusions: These findings, based on police data, suggest no overall effect on charges aggregated over the 11 p.m. to 4 a.m. time window, although some differences were observed for the different hours after 2 a.m., with a possible effect of the one hour extension of drinking in licensed establishments. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: The purpose of this study was to investigate the participation and knowledge of Icelandic nurses in smoking cessation counselling and to find barriers to smoking interventions by nurses. BACKGROUND: Research has shown that clinical intervention as brief as three minutes can substantially increase smoking cessation success. Several studies have revealed that majority of nurses agree that smoking cessation counselling is within their duties. However, the percentage of nurses who report advising and/or counselling patients remains low. DESIGN AND METHODS: An anonymous mail survey of all practicing nurses in Iceland was conducted in September 2004. A self-administered questionnaire was used, consisting of 74 questions in six sections: asking about smoking behaviour, to advise, to assess/assist/arrange, children and passive smoking, other questions and demographic questions. RESULTS: Of 2453 questionnaires, 868 complete questionnaires were returned, giving a 36% response rate. While the majority of nurses 'asked' about smoking behaviour, a minority 'advised' or 'assisted' their clients with smoking cessation. However, if the clients had no smoking-related symptoms, less than half of the nurses asked about smoking behaviour. Failure to ask and advise clients about the importance of smoking cessation and assisting with smoking cessation correlated (p < 0.001) with several factors, including: lack of time, insufficient knowledge or training and not considered as a part of daily duty. Nurses who smoked were less likely to advise against smoking (p < 0.05). CONCLUSIONS: Nurses frequently neglect to counsel clients about smoking cessation. Common barriers to the delivery of smoking cessation interventions by nurses include insufficient education and training in smoking cessation therapy. RELEVANCE TO CLINICAL PRACTICE: The number of patients with tobacco-related illnesses is increasing worldwide. Effective smoking cessation interventions by nurses have the enormous potential of reducing smoking prevalence and improve health. [ABSTRACT FROM AUTHOR]

High-risk drinking on game day represents a unique public health challenge. OBJECTIVE: The authors examined the drinking behavior of college football fans and assessed the support for related interventions. PARTICIPANTS: The authors randomly selected 762 football fans, including college students, alumni, and other college football fans, to complete an anonymous online game-day survey. METHODS: The authors collected data on participants' drinking behaviors and support for specific game-day interventions. RESULTS: Analysis revealed that, overall, fans drank significantly more on game day than they did the last time they partied or socialized. Nondrinkers were the most supportive of game-day interventions, followed by moderate drinkers, whereas heavy drinkers offered the least support. CONCLUSIONS: With the exception of limiting tailgating hours on game day, fans support game-day interventions, including alcohol-free alternatives, designating tailgating areas where open containers are permitted, and increasing law enforcement efforts. [ABSTRACT FROM AUTHOR]

An author index for the September 2007 issue of the "European Society of Intensive Care Medicine" is presented.

The purpose of this case study is to describe three incremental personal digital PDA-based informatics strategies aimed at improving screening for tobacco use and guideline-based tobacco cessation management: 1) PDA clinical log with tobacco cessation diagnoses and plan of care options, 2) PDA decision support system, and 3) PDA decision support system with infobuttons – context-specific links to the National Cancer Institute's Cancer Information Services tobacco cessation information. These strategies were implemented within the context of an evidence-based advanced practice nurse curriculum at the Columbia University School of Nursing. [ABSTRACT FROM AUTHOR]

The article focuses on the study that evaluates the significance of conceptual framework for guiding and studying practice improvement. The study includes the summarization of experiences from various quality improvement research and other relevant information from medicine and other industries concerning successful quality improvement. The study determined that the conceptual framework may be useful to those who are developing interventions and recruiting medical practices.

This study assessed the degree of smoking cessation advice given by health professionals, before and after their participation in a smoking cessation study using bupropion-sustained release (bupropion SR, Zyban®). A total of 690 physicians and nurses who had smoked an average of 10 cigarettes/day over the previous year and were motivated to quit smoking, were randomised in a double-blind manner to receive bupropion SR (days 1–3, 150 mg/day; days 4–49, 150 mg twice daily) or placebo for 7 weeks, with follow-up to week 52. All subjects received regular follow-up and brief motivational support throughout the study. Questions regarding their smoking cessation advice formed part of the study, with the aim of determining whether study participants became more proactive with their smoking cessation advice. A positive shift from baseline to end of study was observed with respect to the advice and support they gave to their smoking patients. These changes were not related to study treatment or current smoking status. An increase in advising patients to quit smoking and in offering cessation counselling was observed. Participation in a smoking-cessation study by physicians and nurses who smoke has a positive effect, regardless of study medication, in smoking cessation advice and counselling given to their patients. [ABSTRACT FROM AUTHOR]

Despite consistent evidence that premenstrual dysphoria (PMD) is not characterized by abnormalities in basal ovarian hormone secretion, the possibility remains that PMD is associated with an abnormality in the regulation of the hypothalamic-pituitary-ovarian (HPO) axis. We studied HPO axis regulation in 11 women with prospectively confirmed PMD and 20 asymptomatic controls, during both the follicular and luteal phases of the menstrual cycle. Plasma levels of the gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), were obtained before and after stimulation with gonadotropin-releasing hormone (GnRH) (100 μg intravenously). Potential diagnostic- and menstrual cycle phase-related differences in basal and plasma hormone levels were analyzed by repeated-measures analysis of variance. No significant differences were observed between women with PMD and controls in either basal or stimulated levels of FSH and LH. Stimulated FSH was significantly increased and stimulated LH was significantly decreased during the follicular compared with the luteal phase in both women with PMD and controls. These data are consistent with prior findings of normal basal reproductive hormone levels in women with PMD. Our data suggest the absence in women with PMD of an abnormality of dynamic ovarian function as measured by GnRH stimulation. [ABSTRACT FROM AUTHOR]

We examined a quality improvement (QI) program, offered to ambulatory care clinics (N = 82) serving human immunodeficiency virus-positive clients, to determine what factors predicted the clinic independently implementing QI processes without their program consultant's help. Initial analyses examined clinics at 4 levels of involvement: withdrew from the project, initial QI proficiency, advanced QI proficiency, and consultant independent. The initial and advanced stages were collapsed into 1 group (consultant dependent) and compared with consultant-independent clinics for multivariate logistic regression. In the multivariate models, 3 factors significantly predicted the clinic being consultant independent: staffing level (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.2-2.2), the number of participating months (OR = 1.4, 95% CI = 1.0-2.0), and baseline QI readiness (OR = 1.1, 95% CI = 1.0-1.3). Receiver operator curves were calculated for significant predictors; the strongest predictor was staffing (c statistic = .79). Clinics that are organizationally prepared for Q1, allow adequate time to adopt QI methods into their organization, and provide adequate QI staffing are more likely to independently apply QI methods. [ABSTRACT FROM PUBLISHER]

This article presents the proceedings of a symposium at the 2001 Research Society on Alcoholism meeting in Montreal, Canada. The symposium was organized and chaired by Joel W. Grube. The presentations and presenters were (1) Introduction and background, by Susan E. Martin; (2) The effect of alcohol ads on youth 15-26 years old, by Leslie Snyder, Mark Hamilton, Fran Fleming-Milici, and Michael D. Slater; (3) A comparison of exposure to alcohol advertising and drinking behavior in elementary versus middle school children, by Phyllis L. Ellickson and Rebecca L. Collins; (4) USC health and advertising project: assessment study on alcohol advertisement memory and exposure, by Alan Stacy; and (5) TV beer and soft drink advertising: what young people like and what effects? by Meng-Jinn Chen and Joel W. Grube. [ABSTRACT FROM AUTHOR]

Presents comments and updates on issues related to psychiatry as of June 2002. Antidepressant effects of repetitive transcranial magnetic stimulation in the elderly; Chorion type and twin similarity for child psychiatric symptoms; Rhythmicity in the regulation of luteinizing hormone release.

Background: Stress and corticotropin-releasing hormone inhibit the reproductive axis. We hypothesized that reproductive axis hormone secretion, particularly luteinizing hormone secretion, is inhibited in women with depression, similar to what has been observed to be caused by stress in numerous species. Methods: Blood samples were collected every 10 minutes for 12 hours in 25 untreated premenopausal women with depression and 25 nondepressed women who were matched by age and menstrual cycle day. Samples were assayed for luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone. Results: The mean plasma estradiol level was 30% lower in the follicular phase in women with depression than in their matched controls: 191 + 136 vs 261 + 169 pmol/L (52 + 37 vs 71 + 46 pg/mL). The half-life of luteinizing hormone was significantly shorter in women with depression than in their matched controls during both the follicular (22% shorter) and luteal (15% shorter) phases. Conclusions: The blood levels of reproductive hormones were mostly normal in women with depression, but the blood level of estradiol was significantly lower. Estradiol is known to affect a number of neurotransmitter systems in the brain. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is a well-known symptom of depression. However, it has received little, if any, attention from clinicians and researchers. A review of published literature suggests that sexual dysfunction occurs in the majority of depressed patients. It has a major impact on the quality of life of the patients. The pathophysiology of sexual dysfunction in depression involves a complex interplay of various neurotransmitters and hormones. Clinicians need to be more proactive in enquiring about sexual dysfunction in depressed patients. More information is needed about the nature, prevalence and pathophysiology of sexual dysfunction in depression. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Infertility is the inability to naturally conceive, carry or deliver a healthy child. The World Health Organization definition based on 24 months of trying to get pregnant is recommended as the definition that is useful in clinical practice and research among different disciplines. All over the World it affects an estimated 10%-15% of couples of reproductive age. In recent years, the number of couples seeking treatment for infertility has dramatically increased. There is less information about effective psychiatric treatments for this population; however, there is some data to support the use of psychotherapeutic interventions. The stress of the non-fulfilment of a wish for a child has been associated with emotional squeal such as anger, depression, anxiety, marital problems and feelings of worthlessness among the parents. In general, among infertile couples, women show higher levels of distress than their male partners. Various research studies support the theory that distress is associated with lower pregnancy rates among women pursuing infertility treatment. Since psychological factors play an important role in the pathogenesis of infertility, exploration of this is also an important task to manage this devastating problem, which has cultural and social impact. [ABSTRACT FROM AUTHOR]

Background: Alcohol intoxication is associated with problems such as violence, injuries, drunk driving and sexual risk-taking, and music festivals are considered a high-risk setting for high levels of alcohol consumption. This study investigates intoxication levels, drinking habits, and opinions on alcohol use and alcohol policies among visitors at one of the largest music festivals in Sweden in 2017.Methods: A cross-sectional study assessing alcohol intoxication levels was conducted at a music festival (~ 50,000 attendees). Two research teams collected data at the two festival entrances during two nights, from approximately 6:00 pm to 01:30 am. Blood alcohol concentration (BAC) levels were measured using breath analyzers. A face-to-face questionnaire was used to interview attendees about their alcohol use in the past 12 months using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), as well as about their personal opinions on alcohol use and alcohol policies (statement). BAC levels were compared between categories of various factors using Mann-Whitney U test and Kruskal-Wallis test. The distributions of BAC, AUDIT-C and statement category across gender was analyzed using Pearson's Chi-square tests. Associations of BAC levels with different factors were analyzed using Spearman rank correlation and multinomial logistic regression.Results: A total of 1663 attendees were randomly selected and invited to participate, and 1410 consented (63.7% men, 34.9% women, age 16-64 years). The proportion of drinkers was 81%. Among the drinkers, the median BAC level was 0.082%. Thirty-one percent of the participants had a BAC level above 0.10%. Forty-two percent of the participants reported binge drinking monthly, and 20% said that they binge drank weekly. Sixty-three percent of participants reported risky drinking habits. A self-reported risky alcohol habit increased the risk of a high alcohol intoxication level at the festival. Respondents were supportive of restrictive alcohol policies. Men had significantly higher BAC levels, reported more often risky alcohol habits and were less supportive of restrictive alcohol policies than women.Conclusions: The results indicate that participants at music festivals in Sweden have high levels of alcohol intoxication and largely support restrictive alcohol policies. Thus, there is both a need and support for the implementation of alcohol prevention strategies at festivals. [ABSTRACT FROM AUTHOR]

Background: Little is known about people's river usage, a leading drowning location. This study examines alcohol consumption patterns of river users and their attitudes to drowning risk.Methods: A convenience sample of adult (18+ years) river users were surveyed at four river locations. The survey covered eight domains: demographics; river attendance frequency; frequency of engaging in water activities; drinking patterns; alcohol and water safety knowledge; alcohol and water safety attitudes; alcohol consumption; and Blood Alcohol Concentration (BAC). For BAC, participants were asked to record time since their last alcoholic drink and were then breathalysed to record an estimate of their BAC. BAC was examined by BAC reading (negative, positive, ≥0.050%). Hazardous lifetime drinking levels were calculated and their impact on drowning risk evaluated. Univariate and chi square analysis (95% confidence interval) was conducted.Results: Six hundred eighty four people participated (51.6% female; 49.0% aged 18-34 years). Sixteen percent (15.9%) had a positive BAC (Mean + BAC = 0.068%; SD ± 0.08; Range = 0.001-0.334%), with 7.2% ≥0.050% (Mean BAC ≥0.050% =0.132%; SD ± 0.06). Those significantly more likely to record a BAC ≥0.050% at the river were: aged 18-34 years, resided in inner regional and low socio-economic areas, visited the river in the afternoon, with friends, on days with higher maximum air temperatures, frequent river users (11+ times in the last 30 days) and those who spend longer in the water (301+ minutes). River users who recorded a BAC ≥0.050% were more likely to self-report engaging in risky activities (i.e. diving into water of unknown depth and jumping into the river from height). River users on Australia day (a national public holiday) were significantly more likely to drink heavily (Mean BAC ≥0.05% = 0.175%; SD ± 0.09).Conclusions: Despite males accounting for 85% of alcohol-related river drowning deaths, similar numbers of males and females were consuming alcohol at the river. This study has addressed a gap in knowledge by identifying river usage and alcohol consumption patterns among those at increased drowning risk. Implications for prevention include delivering alcohol-related river drowning prevention strategies to both males and females; at peak times including during hot weather, afternoons, public holidays and to river users who swim. [ABSTRACT FROM AUTHOR]

Introduction and Aims: South Africa is considering a range of alcohol policy reforms. This study aims to determine the magnitude of public support for 13 alcohol policies in the Tshwane Metropolitan Municipality and whether this varies by demographic factors and heavy drinking status.Design and Methods: Data are from the South African arm of the International Alcohol Control study, a household survey of adult drinkers using a multistage stratified cluster random sampling design. The sample included 1920 drinkers aged 18-65 years (62% men), with complete drinking data for 16 drinking locations on 955 persons (510 heavy and 445 not heavy drinkers).Results: Over half (53%) of the sample were found to be heavy drinkers. Support varied by alcohol policy, ranging from 31% to 77%, with support above 50% for 11 of the 13 policies. Policy support was higher for policies increasing the purchase age to 21 years (77%), addressing drink driving (58-76%) and restricting physical availability (60-66%). There was slightly less support for policies restricting alcohol marketing (59%) or for policies increasing the price of alcohol (34-58%), especially if no justification was given or the funds were not earmarked. Policy support differed by age, gender, heavy drinking status and income.Discussion and Conclusions: Public support from adult drinkers for a range of alcohol policies is extensive and, as found elsewhere, was strongest for raising the minimum drinking age and lowest for increasing prices. The support from drinkers to increasing controls on alcohol could be one lever to getting control measures implemented. [Parry CDH, Trangenstein P, Lombard C, Jernigan DH, Morojele NK. Support for alcohol policies from drinkers in the City of Tshwane, South Africa: Data from the International Alcohol Control study. Drug Alcohol Rev 2017;00:000-000]. [ABSTRACT FROM AUTHOR]

Addresses issues in depression among women. Effects of estrogen on the central nervous system; Importance of the hypothalamo-pituitary-gonadal axis in the pathobiology of depression in women; Difference between women and men during the reproductive age.

: Background Despite increased risks of postoperative complications among patients who use tobacco, a number of barriers hinder the systematic identification of surgical patients who smoke. The study investigated the accuracy and acceptability of a patient-completed touchscreen computer program, which assessed patient smoking status during attendance at a surgical pre-operative clinic. : Methods One thousand and four patients participated in the study and completed a touchscreen computer smoking assessment program. : Results The sensitivity and specificity measures of the computerized assessment were 93% and 95%  respectively. Patients, and clinic receptionists, nurses and anaesthetists found the touchscreen computer-based assessment acceptable. : Conclusions The findings suggest that computerized assessment of smoking status is an accurate and acceptable way to identify tobacco users in a pre-operative clinic setting. [ABSTRACT FROM AUTHOR]