bluuebunny/crossref_metadata_2025 huggingface dataset:
POPULATION‐BASED STUDY OF AGE, GENDER AND CAUSES OF SEVERE INJURY IN AUCKLAND, 2004
Authors: Creamer Gowan L. , Civil Ian , Koelmeyer Timothy , Adams David , ČAčala Shas , Thompson John
Published: August 2010

Background:  The burden of severe injury is an important health statistic. When accurate injury data are linked to census population data a reference dataset can be obtained. This information is vital to direct injury prevention and trauma system development.

Methods:  Severe injury was defined as death or injury severity score more than 15. Resident population projections for the Auckland region (2004) were provided by New Zealand Statistics. Combining data from coronial autopsy and four hospital trauma databases provided age, sex, mechanism, mortality and hospitalization information for severely injured Aucklanders. Mechanism groupings were both blunt, penetrating or burn; and activity based (motor vehicle related (occupant and pedestrian), falls, hanging, assault, burns, sports, playing, aircraft, boating and work related).

Results:  Four hundred and forty‐eight Auckland residents had severe injuries of which 192 died. The mortality and severe injury rates (includes mortality) were 14.4/100 000 and 33.6/100 000, respectively. Groups that were overrepresented in the population were male sex, those aged 15–29, those aged >75. Injury rate was lowest in those aged 0–14 years. Injury causes were motor vehicle related (50%), falls (19%), hangings (15%), assault (11%) and other: burns, work related, sports, playing, aircraft and boating related (5%) and 3.8% of cases were from penetrating mechanism. Hangings, road traffic crashes, assaults and falls had at‐scene mortality rates of 100, 26, 25 and 6% and inpatient mortality rates of 0, 11, 4 and 17%, respectively (P < 0.05).

Conclusion:  Auckland has a severe injury rate that is lower than other similar studies. Contributing factors include: low interpersonal violence rates, the predominantly urban population, the data source and the inclusion of the paediatric age group.
HIRSCHSPRUNG’S DISEASE: A REGIONAL EXPERIENCE
Authors: Koh Cherry E. , Yong Tuck L. , Fenton Edmond J. M.
Published: August 2010

Background:  Hirschsprung’s disease (HD) is widely quoted to have an incidence of approximately 1 in 5000 live births. However, it is also known that regional variation in incidence can occur. The aim of this paper was to study the incidence of Hirschsprung’s disease in Tasmania and to document a regional experience of HD.

Methods:  A retrospective review of all patients with newly diagnosed HD between January 1998 and December 2005 was carried out. Data were extracted from medical records and reported. Tasmanian birth statistics from 1998 to 2005 were obtained from the Australian Bureau of Statistics website and the incidence was calculated.

Results:  Over the 8‐year study period, 14 new cases of HD were identified in Tasmania. The estimated incidence of HD in Tasmania based on this study is 1 in 3429. This incidence is higher than the widely quoted incidence of 1 in 5000, but the difference did not reach statistical significance. Between 2003 and 2005, there was a surge in the number of cases with 11 of 14 cases being derived from these 3 years. No obvious reasons were found to explain this surge in the number of cases. Abdominal distension and vomiting were most common modes of presentation (100 and 71%, respectively). There was delayed passage of meconium in 43%.

Conclusion:  The incidence of Hirschsprung’s disease seems higher in Tasmania. The surge in the number of cases is also of interest, although the reasons behind this remain unknown. Delayed passage of meconium was also less common than previously cited.
RAPID VERSUS FULL SYSTEMATIC REVIEWS: VALIDITY IN CLINICAL PRACTICE?
Authors: Watt Amber , Cameron Alun , Sturm Lana , Lathlean Timothy , Babidge Wendy , Blamey Stephen , Facey Karen , Hailey David , Norderhaug Inger , Maddern Guy
Published: August 2010

Introduction:  Rapid reviews are being produced with greater frequency by health technology assessment (HTA) agencies in response to increased pressure from end‐user clinicians and policy‐makers for rapid, evidence‐based advice on health‐care technologies. This comparative study examines the differences in methodologies and essential conclusions between rapid and full reviews on the same topic, with the aim of determining the validity of rapid reviews in the clinical context and making recommendations for their future application.

Methods:  Rapid reviews were located by Internet searching of international HTA agency websites, with any ambiguities resolved by further communication with the agencies. Comparator full systematic reviews were identified using the University of York Centre for Reviews and Dissemination HTA database. Data on a number of review components were extracted using standardized data extraction tables, then analysed and reported narratively.

Results:  Axiomatic differences between all the rapid and full reviews were identified; however, the essential conclusions of the rapid and full reviews did not differ extensively across the topics. For each of the four topics examined, it was clear that the scope of the rapid reviews was substantially narrower than that of full reviews. The methodology underpinning the rapid reviews was often inadequately described.

Conclusions:  Rapid reviews do not adhere to any single validated methodology. They frequently provide adequate advice on which to base clinical and policy decisions; however, their scope is limited, which may compromise their appropriateness for evaluating technologies in certain circumstances.
REVIEW OF THE EXTENT TO WHICH ORCHIDOPEXY IS PERFORMED AT THE OPTIMAL AGE: IMPLICATIONS FOR HEALTH SERVICES
Authors: Bruijnen Christine J. P. , Vogels Helen D. E. , Beasley Spencer W.
Published: August 2010

Background:  In recent decades, the recommended age for orchidopexy for primary undescended testes has decreased, in the expectation that this might improve subsequent fertility. The aim of this study was to investigate whether this is reflected in a reduction in the age at which orchidopexies are carried out, and the implications for child health services.

Methods:  All boys who underwent an orchidopexy for an undescended testis carried out by the Christchurch‐based paediatric surgical service between January 1997 and December 2007 were identified through a prospectively collected database. They were analysed according to the age at time of operation and year of surgery to determine whether there was any trend over time. The proportions of children younger than 2 years and between 2 and 5 years of age were calculated for each year.

Results:  In total, 788 boys underwent orchidopexies for primary undescended testes, with 335 (42.5%) boys having surgery before the age of 2 (mean age 54.3 months, median 31.1 months). During the whole 11‐year period, there was no significant change in age at orchidopexy, whereas from 2003, a significant trend towards lower age at operation (Spearman’s rank −0.1112, P = 0.0071) and a significant increase in the proportion of boys having surgery before the age of 2 (Spearman’s rank 0.9000, P = 0.0374) were seen.

Conclusions:  Although there has been a modest reduction in the mean age of orchidopexy since 2003, overall, the mean age at orchidopexy remains well above the recommended optimal age, implying that more attention should be paid towards earlier diagnosis and referral for primary undescended testes.
Intraoperative radiotherapy in women with early breast cancer treated by breast‐conserving therapy
Authors: Chua Boon H. , Henderson Michael A. , Milner Alvin D.
Published: August 2010

Background:  Previous studies demonstrated the feasibility of intraoperative radiotherapy (IORT) to the primary tumour bed using a miniature electron beam driven X‐ray source for early breast cancer. This study aimed to evaluate the feasibility of IORT as a tumour bed boost after whole breast irradiation (WBI) in breast conserving therapy.

Methods:  This was a single‐arm prospective trial for women with breast cancer measuring <3 cm. After breast‐conserving surgery, a single IORT dose of 5 Gray (Gy) prescribed to 10 mm from the applicator surface was delivered to the breast tissues using 50 kV X‐ray followed by standard WBI. The feasibility rate of protocol therapy was defined as the percentage of all women who completed both IORT and WBI. A desirable completion rate was >90%. The protocol therapy would be considered unsuitable for further development if the completion rate was <75% or severe acute toxicity occurred in >15% of women who received IORT.

Results:  Sixty patients were recruited for the study. IORT and WBI were delivered in 58 and 55 patients, respectively. Thus, the feasibility rates of IORT alone and both IORT and WBI were 97% (95% confidence interval (CI), 89–99%) and 92% (95% CI, 83–97%), respectively. A severe surgical complication or grade 3 or 4 acute radiation toxicity were identified in 10% (6/58) of women who had IORT.

Conclusion:  Tumour bed boost using IORT in women with early breast cancer treated with conservative surgery and WBI was shown to be feasibly consistent with previous studies.
Ethical issues with the disclosure of surgical trial short‐term data
Authors: Allardyce Randall A. , Bagshaw Philip F. , Frampton Christopher M. , Frizelle Francis A. , Hewett Peter J. , Rieger Nicholas A , Smith J. Shona , Solomon Michael J. , Stevenson Andrew R. L.
Published: August 2010

Background:  This paper describes the distinctions between major surgical and pharmaceutical trials and questions the application of a common ethical paradigm to guide their conduct and reporting.

Methods:  Surgical trials differ from other trials in cumulative therapeutic effects, operator dependence, the clinical setting, interdependence of short‐ and long‐term outcomes, and equipoise. A principal tenant of randomized controlled trial management is the maintenance of interim data confidentiality. Its application to complete surgical short‐term data is examined across a variety of common clinical trial circumstances that influence data integrity and the reliability of conclusions regarding the benefit‐to‐risk profile of experimental interventions.

Results:  Complete perioperative results describe important treatment ends that cannot influence primary outcomes. These short‐term results may inform patient consent, teaching and provide valuable procedural insights to surgeons outside trial precincts.

Conclusion:  Structured experimentation standards are necessary. But, the common paradigm applied across all clinical trials and the prohibition on short term data reporting may not serve the achievement of safe and effective advancements in surgery.
Strategies in cardiac tissue engineering
Authors: Tee Richard , Lokmic Zerina , Morrison Wayne A. , Dilley Rodney J.
Published: August 2010

In heart failure, post‐myocardial infarction and some congenital cardiac anomalies, organ transplantation is the only effective cure. Shortage of organ donors and complications of orthotopic heart transplant remain major challenges to the modern field of transplantation. Tissue engineering using cell‐based strategies presents itself as a new way of generating functional myocardium. Engineering functional myocardium de novo requires an abundant source of cells that can form cardiomyocytes. These cells may be used with biocompatible scaffold materials to generate a contractile myocardium. Lastly, to sustain the high metabolism of the construct, a functional vasculature needs to be developed with the forming cardiac tissue. This review provides an update on the progress of stem cell research in the context of cardiac tissue development, types of biomaterials used in cardiac tissue engineering (CTE) and currently employed strategies for vascularization in CTE. In addition, a brief overview of strategies utilized in CTE is provided.
Evaluating the safety of the Harmonic Scalpel around the recurrent laryngeal nerve
Authors: Jiang Hang , Shen Hongliang , Jiang Daozhen , Zheng Xiangmin , Zhang Wei , Lu Lei , Jiang Zhiguo , Qiu Ming
Published: August 2010

Background:  The Harmonic Scalpel (HS) is widely used in thyroidectomy. Determining the safety margin of using the HS near the recurrent laryngeal nerve (RLN) is helpful in preventing the injury to this nerve during thyroidectomy.

Methods:  The parameters of evoked electromyography (EEMG) of vocal muscles before and after using the HS at a power level of 3 were recorded in a rabbit model. Masson staining was used to determine lateral injury caused by incisions using the HS.

Results:  After the activated tip of the HS made contact with the RLN for ≥1 s or was placed 1 mm from the nerve for 3 or 5 s or 2 mm from the nerve for 5 s, significant changes were observed in the minimal stimulus current intensity threshold, the optimal stimulus current intensity threshold, the onset latency and the wave amplitude of EEMG. After the activated HS tip touched the RLN or was placed 1 mm to the nerve for ≥1 s or 2 mm to the nerve for 5 s, significant changes were found in peak latency. The thickness of injured lateral tissue was <1, 1–2 and >2 mm when using HS for 1, 3 and 5 s, respectively.

Conclusion:  When used near the RLN at a power level of 3, the activated HS tip should be ≥2 mm from the nerve and the duration of incision should be ≤3 s.
Dissociating the role of the caudate nucleus and dorsolateral prefrontal cortex in the monitoring of events within human working memory
Authors: Provost Jean‐Sebastien , Petrides Michael , Monchi Oury
Published: August 2010

There is evidence that the dorsolateral prefrontal cortex is involved in the monitoring of information held in memory whether it is self‐ordered or externally triggered. However, the functional contribution of the caudate nucleus in the monitoring of events has not yet been studied. We have previously proposed that the striatum is involved when a novel self‐initiated action needs to be generated. The present study aimed to test the hypothesis that the caudate nucleus is significantly more required when the monitoring is self‐ordered as opposed to externally triggered. Self‐ordered monitoring refers to keeping track of which items have been selected so far in order to perform the current selection. Externally triggered monitoring refers to keeping track of which items have been selected by an outside source. Thirteen healthy young adults were scanned using functional magnetic resonance imaging while performing a monitoring task with three conditions: self‐ordered, externally triggered and recognition. As predicted, a significant increase of activity was found in the dorsolateral prefrontal cortex bilaterally when the self‐ordered and externally triggered conditions were compared with the recognition condition. Most importantly, significantly increased activity was found in the right caudate nucleus when comparing the self‐ordered with the recognition condition or with the externally triggered condition, but not when comparing the externally triggered with the recognition condition. We suggest that the caudate nucleus is involved in the planning of a self‐initiated novel action, especially when no clear indication is given for the response choice, and that this may be the case across different domains of cognition.
DIAGNOSIS OF CARCINOMA OF PROSTATE
Authors: MIMPRISS T. W.
Published: August 2010

1. Histological proof of the diagnosis of carcinoma of prostate should be obtained if possible. Biopsy techniques are discussed.

2. There is no entirely satisfactory method of biopsy.

3. The cytological diagnosis of smears of prostatic secretion is by no means reliable and is open to serious objections. Moreover, it is useless in the diagnosis of the early case.

4. Transrectal biopsy is a more reliable method and can be used in the diagnosis of the early case and suspicious nodule.

5. By using transrectal biopsy an occasional patient suitable for radical operation can be selected.
PROSTATECTOMY: An Analysis of the Factors contributing to Mortality and Morbidity after Prostatectomy and a Description of a Personal Technique
Authors: JEEJEEBHOY H.
Published: August 2010

1. The factors contributing to mortality and morbidity after prostatectomy are discussed.

2. It is concluded that the ideal operation would be a modification of the Freyer technique so designed as to eliminate its disadvantages of slow healing, and occasional bladder‐neck stenosis, while at the same time retaining its advantages of simplicity and safety.

3. An operative technique is described and the results in a consecutive unselected series of twenty‐eight cases are presented.

Some of these operations were performed while I was in England. My thanks are due to the various surgeons under whose care the patients were admitted for permission to perform the operations. The remainder were performed in Bombay, and my thanks are due to the Superintendent, J.J. Group of Hospitals, Bombay, for permission to include the cases operated on at that hospital.

One of my past House Surgeons, Dr A. Khambatta, M.B., B.S., drew the illustrations, and to him I tender my sincerest gratitude.
A TECHNIQUE OF VASECTOMY FOR THE PREVENTION OF EPIDIDYMITIS AFTER PROSTATECTOMY
Authors: BROOKE BRYAN N. , WALKER FRANK C.
Published: August 2010

The incidence and aetiology of acute epididymitis following prostatic operations are discussed with reference to the advent of antibiotics.

Techniques of vasal interruption are summarised and a further method is described with mention of its advantages.
DOUBLE BLADDER AND RELATED ANOMALIES: CLINICAL AND EMBRYOLOGICAL ASPECTS AND A CASE REPORT
Authors: ABRAHAMSON JACK
Published: August 2010

1. Reduplication and similar abnormalities of the urinary bladder and associated anomalies are classified and described.

2. The literature on this subject is reviewed.

3. The embryology, clinical features, diagnosis, treatment, and prognosis are discussed.

4. A case report is given of a female aged 9 years presenting with lower urinary tract obstruction and failing renal function, found to have a bladder with a complete sagittal septum with the closed and distended left‐sided chamber obstructing the right‐sided chamber. Bilateral hydro‐ureter and right hydronephrosis were present. The left kidney was hypoplastic. Other associated anomalies were sacral agenesis and an abnormal first lumbar vertebra. Besides the uramia, hypertension, a bleeding tendency, ansmia, uremic pericarditis, and cardiac failure were also present.

5. Some features of the case are discussed.

I wish to record my gratitude to Mr D. Innes Williams for permission to publish this case and for his encouragement and help in the preparation of this paper. Thanks are also due to Mr D. Martin and Mr G. Lyth of the Departments of Clinical Photography and Medical Illustration, The Hospital for Sick Children, Great Ormond Street, London, for the photographs and drawings.
UNUSUAL VESICAL CALCULI
Authors: STEWART J. O. R. , O'CONNELL N. D.
Published: August 2010

An unusual case is reported, in which “ jackstone ” calculi were associated with an enlarged prostate and papilloma of the bladder. The literature is reviewed and a note added on treatment.

We wish to thank Mr B. McN. Truscott for permission to treat and publish this case, Dr F. R. Berridge for permission to reproduce the X‐ray films, and Mr S. W. Vince of the Department of Medical Photography, United Cambridge Hospitals, for the photographs.
MALIGNANT BLADDER TUMOURS IN INFANTS
Authors: SHOESMITH J. H. , ROBINSON M. P.
Published: August 2010

A malignant tumour of the bladder in a child of 31/2 years is reported. The pathology and treatment of this condition are briefly reviewed.
ANALYSIS OF NEUROGENIC DYSFUNCTION OF THE LOWER URINARY TRACT1
Authors: MURPHY JOHN J. , SCHOENBERG HARRY W. , TRISTAN THEODORE A.
Published: August 2010

Analysis of lower urinary tract dysfunction due to neurological disease by means of combined simultaneous cinefluorographic cysto‐urethrography and direct cystometry indicates that patients with reflex neurogenic bladders have high resting intravesical pressures with further increase at the time of reflex contraction and that this contraction is not sustained. The high pressures result from hypertonicity of the detrusor and lack of co‐ordination of the outlet mechanism. Abdominal straining and suprapubic pressure produce high intravesical pressures and may lead to the sequela? of bacteremia and ascending urinary tract infection when used to effect emptying of autonomous‐type neurogenic bladders. As a result of these findings, methods of management which remove the danger of high intravesical pressures are recommended.
LIPID GRANULOMATA OF THE TESTIS AND EPIDIDYMIS1
Authors: PHILLIPS D. E. H.
Published: August 2010

In summary it may be stated that a lipid has been demonstrated to be liberated from spermatozoa during the tissue reactions resultant upon extravasation, and that a similar lipid has been demonstrated to be present in the lesions of granulomatous orchitis. There are good reasons for believing that the granulomatous reaction in these conditions is a specific response to the presence of the lipid, and, from the similarities in this lipid histochemically, it seems likely that it is identical in the two conditions, suggesting that the original source of the lipid in the case of granulomatous orchitis is probably disintegrating spermatozoa within the seminiferous tubules.
TWO CASES OF COMPLETE DOUBLE FUNCTIONAL URETHRA WITH A SINGLE BLADDER1
Authors: BOISSONNAT PIERRE
Published: August 2010

Two unusual cases of complete double functional urethra, one in a male and the other in a female, with a single bladder (and a single penis in the male case) are presented. No cases exactly like these could be found in the literature. The treatment and aetiology are discussed and the past literature is reviewed.
SUPERVOLTAGE X‐RAY THERAPY AND THE MANAGEMENT OF BLADDER CANCER1
Authors: NEWALL JOSEPH
Published: August 2010

The results of treatment of bladder cancer in Edinburgh are reviewed. The best results are obtained from small localised tumours in which localised interstitial irradiation can be given. The results in those patients in whom spread outwith the bladder has occurred are disappointing and the salvage both by irradiation and surgery appears to be small. The real problem is the patient with extensive disease confined to the bladder, and it is suggested that such patients should be treated in the first instance by supervoltage X‐ray therapy, but that if no obvious response is obtained within a short period after completion of the course of therapy then consideration should be given to radical surgery.
THE QUANTJTATION OF RENAL BLOOD FLOW USING I125HIPPURAN
Authors: Chisholm G. D. , Evans K. , Kulatilake A. E.
Published: August 2010

Experimental studies of renal blood flow have been made with radio‐Hippuran I125using isolated perfused canine kidneys. These studies were made in two groups. First, the renogram curve was analysed by applying theoretical equations and it was shown that quantitative values could be obtained for the effective renal blood flow. In the second group of experiments the analysis of the rate of disappearance of the isotope from the blood showed a definite relationship with directly measured renal blood flow, but this could not be resolved into a quantitative value.

The authors' thanks are due to Professor Ralph Shackman for his encouragement and guidance in this work, to Mr E. Gains and his technical staff for their help, to the Department of Photography and Medical Illustration of the Post‐graduate School for their assistance in drawing of the charts, and to Mr Ole Kalnaes, Radiofysisk laboratorium, Arhus Kommunehospital, for his help with mathematical equations.

The expenses incurred in these experiments were defrayed by a grant to one of us (A. E. K.) from the Medical Research Council.
EXPERIENCE AND RECENT CONTRIBUTIONS IN SACRAL NERVE STIMULATION FOR VOIDING IN BOTH HUMAN AND ANIMAL1
Authors: Habib HenryN.
Published: August 2010

Preliminary investigations on sixty‐four dogs and five human paraplegics in the past three years have led to the location of neural trigger points, which in the human were found to be the third and fourth sacral nerves at their exit from the sacral foramina anteriorly. Successful voiding was induced with reproducible results for four to five months using an electrical current about 80 to 100 times smaller than the one used for stimulation of the muscle directly.

An interesting by‐product of this chronic stimulation led to the discovery of a neural trigger point which, when stimulated, causes immediate and sustained erection of the penis in paraplegic patients. We plan to try our methods in cases of impotence caused by a nerve lesion proximal to the point of electrical nerve excitation.

The present work consists mainly in improving our surgical approach in the human and designing electrodes of special configuration with material well insulated. The electronic exciting mechanism is also being developed in miniature size for prolonged use. Special precautions are being developed to minimise as much as possible the inflammatory reaction of nerve tissue to the electrodes.
THE DIAGNOSIS OF PROSTATIC CANCER: CYTOLOGICAL AND BIOCHEMICAL STUDIES USING THE FRANZEN BIOPSY NEEDLE
Authors: Williams J. P. , Still BessM. , Pugh R. C. B.
Published: August 2010

Experience of trans‐rectal biopsy, using a fine needle, as a means of diagnosing carcinoma of the prostate is described. Emphasis is laid on the minor nature of the procedure, its cytological reliability and on the useful supporting evidence of malignancy afforded by enzyme estimation of the aspirate. The technique is considered to be a valuable diagnostic method in prostatic disease.
Prescription drug misuse: Is technology friend or foe?
Authors: NIELSEN SUZANNE , BARRATT MONICA JANE
Published: August 2010

Introduction and Aims. Prescription drug misuse and related harms have been increasing considerably over the past decade. At the same time, there has also been rapid growth in the use of online and Internet technologies. Thus, it is important that we understand the role online and Internet technologies play in prescription drug misuse. Design and Methods. Published work addressing the role of technology in prescription drug misuse is explored. Topics include: Internet supply, online monitoring of prescription drug use trends and electronic prescription monitoring. Results. Little is known about the prevalence of acquiring prescription drugs from online pharmacies. Prescription drugs are easily accessible through vendor websites, and ‘rogue’ no‐prescription websites have proven difficult to control. There has so far been limited application of real‐time monitoring to prevent overuse of prescription medications. Online monitoring of drug use trends may also prove to be a useful and timely source of information about new methods of ‘off‐label’ prescription drug use. Discussion and Conclusions. Technology has the potential to play a more prominent role in facilitating drug acquisition, while also enhancing the monitoring and prevention of prescription drug misuse. As technology becomes more ubiquitous in everyday life, the continued investigation of its relationship with prescription drug misuse becomes even more important.[Nielsen S, Barratt MJ. Prescription drug misuse: Is technology friend or foe? Drug Alcohol Rev 2009;28:81–86]
Web‐based screening and advice for hazardous drinkers: Use of a Spanish site
Authors: RODRÍGUEZ‐MARTOS A. , CASTELLANO Y.
Published: August 2010

Introduction and Aims. A website for implementing screening and brief intervention on alcohol was launched in Barcelona, Spain, in October 2006. Its aim was to reach hazardous drinkers who probably would not ask for advice. This article describes use of the site, profiles users and discusses limitations concerning screening. Design and Methods. The website included screening, advice and information. Demographic and self‐screening data (typical weekly consumption and the Alcohol Use Disorders Identification Test, AUDIT) were examined. Results. In a 12 month period, 12 138 visitors entered the website, 2574 started self‐assessment, 1342 completed the table and 724 of these participants completed the AUDIT. These users had a mean age of 27.6 years, one‐third of them drank above recommended weekly limits and 84.1% of those who completed the AUDIT (n = 724) scored positive (≥5); a total of 70.3% of identified at‐risk drinkers entered the advice section. Among visitors to the site, risk factors for hazardous drinking were: being male,≥35 years of age, and drinking heavily at weekends. Discussion and conclusions. The percentage of hazardous drinkers accessing the site was high, and visitors reported that they liked the design, that it was easy to use and that it provided relevant information. Most of those who had sought advice considered it to be helpful. The website seems to be an accessible and useful tool for young people and might be used in youth centres as well as in health‐care settings, such as primary care and emergency centres, where it could contribute to health promotion and constitute an easier alternative to screening and brief intervention given by the staff.[Rodríguez‐Martos A, Castellano Y. Web‐based screening and advice for hazardous drinkers: Use of a Spanish site. Drug Alcohol Rev 2009;28:54–59]
Development of a Web‐based alcohol intervention for university students: Processes and challenges
Authors: HALLETT JONATHAN , MAYCOCK BRUCE , KYPRI KYPROS , HOWAT PETER , MCMANUS ALEXANDRA
Published: August 2010

Introduction and Aims. Despite growing evidence of the efficacy of electronic screening and brief interventions for reducing unhealthy alcohol use, there is no published work describing the development of such interventions. We describe the process of developing and implementing an electronic screening and brief intervention in a large university population. Design and Methods. Thematic analysis of seven focus groups, involving a total of 69 students, informed the content and design of THRIVE (Tertiary Health Research Intervention Via Email). Pilot testing was conducted through usability analysis with a further 16 students. A random sample of 13 000 undergraduates was invited to complete screening and hazardous drinkers were randomised to receive Web‐based assessment and feedback or screening alone. Participants' use of THRIVE was examined through server log analysis and responses to questions on instrument design/usability during follow‐up assessment 6 months later. Results. A total of 7237 students (56% of those invited) completed screening; 2435 (34%) screened positive for unhealthy drinking; 1251 were randomly assigned to receive the intervention; and 1184 served as controls. In total, 99% of participants found THRIVE easy to complete, 76% said it provided personally relevant information and 55% said they would recommend it to a friend with a drinking problem. Thirty per cent sought additional information on support services through the site. Discussion and Conclusions. Key design elements include ease of access (e.g. via an emailed hyperlink), length (<10 min), clear, non‐judgmental language, personalised normative feedback and links to appropriate services. The study demonstrates the potential reach of a carefully implemented intervention in a high‐risk, non‐treatment‐seeking population group.[Hallett J, Maycock B, Kypri K, Howat P, McManus A. Development of a Web‐based alcohol intervention for university students: Processes and challenges. Drug Alcohol Rev 2009;28:31–39]
Short forms of the AUDIT in a Web‐based study of young drinkers
Authors: MCCAMBRIDGE JIM , THOMAS BONNITA A.
Published: August 2010

Introduction. The Alcohol Use Disorders Identification Test (AUDIT) is under‐studied among young drinkers, as are the contributions of individual items to total AUDIT scores, and online performance of the existing briefer versions of this instrument. Design and Methods. This study examined individual items of the AUDIT, and various combinations, including the existing briefer versions, in relation to total AUDIT scores in a Web‐based study of young drinkers. A total of 167 young people aged 16–24 years old who had consumed any alcohol within the previous 7 days were recruited by both offline and online methods. Results. Considered individually, items 3, 4, 5 and 8 were predictive of the majority of the variance in total AUDIT scores in this Web‐based study. Existing briefer versions of the AUDIT do not better predict total scores than possible alternative combinations of items, for which acceptable levels of sensitivity and specificity for screening have been demonstrated. Conclusions. Short forms of the AUDIT, particularly those based only on consumption questions, require further validation study in online applications with young people.[McCambridge J, Thomas BA. Short forms of the AUDIT in a Web‐based study of young drinkers. Drug Alcohol Rev 2009;28:18–24]
Drug‐using mothers: Factors associated with retaining care of their children
Authors: GILCHRIST GAIL , TAYLOR AVRIL
Published: August 2010

Introduction and Aims.Research suggests that upwards of 50% of drug users do not live with their children, yet little is known about these children's living arrangements or the variables associated with mothers retaining care of their children.Design and Methods.This cross‐sectional study examined the number of pregnancies and children born to female drug users receiving and not receiving treatment, the living arrangements of their children and the variables associated with not living with their children.Results.Data on 185 mothers from a study on psychiatric morbidity among drug users in Glasgow, Scotland were analysed. Participants had given birth to 327 children, 44% (132/297) of children were living with their mother; 26% (78/297) were being cared for by a family member and 20% (59/297) were in local authority care or had been adopted. 49% (87/179) of participants did not live with any of their children. Stepwise multiple forward logistic regression found that current depressive symptoms [odds ratios (OR) 3.90, 95% confidence intervals (CI) 1.78–8.55], lifetime involvement in prostitution (OR 3.12, 95% CI 1.41–6.93), lifetime history of homeless (OR 2.96, 95% CI 1.13–6.39), living with a drug user (OR 2.71, 95% CI 1.30–5.65) and ever being incarcerated (OR 2.47, 95% CI 1.17–5.21) were associated with participants not living with any of their children versus living with at least one of their children.Discussion and Conclusions.Access to drug treatment, mental health treatment and parent craft education should be enhanced for female drug users to assist them retain care of their children where possible.[Gilchrist G, Taylor A. Drug‐using mothers: Factors associated with retaining care of their children.Drug Alcohol Rev2009]
The association of alcohol dependence with general practice attendance
Authors: PROUDFOOT HEATHER , TEESSON MAREE
Published: August 2010

Introduction and Aims. This study was designed to examine the relationship between alcohol dependence and general practitioner (GP) service attendance in Australia. Design and Methods. Data were analysed from the 1997 Australian National Survey of Mental Health and Wellbeing. In this survey, a representative sample of the Australian population was interviewed to ascertain past 12 month psychiatric diagnoses for all major mental disorders as well as the use of primary and other health services (n = 10 641, 79% response rate). Results. People with alcohol dependence comorbid with other psychiatric disorders have higher rates of service usage than those without such disorders. Discussion and Conclusions. Alcohol dependence comorbid with mental disorders has a significant impact on GP service in Australia. High rates of service use by individuals with such comorbidities were a considerable burden for GP services.[Proudfoot H, Teesson M. The association of alcohol dependence with general practice attendance. Drug Alcohol Rev 2009]
The ageing heroin user: Career length, clinical profile and outcomes across 36 months
Authors: DARKE SHANE , MILLS KATHERINE L. , ROSS JOANNE , WILLIAMSON ANNA , HAVARD ALYS , TEESSON MAREE
Published: August 2010

Introduction and Aims. The study examined the relationships between length of career (LOC), clinical presentation and outcomes across 36 months among a cohort of 615 heroin users. Design and Methods. Longitudinal cohort study. Results. At baseline, each additional year of heroin use was associated with increased likelihood of: being male, exposure to treatment, having been imprisoned, daily injecting, lifetime and recent polydrug use, having overdosed, poorer physical health and reduced likelihood of heroin smoking. In contrast, LOC was not related to frequency of heroin use, current polydrug use, recent heroin overdose, recent imprisonment, recent criminality or psychopathology. There were also no associations between LOC and outcomes across 36 months in terms of treatment, drug use, crime, severe psychiatric disability or major depression. Longer LOC was associated across 36 months, however, with daily injecting, poorer physical health, severe physical disability and poorer mental health. Discussion and Conclusions. The data point to the maintenance of heroin‐related harms well into the third decade of use.[Darke S, Mills KL, Ross J, Williamson A, Havard A, Teesson M. The ageing heroin user: Career length, clinical profile and outcomes across 36 months. Drug Alcohol Rev 2009]
It ain't what you do, it's the way that you do it: A qualitative study of advice for young cannabis users
Authors: FAULKNER NATHAN , MCCAMBRIDGE JIM , SLYM RENEE L. , ROLLNICK STEPHEN
Published: August 2010

Introduction: Advice is a widely recommended and practised intervention with young drug users. Study of precisely how advice is given and received in any setting has, however, been limited. Design and Methods: We qualitatively analysed 106 audio‐recordings of advice sessions on cannabis use for young people within a randomised trial. Inductive data analysis was guided by a focus on practitioner behaviour which served to engage the active participation of the young drug user in the session. Results: A cluster of ‘Information Management’ activities was identified together with an ‘Interactive Orientation’ evident in a series of specific behaviours. Participants were most successfully engaged when both were combined, understood here as ‘Personalised Advice‐giving’. Discussion and Conclusions: These components identified in this exploratory study might assist further research in rectifying the absence of a solid empirical basis for effective practice in advice giving with young drug users and more widely.[Faulkner N, McCambridge J, Slym RL, Rollnick S. It ain't what you do, it's the way that you do it: A qualitative study of advice for young cannabis users. Drug Alcohol Rev 2009;28:129–134]
Access to health and social services for IDU: The impact of a medically supervised injection facility
Authors: SMALL WILL , VAN BOREK NATASHA , FAIRBAIRN NADIA , WOOD EVAN , KERR THOMAS
Published: August 2010

Introduction and Aims. Injection drug users (IDU) often experience barriers to conventional health‐care services, and consequently might rely on acute and emergency services. This study sought to investigate IDU perspectives regarding the impact of supervised injection facility (SIF) use on access to health‐care services. Design and Methods. Semi‐structured qualitative interviews were conducted with 50 Vancouver‐based IDU participating in the Scientific Evaluation of Supervised Injecting cohort. Audio‐recorded interviews elicited IDU perspectives regarding the impact of SIF use on access to health and social services. Interviews were transcribed verbatim and a thematic analysis was conducted. Results. Fifty IDU, including 21 women, participated in this study. IDU narratives indicate that the SIF serves to facilitate access to health care by providing much‐needed care on‐site and connects IDU to external services through referrals. Participants’ perspectives suggest that the SIF has facilitated increased uptake of health and social services among IDU. Discussion and Conclusions. Although challenges related to access to care remain in many settings, SIF have potential to promote health by facilitating enhanced access to health‐care and social services through a model of care that is accessible to high‐risk IDU.[Small W, Van Borek N, Fairbairn N, Wood E, Kerr T. Access to health and social services for IDU: The impact of a medically supervised injection facility. Drug Alcohol Rev 2009;28:341–346]
From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol
Authors: BROWN THOMAS G. , OUIMET MARIE CLAUDE , NADEAU LOUISE , GIANOULAKIS CHRISTINA , LEPAGE MARTIN , TREMBLAY JACQUES , DONGIER MAURICE
Published: August 2010

Issues. Driving while impaired by alcohol (DWI) is responsible for substantial mortality and injury. Significant gaps in our understanding of DWI re‐offending, or recidivism, reduce our ability to practically assess recidivism probability and to match interventions to individual risk profiles. These shortcomings reflect the baffling heterogeneity in the DWI population and the limited focus of much existing DWI recidivism research to psychosocial, psychological and substance use correlates. Approach. This narrative review summarises the evidence for the contribution of neurocognitive and psychobiological mechanisms to DWI behaviour and recidivism. Given the nascent nature of this literature, insight into the putative contribution of these mechanisms to DWI is also drawn from other experimental literatures, particularly those on alcohol use disorders and cognitive and behavioural neuroscience. Key Findings. Alcohol‐related neurotoxicity and dysregulation of hypothalamic–pituitary–adrenal axis and serotonergic systems may underlie certain offender characteristics consistently correlated with heightened DWI risk, persistence and intervention resistance. Their markers are less vulnerable to sources of bias than subjective psychosocial indices and are more far‐reaching than alcohol abuse in explaining DWI behaviour and recidivism. Implications. The investigation of neurocognitive and psychobiological mechanisms in DWI research is a promising avenue for discerning clinically meaningful subgroups within the DWI population. This can lead to research and development in alternative assessment and more targeted intervention technologies. Conclusion. Multidimensional research in DWI and recidivism offers novel avenues for increasing road safety.[Brown TG, Ouimet MC, Nadeau L, Gianoulakis C, Lepage M, Tremblay J, Dongier M. From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol. Drug Alcohol Rev 2009;28:406–418]
Warnings on alcohol containers and advertisements: International experience and evidence on effects
Authors: WILKINSON CLAIRE , ROOM ROBIN
Published: August 2010

Issues. In light of possible introduction of alcohol warning labels in Australia and New Zealand, this paper discusses the international experience with and evidence of effects of alcohol warning labels. Approach. The report describes international experience with providing information and warnings concerning the promotion or sale of alcoholic beverages, and considers the evidence on the effects of such information and warnings. The experience with and evaluations of the effects of tobacco warning labels are also considered. Key Findings. The most methodologically sound evaluations of alcohol warning labels are based on the US experience. Although these evaluations find little evidence that the introduction of the warning label in the USA had an impact on drinking behaviour, there is evidence that they led to an increase in awareness of the message they contained. In contrast, evaluations of tobacco warning labels find clear evidence of effects on behaviour. Implications. There is a need and opportunity for a rigorous evaluation of the impacts of introducing alcohol warning labels to add to the published work on their effectiveness. The experience with tobacco labels might guide the way for more effective alcohol warning labels. Conclusion. Alcohol warning labels are an increasingly popular alcohol policy initiative. It is clear that warning labels can be ineffective, but the tobacco experience suggests that effective warning labels are possible. Any introduction of alcohol warning labels should be evaluated in terms of effects on attitudes and behaviour.[Wilkinson C, Room R. Warnings on alcohol containers and advertisements: International experience and evidence on effects. Drug Alcohol Rev 2009;28:426–435]
Fluctuations in male ischaemic heart disease mortality in Russia 1959–1998: Assessing the importance of alcohol
Authors: RAMSTEDT MATS
Published: August 2010

Introduction and Aims.The decline in cardiovascular mortality in Russia following the Soviet anti‐alcohol campaign of 1985–1988 and the subsequent increase when these extreme alcohol controls were repealed suggested that alcohol consumption is responsible for a substantial number of ischaemic heart disease (IHD) deaths in Russia. To examine whether a similar conclusion can be drawn on the basis of a time‐series analysis covering a longer time period, namely 1959–1998.Design and Methods.Using ARIMA time‐series analysis, the male IHD mortality rates from 1959 to 1998 were analysed in relation to three indicators of alcohol consumption: estimated per capita consumption, mortality from liver cirrhosis and alcohol poisonings. Cigarette sales and lung cancer mortality were used as indicators of smoking.Results.Each indicator of alcohol consumption had positive and statistically significant relationships with male IHD mortality in bivariate autoregressive integrated moving average models. The association was stronger in models predicting changes in premature male IHD mortality (30–54 years). At least one alcohol indicator was significantly related to IHD mortality in multivariate models, and in the case of premature IHD mortality, both mortality indicators were significant.Discussion and Conclusions.The results provide additional empirical evidence supporting alcohol's conceivable negative effects on IHD in Russia and the idea that binge drinking could be the mechanism through which this effect is mediated. There were no signs of any protective effects from alcohol among Russian men.[Ramstedt M. Fluctuations in male ischaemic heart disease mortality in Russia 1959–1998: Assessing the importance of alcohol.Drug Alcohol Rev2009;28:390–395]