bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary embolism associated with combined oral contraceptives: reporting incidences and potential risk factors for a fatal outcome
Authors: Hedenmalm Karin , Samuelsson Eva , Spigset Olav 
Published: May 2004

Background.  It is established that combined oral contraceptive (COC) treatment increases the risk of a pulmonary embolism (PE), but specific risk factors for a fatal outcome from a PE remain to be determined. This study aimed to identify such risk factors, and to calculate the reporting rates of fatal and non‐fatal PE.Methods.  Cases of suspected PE during treatment with COCs reported to the Swedish Adverse Drug Reactions Advisory Committee (SADRAC) between 1965 and 2001 were included. Medical records were scrutinized for potential risk factors for a venous thromboembolism (VTE). Annual sales data were obtained from the National Corporation of Pharmacies.Results.  A total of 248 cases of a suspected PE were reported; 207 non‐fatal and 41 fatal. A VTE was verified in all fatal, and in 83.5% of non‐fatal cases. The presence of nausea or abdominal pain, an age >35 years, concomitant treatment with other drugs which may increase the VTE risk, vein or lymph vessel malformation, and a deep vein thrombosis above the knee level were positively associated with a fatal outcome. Chest pain and previous COC use were negatively associated with a fatal outcome. The reporting rate of a PE with a verified VTE was 1.72 (95% confidence interval 1.47–2.00) cases per 100 000 treatment years, and of a fatal PE 0.25 (95% confidence interval 0.16–0.37) cases per 100 000 treatment years.Conclusion.  Several specific potential risk factors for a fatal outcome from a COC‐induced PE were identified. Recognition of these in combination with a high suspicion of VTE in COC users may reduce the risk of a fatal outcome.
A multi‐site comparison of psychosocial approaches for the treatment of methamphetamine dependence
Authors: Rawson Richard A. , Marinelli‐Casey Patricia , Anglin M. Douglas , Dickow Alice , Frazier Yvonne , Gallagher Cheryl , Galloway Gantt P. , Herrell James , Huber Alice , McCann Michael J. , Obert Jeanne , Pennell Susan , Reiber Chris , Vandersloot Denna , Zweben Joan ,   the Methamphetamine Treatment Project Corporate Authors
Published: May 2004

ABSTRACTAims  The Center for Substance Abuse Treatment (CSAT) Methamphetamine Treatment Project (MTP) is the largest randomized clinical trial of treatments for methamphetamine (MA) dependence to date. The objective of the study was to compare the Matrix Model, a manualized treatment method, with treatment‐as‐usual (TAU) in eight community out‐patient settings in the Western United States.Design  Over an 18‐month period between 1999 and 2001, 978 treatment‐seeking, MA‐dependent people were randomly assigned to receive either TAU at each site or a manualized 16‐week treatment (Matrix Model).Setting  The study was conducted as an eight‐site out‐patient trial, with six sites located in California and one each in Montana and Hawaii.Findings  In the overall sample, and in the majority of sites, those who were assigned to Matrix treatment attended more clinical sessions, stayed in treatment longer, provided more MA‐free urine samples during the treatment period and had longer periods of MA abstinence than those assigned to receive TAU. Measures of drug use and functioning collected at treatment discharge and 6 months post‐admission indicate significant improvement by participants in all sites and conditions when compared to baseline levels, but the superiority of the Matrix approach did not persist at these two timepoints.Conclusions  Study results demonstrate a significant initial step in documenting the efficacy of the Matrix approach. Although the superiority of the Matrix approach over TAU was not maintained at the post‐treatment timepoints, the in‐treatment benefit is an important demonstration of empirical support for this psychosocial treatment approach.
Mortality in England and Wales attributable to any drinking, drinking above sensible limits and drinking above lowest‐risk level
Authors: White Ian R. , Altmann Dan R. , Nanchahal Kiran 
Published: May 2004

ABSTRACTAims  To quantify mortality attributable to any alcohol consumption, and mortality attributable to consumption above different levels.Design  We related all‐cause mortality to alcohol consumption using cause‐specific mortality models from a systematic review and using the distribution of alcohol consumption and causes of death by age and sex in England and Wales in 1997. We estimated the deaths and person‐years of life lost to age 65 that were attributable: to any drinking; to drinking above the nadir (the level of alcohol consumption carrying the lowest risk); and to drinking more than the British Royal Colleges’ recommended limits of 21 units/week in men and 14 units/week in women.Findings  Ischaemic heart disease deaths prevented by alcohol consumption (11 276 in men, 4050 in women) roughly balanced other deaths attributable to alcohol consumption (9246 in men, 4216 in women). Overall, 0.8% of all deaths in men were prevented by alcohol consumption (95% confidence interval, 0.2% to 1.3%), while 0.1% of all deaths in women were attributable to alcohol consumption (95% confidence interval, – 0.3% to 0.4%); 2.1% (1.9–2.3%) of all deaths in men and 0.8% (0.6–1.0%) of all deaths in women were attributable to drinking more than the recommended limits, while 2.8% and 1.2% of deaths, respectively, were attributable to drinking above the nadir. Of all person‐years of life lost to age 65, 10.3% in men and 5.6% in women were attributable to any drinking; 8.5% and 4.0% were attributable to drinking above the recommended limits; and 12.6% and 6.0% were attributable to drinking above the nadir.Conclusions  Although overall mortality risks and benefits of alcohol consumption appear roughly equal, drinking above recommended limits remains responsible for many deaths and a large loss of person‐years of life.
Intensity of drug injection as a determinant of sustained injection cessation among chronic drug users: the interface with social factors and service utilization
Authors: Bruneau Julie , Brogly Susan B. , Tyndall Mark W. , Lamothe François , Franco Eduardo L. 
Published: May 2004

ABSTRACTAims  The objective of this study was to identify factors associated with sustained injection cessation and to examine further the relationship between the occurrence of sustained injection cessation of injection drug users (IDUs) and prior injection frequency.Design and setting  IDUs in the Montreal St Luc Cohort who had at least three consecutive interviews between 1995 and 1999 were included. Sustained injection cessation was defined as a period of at least 7 consecutive months without injection. All IDUs completed interview‐administered questionnaires on socio‐demographic characteristics, drug and sexual behaviours and health‐related issues. Logistic regression was used for analyses.Findings  A total of 186/1004 (18.5%) IDUs reported a period of sustained injection cessation during the study period. In multivariate analysis, HIV‐positive status, ‘booting’ and cumulative time spent in prison were negatively associated with injection cessation, while injection initiation after 35 years of age and frequent crack use were positively associated with injection cessation. We found a negative association between the occurrence of injection cessation and the frequency of injection; the odds ratios (OR) for cessation were 0.49 [95% confidence interval (CI): 0.03, 0.78] for IDUs who injected 30–100 times and 0.21 (95% CI: 0.10, 0.46) for IDUs who injected more than 100 times in the previous month. Attending needle exchange programmes (NEPs) or pharmacies appeared to be a modifier of the relation between cessation and prior injection frequency. The OR was 0.68 (95% CI: 0.42, 1.12) for IDUs who injected 30–100 times prior to injection and attended NEPs or pharmacies and was 0.07 (0.01, 0.30) for IDUs who did not use these services.Conclusions  Overall, a fifth of IDUs experienced at least one episode of injection cessation of 7 months or more during a period of 4.5 years. Our data suggest that NEPs and pharmacies may have played a role in inducing injection cessation episodes in a subgroup of IDUs. Research is needed to better identify the characteristics of IDUs who could benefit from an injection cessation intervention strategy. This information is important for social and health policy planning.
Cost and cost‐effectiveness of standard methadone maintenance treatment compared to enriched 180‐day methadone detoxification
Authors: Masson Carmen L. , Barnett Paul G. , Sees Karen L. , Delucchi Kevin L. , Rosen Amy , Wong Wynnie , Hall Sharon M. 
Published: May 2004

ABSTRACTAims To compare the cost and cost‐effectiveness of methadone maintenance treatment and 180‐day methadone detoxification enriched with psychosocial services.Design Randomized controlled study conducted from May 1995 to April 1999.Setting Research clinic in an established drug treatment program.Participants One hundred and seventy‐nine adults with diagnosed opioid dependence.Intervention Patients were randomized to methadone maintenance (n = 91), which required monthly 1 hour/week of psychosocial therapy during the first 6 months or 180‐day detoxification (n = 88), which required 3 hours/week of psychosocial therapy and 14 education sessions during the first 6 months.Measurements Total health‐care costs and self‐reported injection drug use. A two‐state Markov model was used to estimate quality‐adjusted years of survival.Findings Methadone maintenance produced significantly greater reductions in illicit opioid use than 180‐day detoxification during the last 6 months of treatment. Total health‐care costs were greater for maintenance than detoxification treatment ($7564 versus $6687;P < 0.001). Although study costs were significantly higher for methadone maintenance than detoxification patients ($4739 versus $2855,P < 0.001), detoxification patients incurred significantly higher costs for substance abuse and mental health care received outside the study. Methadone maintenance may provide a modest survival advantage compared with detoxification. The cost per life‐year gained is $16 967. Sensitivity analysis revealed a cost‐effectiveness ratio of less than $20 000 per quality‐adjusted life‐year over a wide range of modeling assumptions.Conclusions Compared with enriched detoxification services, methadone maintenance is more effective than enriched detoxification services with a cost‐effectiveness ratio within the range of many accepted medical interventions and may provide a survival advantage. Results provide additional support for the use of sustained methadone therapy as opposed to detoxification for treating opioid addiction.
The Society for the Study of Addiction (SSA)
Authors: Tober Gillian 
Published: May 2004

ABSTRACTThe Society for the Study of Addiction (SSA) is a learned society which is a company limited by guarantee with charitable status, an independent organization promoting the cause of research, public policy and treatment of addiction. Founded in London in 1884 with the aim of promoting a research‐based understanding of inebriety, it is the oldest society of its kind. The pursuit and enhancement of evidence‐based policy and treatment informed its work in the early days and has remained its organizing principle throughout its history. Led initially by medical political interests, the Society has grown to encompass a broader disciplinary base, reflecting the expansion of interest in addiction from biological, psychological and social science into nursing, social work, probation, other arms of criminal justice work and voluntary sector professionals. Today its membership is made up of researchers, practitioners and policy makers from all these disciplines, the majority of whom reside and work in the United Kingdom; its international membership makes up nearly one‐third of the total membership and there are current endeavours to expand collaboration with other national societies in the field. Its activities are focused upon the Society journals,AddictionandAddiction Biology, other publishing activities, the annual symposium and a number of policy initiatives.
Comparison of acute lethal toxicity of commonly abused psychoactive substances
Authors: Gable Robert S. 
Published: May 2004

ABSTRACTAims  To determine the acute lethal toxicity of a range of psychoactive substances in terms of the dose customarily used as a single substance for non‐medical purposes.Design and method  A structured English‐language literature search was conducted to identify experimental studies and clinical reports that documented human and non‐human lethal doses of 20 abused substances that are distributed widely in Europe and North America. Four inclusion criteria were specified for the reports, and approximately 3000 relevant records were retrieved from search engines at Biosis, Science Citation Index, Google and the National Library of Medicine's Gateway. In order to account for different drug potencies, a ‘safety ratio’ was computed for each substance by comparing its reported acute lethal dose with the dose most commonly used for non‐medical purposes.Findings  The majority of published reports of acute lethal toxicity indicate that the decedent used a co‐intoxicant (most often alcohol). The calculated safety ratios varied between substances by more than a factor of 100. Intravenous heroin appeared to have the greatest direct physiological toxicity; several hallucinogens appeared to have the least direct physiological toxicity.Conclusions  Despite residual uncertainties, the substantial difference in safety ratios suggests that abused substances can be rank‐ordered on the basis of their potential acute lethality.
Economic analysis of costs and consequences of the treatment of drug misuse: 2‐year outcome data from the National Treatment Outcome Research Study (NTORS)
Authors: Godfrey Christine , Stewart Duncan , Gossop Michael 
Published: May 2004

ABSTRACTAims  Some economic costs and consequences of drug misuse and treatment were investigated among clients recruited to the National Treatment Outcome Research Study (NTORS).Design  This was a longitudinal prospective cohort design comprising549 clients recruited from 54 residential and community treatment programmes: data were collected from interviews conducted at treatment intake, at 1 year and at 2‐year follow‐ups.Measurements  Treatment costs included index and other drug treatments. Costs were estimated for use of health and social care services, criminal activity and the use of criminal justice resources. Costs were based upon self‐reported data collected by structured face‐to‐face interviews combined with unit cost estimates taken from a variety of sources.Findings  Addiction treatment was costed at £2.9 million in the 2 years prior to index treatment, and a further £4.4 million in the subsequent 2 years. Economic benefits were largely accounted for by reduced crime and victim costs of crime. Crime costs fell by £16.1 million during the first year, and by £11.3 million during the second year. Health‐care costs were relatively small but approximately doubled during the course of the study. The ratio of consequences to net treatment investment varied from 18 : 1 to 9.5 : 1, depending on assumptions. This is likely to be a conservative estimate of the benefit–cost ratio because many potential benefits were not estimated.Conclusions  The data showed clear economic benefits to treating drug misusers in England.
The Gambling Related Cognitions Scale (GRCS): development, confirmatory factor validation and psychometric properties
Authors: Raylu Namrata , Oei Tian P. S. 
Published: May 2004

ABSTRACTAims  The aims of this study are to develop and validate a measure to screen for a range of gambling‐related cognitions (GRC) in gamblers.Design and participants  A total of 968 volunteers were recruited from a community‐based population. They were divided randomly into two groups. Principal axis factoring with varimax rotation was performed on group one and confirmatory factor analysis (CFA) was used on group two to confirm the best‐fitted solution.Measurements  The Gambling Related Cognition Scale (GRCS) was developed for this study and the South Oaks Gambling Screen (SOGS), the Motivation Towards Gambling Scale (MTGS) and the Depression Anxiety Stress Scale (DASS‐21) were used for validation.Findings  Exploratory factor analysis performed using half the sample indicated five factors, which included interpretative control/bias (GRCS‐IB), illusion of control (GRCS‐IC), predictive control (GRCS‐PC), gambling‐related expectancies (GRCS‐GE) and a perceived inability to stop gambling (GRCS‐IS). These accounted for 70% of the total variance. Using the other half of the sample, CFA confirmed that the five‐factor solution fitted the data most effectively. Cronbach's alpha coefficients for the factors ranged from 0.77 to 0.91, and 0.93 for the overall scale.Conclusions  This paper demonstrated that the 23‐item GRCS has good psychometric properties and thus is a useful instrument for identifying GRC among non‐clinical gamblers. It provides the first step towards devising/adapting similar tools for problem gamblers as well as developing more specialized instruments to assess particular domains of GRC.
Abstinence rates and predictors of outcome for smoking cessation: do Brazilian smokers need special strategies?
Authors: Chatkin José Miguel , Mariante de Abreu Carolina , Haggsträm Fábio Maraschin , Wagner Mário Bernardes , Fritscher Carlos Cezar 
Published: May 2004

ABSTRACTAims  To study tobacco abstinence and risk factors for failure in smoking cessation program and to evaluate the need for special strategies in a Brazilian cohort of smokers.Design  A non‐randomized, prospective, open clinical trial.Patients and methods  We studied smokers who attended the Smoking Cessation Clinics of Hospital Sao Lucas da PUCRS, in Porto Alegre, Brazil between July, 1999 and June, 2003. All participated in the same behavioral therapy program and, according to the Fagerstrom test, also received nicotine patches and/or bupropion. Sustained abstinence was confirmed by exhaled CO measurements ≤ 10 parts per million (p.p.m.). Quit rates were evaluated at 12 months. The study included 381 patients (62% women, mean age ± SD 47.4 ± 11.5 years).Findings  Smokers treated with only counseling, counseling + NRT, counseling + bupropion, and counseling + bupropion + NRT had an abstinence rates at the end of 12 months of 14.5%, 25.4%, 22.8% and 38.5%, respectively (P < 0.001). The estimated success rate was 23.2% at 12 months. The likelihood of failure in smoking cessation at the end of 12 months increased with higher nicotine dependence (HR: 1.63; 95% CI: 1.13–2.35; P = 0.009). Failure occurred significantly less in those patients treated with counseling + NRT + bupropion (HR: 0.39; 95% CI: 0.24–0.63 P < 0.001).Conclusions  The higher percentage of smoking cessation was achieved using multiple therapies (counseling + NRT + bupropion). The only significant predictor of failure detected was severe nicotine dependence.
Socio‐demographic predictors of quitting smoking: how important are household factors?
Authors: Chandola Tarani , Head Jenny , Bartley Mel 
Published: May 2004

ABSTRACTAims  To compare different socio‐demographic predictors of quitting smoking in a cohort representative of adult smokers in the British population using appropriate models that take into account the clustering of smoking behaviours at the household and area levels.Design  A longitudinal, population representative survey of British adults (the British Household Panel Survey, BHPS) from 1991 to 2000.Setting and participants  At wave 1 of the BHPS, 10264 adults living in 5511 households were interviewed. Around 30% of the wave 1 respondents reported smoking cigarettes. Of these, 21% had quit smoking over a 10‐year period.Measurements  ‘Quitters’ (quitting smoking) were defined as smokers who had subsequently described themselves as non‐smokers for at least 2 consecutive waves (years) of the BHPS. Degree of dependence was indexed using the number of cigarettes currently smoked per day.Findings  Degree of dependence was the strongest predictor of quitting smoking, followed by occupational social class, social support, marital status and the proportion of smokers in the household. There was some evidence of clustering of quitting smoking behaviour within households—members of the same household had similar quitting smoking behaviours. This clustering at the household level appeared to be explained by mechanisms related to the household level. However, there was little evidence for clustering of smoking behaviour within areas.Conclusions  In addition to reducing addiction to cigarettes, policies designed to encourage smokers to quit may need to take into account factors related to household support and employment relations, in order to encourage smokers from all socio‐demographic groups to quit
Gender convergence in alcohol consumption and related problems: issues and outcomes from comparisons of New Zealand survey data
Authors: McPherson Mervyl , Casswell Sally , Pledger Megan 
Published: May 2004

ABSTRACTAims  This paper aims to compare women's and men's alcohol consumption patterns and alcohol‐related problems in New Zealand in 1995 and 2000, by age groups. Secondary aims are to consider the findings in relation to debates on the gender convergence hypothesis regarding the link between gender convergence in alcohol consumption and possible explanations, such as social role convergence and policy changes.Design  Data were collected in two general population surveys conducted in New Zealand in 1995 (n = 4232) and 2000 (n = 5113) using the same questionnaire.Measurements  Quantity consumed on a typical drinking occasion, volume of absolute alcohol consumed per annum, proportions drinking 20+ litres per annum, proportion of total consumption consumed in heavy drinking occasions, frequency of consumption, proportion who drink enough to feel drunk at least once a week, proportions reporting three or more alcohol‐related problems and attitudes to intoxication.Findings  Evidence for gender convergence was found across a range of measures of alcohol consumption and alcohol‐related problems. In the 20–39‐year age group quantities of alcohol consumed on a typical occasion and the related measures of volume, drunkenness and problems all showed convergence. In the groups over 40 years of age convergence occurred in relation to frequency of drinking. In the groups below 20 years, which consumed relatively high quantities and where the differences in consumption between gender groups were relatively small, further convergence did not occur.Conclusions  Gender convergence took place in New Zealand from 1995 to 2000.