bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol and coronary heart disease risk—is there an unknown confounder?
Authors: Poikolainen Kari , Vahtera Jussi , Virtanen Marianna , Linna Anne , Kivimäki Mika 
Published: July 2005

ABSTRACTAims To evaluate whether confounding by several known or suspected coronary heart disease risk factors are likely to explain the lower coronary heart disease risk among light alcohol drinkers compared with never‐drinkers.Design A population‐based cross‐sectional study.Methods Hypertension, body mass index (BMI), diabetes, depression, sleep disturbances, smoking, physical activity, life satisfaction, psychological distress, trait anxiety, independent and dependent life events, length of working hours, job control, job strain and effort–reward imbalance were compared between never‐drinkers and light drinkers (<70 g of alcohol per week). Data on 41 099 participants (6222 men, 34 877 women) were derived from two ongoing cohort studies, the ‘10‐Town Study’ and ‘Finnish Hospital Personnel Study’, in Finland in 2000–02.Results Of the 16 comparisons under study, seven showed significant differences between never‐drinkers and light drinkers. Five of the differences favoured never‐drinkers and two showed a disadvantage. The latter were low BMI and low leisure‐time physical activity, both more common among never‐drinkers than among light drinkers. In contrast, smoking, sleep disturbances, trait anxiety, effort–reward imbalance and dependent life events were less common among never‐drinkers than among light drinkers.Conclusions None of the risk factors studied was a likely candidate for an unknown confounder.
Five‐year trends in patterns of drug use among people who use stimulants in dance contexts in the United Kingdom
Authors: McCambridge Jim , Mitcheson Luke , Winstock Adam , Hunt Neil 
Published: July 2005

ABSTRACTAims  To describe and evaluate trends in the use of stimulant drugs over a 5‐year period using an under‐studied data collection method.Design  Repeated‐measures cross‐sectional survey.Setting and participants  Annual magazine‐based survey targeting people who use stimulant drugs in dance contexts.Measurements  Life‐time use prevalence (ever used), age of first use, current use prevalence (any use within the last month) and extent of use within the last month (number of days used) for a range of stimulant drugs. Additional measures of quantity of ecstasy used were also collected.Findings  Trends in life‐time and current prevalence over time have been detected and comparisons made between different stimulant drugs. Evidence is obtained of broad stability in patterns of stimulant use in respect of age of first use and frequency of use among ongoing users. Despite an apparent reduction in the current prevalence of ecstasy use, the proportion of heavy users (usually >4 pills per session) has more than doubled between 1999 and 2003.Conclusions  This purposively sampled population study has yielded time trend data broadly consistent with other indicators, where they exist, and also has demonstrable potential to identify new drug trends. Further comparisons of purposive samples and randomly formed samples are needed.
Comparative study of the effectiveness of slow‐release morphine and methadone for opioid maintenance therapy
Authors: Eder Harald , Jagsch Reinhold , Kraigher Dominik , Primorac Andjela , Ebner Nina , Fischer Gabriele 
Published: July 2005

ABSTRACTAims  Slow‐release morphine may represent a much‐needed new pharmacological treatment for opioid dependence.Design  In a 14‐week randomized, double‐blind, double‐dummy, cross‐over study oral slow‐release morphine was compared with methadone as a treatment for opioid dependency. During two study periods, each consisting of a 1‐week titration and a 6‐week fixed‐dose treatment phase, medication was administered daily under supervised conditions.Setting  The study was carried out at the Addiction Clinic, Department of Psychiatry, Medical University Vienna.Participants  Sixty‐four subjects (56 males, eight females) with opioid dependence participated in the trial.Measurements  Efficacy was evaluated on the basis of retention, use of illicit substances based on urinalysis, extent of drug cravings, withdrawal symptoms and general wellbeing. Safety was assessed on the basis of adverse events and clinical and physical examination. Demographic and baseline characteristics were assessed using the European Addiction Severity Index.Findings  Fifty‐five patients (86%) completed the study, with a mean methadone dose of 85 mg and a mean slow‐release morphine dose of 680 mg. No significant differences in retention or use of illicit substances (opioids, benzodiazepines, cocaine) were observed, irrespective of treatment group or medication. However, patients receiving slow‐release morphine had significantly lower depression (P < 0.001) and anxiety scores (P = 0.008) and fewer physical complaints (P < 0.001).Conclusions  Oral slow‐release morphine is as effective as methadone in the treatment of opioid dependency, with comparable safety and tolerability and a greater benefit on patient wellbeing. Greater pharmaceutical diversity represents a modern development in mainstream medicine. Slow‐release morphine might represent a future treatment option that will improve long‐term outcomes for this target group.
Alcohol price elasticities in control and license states in the United States, 1982–99
Authors: Trolldal Björn , Ponicki William 
Published: July 2005

ABSTRACTAim The demand for alcohol has been demonstrated repeatedly to be sensitive to price changes. However, estimated price elasticities vary by study region and over time. One explanation for these variations might be that different countries or parts of countries have had different alcohol control systems. The hypothesis addressed in this study was that a regulated market leads to higher transaction costs associated with purchasing alcohol, which in turn increases the full price of the beverages (the nominal cash price plus transaction costs). As a result, the cash price of alcohol represents a smaller part of the full price in a highly regulated market. Assuming that customers respond primarily to changes in full price, the demand for alcohol should be less sensitive to changes in cash price where regulation is stricter. This study examined whether variations in price elasticities were a function of the different regulatory systems in control and license states in the United States during the period 1982–99.Data and methods Time‐series cross‐sectional analyses (in 50 states over 18 years) were conducted. Elasticities were estimated using a multiplicative model based upon first‐differences of time‐series within states. Disposable income and other socio‐demographic variables were used as control variables. All data were obtained from archival sources.Findings The demand for spirits and beer were significantly more sensitive to price changes in license states than in control states. The estimated price elasticity for wine sales was also somewhat larger in license states, but not significantly so.Conclusion The lower price elasticities for spirits and beer in the control states support the hypothesis that customers respond primarily to changes in the full price of alcohol.
Levo‐alpha‐acetylmethadol (LAAM) versus methadone: treatment retention and opiate use
Authors: Longshore Douglas , Annon Jeffrey , Anglin M. Douglas , Rawson Richard A. 
Published: July 2005

ABSTRACTAims  To compare the effects of levo‐alpha‐acetylmethadol (LAAM) and methadone maintenance (MM) on treatment retention and abstinence from opiate use.Design  A two‐group experimental design with patients randomly assigned (2 : 1 LAAM : MM) to receive LAAM (three doses per week) or methadone (daily dosing).Setting  A community clinic in Los Angeles, California.Participants  A total of 315 patients seeking LAAM or methadone maintenance.Intervention  LAAM or methadone maintenance, plus ancillary services available to all patients. LAAM and methadone dose levels varied according to clinical judgement. Electrocardiograms were administered to LAAM patients monthly.Measurements  Treatment status at 26‐week follow‐up and number of days retained in treatment, weekly clinical urine tests and 26‐week research urine test.Findings  LAAM and methadone patients did not differ on treatment retention. LAAM patients were less likely to test positive for opiate use during treatment (40% versus 60%) and at 26‐week follow up (39.8% versus 60.2%). Benefits of LAAM were confined to patients (n = 204) still in treatment at 26 weeks (33% positive in patients receiving LAAM and 61% in patients receiving methadone). No adverse events, cardiological or otherwise, were observed with LAAM administration.Conclusions  LAAM is an effective medication for the treatment of opiate dependence with clinical advantages due not only to the reduction of opiate use but also to the alternate‐day dosing schedule. LAAM may be more effective than methadone in promoting abstinence from opiate use among patients for whom LAAM is an acceptable alternative to methadone.
The impact of borderline personality disorder on 12‐month outcomes for the treatment of heroin dependence
Authors: Darke Shane , Ross Joanne , Williamson Anna , Teesson Maree 
Published: July 2005

ABSTRACTAims  To  determine  the  effects  of  borderline  personality  disorder  (BPD)  on 12‐month treatment retention and outcomes for the treatment of heroin dependence.Design  Longitudinal cohort study.Setting  Sydney, Australia.Participants  A cohort of 495 heroin users enrolled in the Australian Treatment Outcome Study.Findings  Criteria for BPD were met by 45% of the cohort. At baseline there were no differences in heroin use, but the BPD group had higher levels of polydrug use, crime, needle risk‐taking, more injection‐related health problems, higher levels of overdose, poorer psychological health and more extensive suicide histories. At 12 months there was no group difference in the cumulative number of treatment days received, but the BPD group had enrolled in more different treatment episodes. Within both groups reductions had occurred in drug use and drug‐related problems, with no differences in heroin use, polydrug use or global physical health at 12 months. After taking into account the effects of treatment on outcome, however, BPD was associated independently with a higher level of needle sharing [odds ratio (OR) 3.21], more injection‐related health problems (OR 1.90), a higher likelihood of heroin overdose (OR 1.92), poorer global psychological health (OR 2.43), higher levels of current major depression (OR 3.19) and a higher likelihood of attempted suicide (OR 3.89). While BPD participants showed similar reductions in heroin and other drug use to other patients at 12 months, they continued to exhibit higher levels of risk and harm across a range of outcomes.Conclusions  Screening would appear to be warranted to identify a group who may overtly respond to treatment in terms of drug use per se, but remain at substantially greater risk.
When smokers are resistant to change: experimental analysis of the effect of patient resistance on practitioner behaviour
Authors: Francis Nick , Rollnick Stephen , McCambridge Jim , Butler Chris , Lane Claire , Hood Kerenza 
Published: July 2005

ABSTRACTAims  In the field of motivational interviewing, practitioner confrontational behaviour has been associated with lower levels of patient behaviour change. We set out to explore whether resistance to change among smokers affects practitioner confrontational and other behaviours.Design  Experimental manipulation of levels of patient resistance in a role play.Setting  The study was conducted at the start of a 2‐day health behaviour change workshop.Participants  Thirty‐two practitioners who had registered for the workshop.Intervention  The practitioners were assigned randomly to interview a standardized patient (actor) who portrayed a smoker who had been briefed to display either high or low levels of resistance to change.Measurements  Interviews were audiotaped and transcribed. Practitioners and standardized patients completed interview ratings at the end of each interview. After listening to each taped interview practitioners were assigned a global score for confrontation, empathy and expert instructional style. Interviews were then submitted to a qualitative analysis.Findings  Higher levels of practitioner confrontational behaviour were observed in the high resistance group. This was evident both from the global scores (median 2 versus 0, P = 0.001) and the qualitative analysis. Global scores for empathy and expert instruction were not significantly different. Qualitative analysis also suggests a pervasive negative impact on other practitioner behaviours.Conclusions  Higher patient resistance probably leads to an increase in confrontational and other negative behaviours in health professionals attempting to promote behaviour change. This challenges important assumptions about the influence of practitioner behaviour on patient behaviour and subsequent health‐related outcomes.
A multi‐center randomized trial of buprenorphine–naloxone versus clonidine for opioid, detoxification: findings from the National Institute on Drug Abuse Clinical Trials Network
Authors: Ling Walter , Amass Leslie , Shoptaw Steve , Annon Jeffrey J. , Hillhouse Maureen , Babcock Dean , Brigham Greg , Harrer Judy , Reid Malcolm , Muir Joan , Buchan Betty , Orr Debbie , Woody George , Krejci Jonathan , Ziedonis Douglas ,   the Buprenorphine Study Protocol Group
Published: July 2005

ABSTRACTAims  The clinical effectiveness of buprenorphine–naloxone (bup‐nx) and clonidine for opioid detoxification in in‐patient and out‐patient community treatment programs was investigated in the first studies of the National Institute of Drug Abuse Clinical Trials Network.Design  Diagnostic and Statistical Manual version IV (DSM IV)‐diagnosed opioid‐dependent individuals seeking short‐term treatment were randomly assigned, in a 2 : 1 ratio favoring bup‐nx, to a 13‐day detoxification using bup‐nx or clonidine.Methods  A total of 113 in‐patients (77 bup‐nx, 36 clonidine) and 231 out‐patients (157 bup‐nx, 74 clonidine) participated. Supportive interventions included appropriate ancillary medications and standard counseling procedures guided by a self‐help handbook. The criterion for treatment success was defined as the proportion of participants in each condition who were both retained in the study for the entire duration and provided an opioid‐free urine sample on the last day of clinic attendance. Secondary outcome measures included use of ancillary medications, number of side effects reported and withdrawal and craving ratings.Findings  A total of 59 of the 77 (77%) in‐patients assigned to the bup‐nx condition achieved the treatment success criterion compared to eight of the 36 (22%) assigned to clonidine, whereas 46 of the 157 (29%) out‐patients assigned to the bup‐nx condition achieved the treatment success criterion, compared to four of the 74 (5%) assigned to clonidine.Conclusion  The benefits of bup‐nx for opioid detoxification are supported and illustrate important ways in which clinical research can be conducted in community treatment programs.
Impact of Federal drug law enforcement on the supply of heroin in Australia
Authors: Smithson Michael , McFadden Michael , Mwesigye Sue‐Ellen 
Published: July 2005

ABSTRACTAims  To conduct an empirical investigation of the efficacy of law enforcement in reducing heroin supply in Australia. Specifically, this paper addresses the question of whether heroin purity levels in the Australian Capital Territory (ACT) could be predicted by heroin seizures at the national level by the Australian Federal Police (AFP) in the preceding year.Design  We considered two forms of evidence. First, a Bayesian Markov Chain Monte Carlo (MCMC) change‐point model was used to discover (a) if there was a substantial increase in heroin seizures by the AFP, (b) when the increase began and (c) whether it occurred after increased funding to the Australian Federal Police for the purpose of drug law enforcement. Second, standard time‐series methods were used to ascertain whether fluctuations in heroin seizure weights or the frequency of large‐scale seizures after the aforementioned changes in seizure levels predicted fluctuations in heroin purity levels in the ACT after autocorrelation had been removed from the purity series.Findings  A Bayesian MCMC change‐point model supported the hypothesis that heroin seizures rapidly increased about a year before the estimated decline in heroin purity and after the increased funding of AFP. The autoregression models suggested that 10–20% of the variance in the residuals of the heroin purity series was predicted by appropriately lagged residuals of the seizure‐number and log‐weight series, after autocorrelation had been removed.Conclusion  The overall results are consistent with the hypothesis that large‐scale heroin seizures by the AFP reduce street‐level heroin supply a year or so later, although the short‐term dynamics suggest an ‘opponent’ response to residual fluctuations in seizures. To our knowledge, this is first time a connection has been identified between large‐scale heroin seizures and street‐level supply.
The feasibility of smoking reduction: an update
Authors: Hughes John R. , Carpenter Matthew J. 
Published: July 2005

ABSTRACTAim To update conclusions of a previous review of smoking reduction on the extent to which (1) smokers spontaneously reduce their smoking, (2) smokers who try to quit and fail return to smoking less, (3) smokers can substantially reduce and maintain reductions via pharmacological and behavioral treatments and (4) smokers compensate when they reduce.Method Qualitative systematic review.Data sources Systematic computer searches and other methods.Study selection Published and unpublished studies of smokers not trying to stop smoking. We located 13–26 studies for each of the four aims.Data extraction The first author entered data with confirmation by second author.Data synthesis Due to the heterogeneity of methods and necessity of extensive recalculation, a meta‐analysis was not feasible.Results Few daily smokers spontaneously reduce. Among those who try to stop smoking and relapse, some return to reduced smoking but whether they maintain this reduction is unclear. Nicotine replacement (and perhaps behavior therapies) can induce smokers not interested in quitting to make significant reductions in their smoking and maintain these over time. Some compensatory smoking occurs with reduction but significant declines in smoke exposure still occur.Conclusions These results indicate that reduction is feasible when aided by treatment. Whether reduction should be promoted will depend on the effect of reduction on health outcomes and future cessation.
Growth hormone deficiency and combined pituitary hormone deficiency: does the genotype matter?
Authors: Dattani Mehul T. 
Published: July 2005

SummaryThe past 12 years have witnessed an explosion in our understanding of the development of the anterior pituitary gland, and of mechanisms that underlie the diagnosis of growth hormone deficiency (GHD) and combined pituitary hormone deficiency (CPHD). The anterior pituitary is the end‐product of a carefully orchestrated pattern of expression of signalling molecules and transcription factors that leads to the development of this complex organ secreting six hormones from five different cell types. Naturally occurring and transgenic murine models have demonstrated a role for many of these molecules in the aetiology of GHD/CPHD. These include the transcription factors HESX1, PROP1, POU1F1, LHX3, LHX4, GLI2 and SOX3. Depending upon the expression patterns of these molecules, the phenotype may consist of isolated hypopituitarism, or more complex disorders such as septo‐optic dysplasia (SOD) and holoprosencephaly. The phenotype and the mode of inheritance can be highly variable. Novel mutations within the GH‐1 and GHRHR genes have also shed light on the phenotype and pathogenesis of isolated GHD (IGHD). To date, genetic mutations have been identified in a modest proportion of patients with IGHD/CPHD and associated syndromes such as SOD. It is, however, clear that many genes remain to be identified, and characterization of these will further elucidate the pathogenesis of these complex conditions.
The relationship between serum resistin, leptin, adiponectin, ghrelin levels and bone mineral density in middle‐aged men
Authors: Oh Ki Won , Lee Won Young , Rhee Eun Jung , Baek Ki Hyun , Yoon Kun Ho , Kang Moo Il , Yun Eun Joo , Park Cheol Young , Ihm Sung Hee , Choi Moon Gi , Yoo Hyung Joon , Park Sung Woo 
Published: July 2005

SummaryObjective Body weight is a significant predictor of bone mass. Hormonal factors such as sex hormones, insulin, leptin and adiponectin are thought to play a role in the mechanisms controlling the association of body weight and fat mass with bone mass. However, contradictory results have been reported for the association between serum adipocytokines and bone mineral density (BMD). We therefore examined whether the serum adipocytokine and ghrelin levels, markers of fat metabolism, are associated with BMD in male adults.Patients and measurements For 80 male adults (average age 54·5 ± 6·4 years; average body mass index (BMI) 24·4 ± 2·5 kg/m2), the correlations between serum resistin, leptin, adiponectin and ghrelin levels with BMD were investigated.Results Among the adipocytokines, serum resistin levels were negatively correlated with lumbar spine BMD (r = –0·237, P = 0·05). After adjustment was made for age and BMI, log‐transformed serum leptin showed a significant negative correlation with lumbar spine BMD, which was not seen on bivariate analysis (r = –0·237, P = 0·039). Femoral neck BMD was marginally associated only with serum adiponectin levels (r = –0·226, P = 0·062). In multiple regression analyses, among the adipokines, only resistin was a significant determinant of lumbar spine BMD, although the variance was small (R2 = 0·256). Serum ghrelin levels were not correlated with the BMD of either body site.Conclusions Serum resistin level showed a significant negative correlation with lumbar spine BMD, although the variance was small. Further studies are needed to elucidate the role of adipocytokines in bone metabolism.