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- Berglund, Mats
(författare)
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A better widget? Three lessons for improving addiction treatment from a meta-analytical study
- 2005
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Ingår i: Addiction. - : Wiley. - 1360-0443 .- 0965-2140. ; 100:6, s. 742-750
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Forskningsöversikt (refereegranskat)abstract
- Objective To discuss how to develop more effective treatment programmes than those currently available for addictive disorders. Data sources The Swedish SBU report, published in English in 2003. was used as a database. It includes 641 randomized controlled trials and seven longitudinal prospective studies. Methods Meta-analytical calculations were performed in several areas using standardized mean differences (d) effect-size estimate and homogeneity testing. Three critical issues have been the focus of the present analysis: the early intervention phase. treatment procedures and their additive properties and the transitional period between early and late effects of treatment. Results The main findings while integrating the results in a new way were that intervention studies with one single session showed a small but robust homogeneous effect size. whereas studies of interventions with several sessions were heterogeneous with large and small effect sizes among the included studies. Similar effect sizes were found in alcohol, opioid and cocaine treatment studies. Agonist treatment yielded the highest effect sizes. Some evidence was found for a possible additive effect for cognitive behaviour therapy and naltrexone as well as for aversive treatment (disulfiram) and psychosocial treatment in alcohol dependence. So far studies on the transition period between short- and long-term outcome are few and inconclusive. Conclusions There is a prospect of improving addiction treatment, and the following areas are suggested by meta-analysis for future research: (a) to examine in more detail the process between the first and second session of intervention; (b) to randomize simultaneously for independent categories of psychosocial and psychopharmacological treatment: and (c) to intensify studies on the transitional period between short- and long-term outcome.
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- Jarl, Johan, et al.
(författare)
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Time pattern of reduction in risk of oesophageal cancer following alcohol cessation - A meta-analysis.
- 2012
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Ingår i: Addiction. - : Wiley. - 1360-0443 .- 0965-2140. ; 107:7, s. 1234-1243
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To establish the current level of knowledge of the effect of drinking cessation on the risk of developing oesophageal cancer. Method: A meta-analysis was conducted based on relevant studies identified through a systematic literature review. A Generalised Least Squares model for trend estimation of summarised dose-response data were utilised in order to estimate the effect of years since drinking cessation on risk of oesophageal cancer. Result: 17 studies that estimate the risk reduction after quantified drinking cessation were identified in the systematic literature review. Nine of these were appropriate for inclusion in the meta-analysis. A large degree of heterogeneity existed between the studies but this was explainable and the increased risk of oesophageal cancer caused by alcohol consumption was found to be reversible with a common trend between studies. A required time period of 16.5 years (95% CI 12.7-23.7) was estimated until no risk from former drinking remained, although this might have been an overestimation due to sample characteristics. The dose-response relationship was found to have an exponential decay. This means about half of the reduction in alcohol-related risk occurred after just a third of the time period required to eliminate the additional risk. Conclusion: The alcohol-related increased risk of oesophageal cancer is reversible following drinking cessation. It is most likely that about 16 years are required until all elevated risk has disappeared. Due to lack of research and data, more research is urgently required to increase the robustness of the estimates and to approach study limitations.
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- Lindström, Martin, et al.
(författare)
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Smoking cessation among daily smokers, aged 45-69 years: a longitudinal study in Malmö, Sweden.
- 2002
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Ingår i: Addiction. - : Wiley. - 1360-0443 .- 0965-2140. ; 97:2, s. 205-215
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate differences in snuff consumption, socio-demographic and psychosocial characteristics between baseline daily smokers who had remained daily smokers, become intermittent smokers or stopped smoking at the 1-year follow-up. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: A population of 12 507 individuals aged 45-69 years, interviewed at baseline in 1992-94 and at a 1-year follow-up, was investigated in this longitudinal study. The three groups of baseline daily smokers were compared to the total population according to socio-demographic, psychosocial and snuff consumption characteristics. A multivariate logistic regression model was used to assess differences in psychosocial conditions, adjusting for age, sex, country of origin, marital status, education and snuff consumption. FINDINGS: Eighty-six per cent of all baseline daily smokers remained daily smokers, 6.5% had become intermittent smokers and 7.3% had stopped smoking at the 1-year follow-up. The daily smokers who remained daily smokers were more likely to be born in other countries than Sweden, not married, have a lower educational level and poorer psychosocial conditions than the total population, while the socio-demographic characteristics and psychosocial resources of those daily smokers who had become intermittent smokers or had stopped smoking were much more similar to the general population, with the exception of a higher snuff consumption, especially for intermittent smokers. CONCLUSIONS: Daily smokers who remained daily smokers at the 1-year follow-up had poorer psychosocial assets, especially social participation, than baseline daily smokers who had become intermittent smokers or had stopped smoking, and the general population. The results suggest that low levels of social participation are a potent barrier against smoking cessation. Snuff consumption may explain a part of the increase in smoking cessation among men as opposed to women in Sweden.
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- Marques, Paul, et al.
(författare)
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Estimating driver risk using alcohol biomarkers, interlock blood alcohol concentration tests and psychometric assessments: initial descriptives
- 2010
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Ingår i: Addiction. - : Wiley. - 1360-0443 .- 0965-2140. ; 105:2, s. 226-239
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Tidskriftsartikel (refereegranskat)abstract
- Aim To identify alcohol biomarker and psychometric measures that relate to drivers' blood alcohol concentration (BAC) patterns from ignition interlock devices (IIDs). Design, setting, participants, measurements In Alberta, Canada, 534 drivers, convicted of driving under the influence of alcohol (DUI), installed IIDs and agreed to participate in a research study. IID BAC tests are an established proxy for predicting future DUI convictions. Three risk groups were defined by rates of failed BAC tests. Program entry and follow-up blood samples (n = 302, 171) were used to measure phosphatidyl ethanol (PETH), carbohydrate deficient transferrin (%CDT), gamma glutamyltransferase (GGT) and other biomarkers. Program entry urine (n = 130) was analyzed for ethyl glucuronide (ETG) and ethyl sulphate (ETS). Entry hair samples were tested for fatty acid ethyl esters (FAEE) (n = 92) and ETG (n = 146). Psychometric measures included the DSM-4 Diagnostic Interview Schedule Alcohol Module, Alcohol Use Disorders Identification Test (AUDIT), the time-line follow-back (TLFB), the Drinker Inventory of Consequences (DRINC) and the Temptation and Restraint Inventory (TRI). Findings Except for FAEE, all alcohol biomarkers were related significantly to the interlock BAC test profiles; higher marker levels predicted higher rates of interlock BAC test failures. PETH, the strongest with an overall analysis of variance F ratio of 35.5, had significant correlations with all nine of the other alcohol biomarkers and with 16 of 19 psychometric variables. Urine ETG and ETS were correlated strongly with the IID BAC tests. Conclusions The findings suggest that several alcohol biomarkers and assessments could play an important role in the prediction and control of driver alcohol risk when re-licensing.
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