Brief alcohol intervention and alcohol assessment do not influence alcohol use in injured patients treated in the emergency department: a randomized controlled clinical trial.

AIMS: To evaluate the effectiveness of brief alcohol intervention (BAI) in reducing alcohol use among hazardous drinkers treated in the emergency department (ED) after an injury; in addition it tests whether assessment of alcohol use without BAI is sufficient to reduce hazardous drinking. DESIGN: Randomized controlled clinical trial with 12-month follow-up conducted between January 2003 and June 2005. SETTING: Urban academic emergency department (ED) of the Lausanne University Hospital, Lausanne, Switzerland. PARTICIPANTS: A total of 5136 consecutive patients attending ED after an injury completed a seven-item general and a three-item alcohol screen and 1472 (28.7%) were positive for hazardous drinking according to the National Institute on Alcohol Abuse and Addiction definition; of these 987 (67.1%) were randomized into a BAI group (n = 310) or a control group with screening and assessment (n = 342) or a control group with screening only (n = 335) and then a total of 770 patients (78.0%) completed the 12-month follow-up procedures. INTERVENTION: A single 10-15-minute session of standardized BAI conducted by a trained research assistant. MEASUREMENTS: Percentage of participants who have changed to low-risk drinking at follow-up. FINDINGS: Data obtained at 12 months indicated that similar proportions were low-risk drinkers in BAI versus control groups with and without assessment (35.6%, 34.0%, 37.0%, respectively, P = 0.71). Data also indicated similar reductions in drinking frequency, quantity, binge drinking frequency and Alcohol Use Disorders Identification Test (AUDIT) scores across groups. All groups reported similar numbers of days hospitalized and numbers of medical consults in the last 12 months. A model including age groups, gender, AUDIT and injury severity scores indicated that BAI had no influence on the main alcohol use outcome. CONCLUSIONS: This study provides the evidence that a 10-15-minute BAI does not decrease alcohol use and health resource utilization in hazardous drinkers treated in the ED, and demonstrates that commonly found decreases in hazardous alcohol use in control groups cannot be attributed to the baseline alcohol assessment.

The Dutung-Thaktote extensional fault zone and nappe structures documented by illite crystallinity and clay-mineral paragenesis in the Tethys Himalaya between Spiti river and Tso Morari, NW India

Numerous measurements by XRD of the Scherrer width at half-peak height (001 reflection of illite), coupled with analyses of clay-size assemblages, provide evidence for strong variations in the conditions of low temperature metamorphism in the Tethyan Himalaya metasediments between the Spiti river and the Tso Morari. Three sectors can be distinguished along the Spiti river-Tso Morari transect. In the SW, the Takling and Parang La area is characterised by a metamorphism around anchizone-epizone boundary conditions. Further north, in the Dutung area, the metamorphic grade abruptly decreases to weak diagenesis, with the presence of mixed-layered clay phases. At the end of the profile towards the NE, a progressive metamorphic increase up to greenschist facies is recorded, marked by the appearance of biotite and chloritoid. The combination of these data with the structural. observations permits to propose that a nappe stack has been crosscut by the younger Dutung-Thaktote extensional fault zone (DTFZ). The change in metamorphism across this zone helps to assess the displacements which occurred during synorogenic extension. In the SW and NE parts of the studied transect, a burial of 12 km has been estimated, assuming a geothermal gradient of 25 degrees C/km. In the SW part, this burial is due to the juxtaposition of the Shikar Beh and Mata nappes and in the NE part, solely to burial beneath the Mata nappe. In the central part of the profile, the effect of the DTFZ is to bring down diagenetic sediments in-between the two aforesaid metamorphic zones. The offset along the Dutung-Thaktote normal faults is estimated at 16 km.

Evidence for daily and weekly rhythmicity but not lunar or seasonal rhythmicity of physical activity in a large cohort of individuals from five different countries.

Background Biological rhythmicity has been extensively studied in animals for many decades. Although temporal patterns of physical activity have been identified in humans, no large-scale, multi-national study has been published, and no comparison has been attempted of the ubiquity of activity rhythms at different time scales (such as daily, weekly, monthly, and annual). Methods Using individually worn actigraphy devices, physical activity of 2,328 individuals from five different countries (adults of African descent from Ghana, South Africa, Jamaica, Seychelles, and the United States) was measured for seven consecutive days at different times of the year. Results Analysis for rhythmic patterns identified daily rhythmicity of physical activity in all five of the represented nationalities. Weekly rhythmicity was found in some, but not all, of the nationalities. No significant evidence of lunar rhythmicity or seasonal rhythmicity was found in any of the groups. Conclusions These findings extend previous small-scale observations of daily rhythmicity to a large cohort of individuals from around the world. The findings also confirm the existence of modest weekly rhythmicity but not lunar or seasonal rhythmicity in human activity. These differences in rhythm strength have implications for the management of health hazards of rhythm misalignment. Key Messages Analysis of the pattern of physical activity of 2,328 individuals from five countries revealed strong daily rhythmicity in all five countries, moderate weekly rhythmicity in some countries, and no lunar rhythmicity or seasonal rhythmicity in any of the countries.