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Biomedical subjects

Sheila M Williams

Publications and source records attributed to Sheila M Williams.

At least 19 recordsLinked to original sources
PubMed2007

DXA measurements confirm that parental perceptions of elevated adiposity in young children are poor.

OBJECTIVE: To compare parental assessments of child body weight status with BMI measurements and determine whether children who are incorrectly classified differ in body composition from those whose parents correctly rate child weight. Also to ascertain whether children of obese parents differ from those of non-obese parents in actual or perceived body weight. RESEARCH METHODS AND PROCEDURES: Weights, heights, BMI, and waist girths of New Zealand children ages 3 to 8 years were determined. Fat mass, fat percentage, and lean mass were measured by DXA (n = 96). Parents classified child weight status as underweight, normal-weight, slightly overweight, or overweight. Centers for Disease Control and Prevention 2000 percentiles of BMI were used. RESULTS: Parents underestimated child weight status. Despite having 83% more fat mass than children with BMI values below the 85th percentile, only 7 of 31 children with BMI values at or above the 85th percentile were rated as slightly overweight or overweight. In the whole sample, participants whose weight status was underestimated by parents (40 of the 96 children) had l9% less fat mass but similar lean mass as children whose weight status was correctly classified. However, children of obese and non-obese parents did not differ in body composition or anthropometry, and obese parents did not underestimate child weight more than non-obese parents. DISCUSSION: Because parents underestimate child weight, but BMI values at or above the 85th percentile identify high body fat well, advising parents of the BMI status of their children should improve strategies to prevent excessive fat gain in young children.

Absorptiometry, Photon↗
PubMed2006

Dental restorations: a risk factor for periodontal attachment loss?

BACKGROUND: Dental caries and restorations in proximal tooth surfaces often impinge upon the periodontal biological width. AIM: This study examines whether these factors may contribute to risk for periodontal attachment loss at these sites. METHODS: The study is based upon data from the Dunedin Multidisciplinary Health and Development Study, a long-standing cohort study. Approximal tooth surfaces of 884 study members were evaluated for restorations and caries at age 26 and again at 32 years, and probing depth and gingival recession were recorded in millimetres at age 32. Attachment loss was computed as the sum of pocket depth and gingival recession. Data were analysed using generalized estimating equations. RESULTS: Where a caries/restorative event had occurred on an inter-proximal tooth surface before age 26, the age-32 attachment loss at the corresponding periodontal site was approximately twice more likely to be >or=3 mm than if the adjacent tooth surface had remained sound to age 32. This was also true where a caries/restorative event had occurred subsequent to age 26. The association remained after controlling for potential confounders, including smoking. CONCLUSIONS: Site-specific periodontal attachment loss due to dental caries or restorative events occurs in adults in their third and fourth decades of life.

Adult↗
PubMed2006

Auditory abilities of speakers who persisted, or recovered, from stuttering.

OBJECTIVE: The purpose of this study was to see whether participants who persist in their stutter have poorer sensitivity in a backward masking task compared to those participants who recover from their stutter. DESIGN: The auditory sensitivity of 30 children who stutter was tested on absolute threshold, simultaneous masking, backward masking with a broadband and with a notched noise masker. The participants had been seen and diagnosed as stuttering at least 1 year before their 12th birthday. The participants were assessed again at age 12 plus to establish whether their stutter had persisted or recovered. Persistence or recovery was based on participant's, parent's and researcher's assessment and Riley's [Riley, G. D. (1994). Stuttering severity instrument for children and adults (3rd ed.). Austin, TX: Pro-Ed.] Stuttering Severity Instrument-3. Based on this assessment, 12 speakers had persisted and 18 had recovered from stuttering. RESULTS: Thresholds differed significantly between persistent and recovered groups for the broadband backward-masked stimulus (thresholds being higher for the persistent group). CONCLUSIONS: Backward masking performance at teenage is one factor that distinguishes speakers who persist in their stutter from those who recover. Education objectives: Readers of this article should: (1) explain why auditory factors have been implicated in stuttering; (2) summarise the work that has examined whether peripheral, and/or central, hearing are problems in stuttering; (3) explain how the hearing ability of persistent and recovered stutterers may differ; (4) discuss how hearing disorders have been implicated in other language disorders.

Adolescent↗
PubMed2006

A controlled trial of homocysteine lowering and cognitive performance.

BACKGROUND: The results of observational studies suggest that plasma homocysteine concentrations are inversely related to cognitive function in older people. Our objective was to test the hypothesis that lowering the plasma homocysteine concentration improves cognitive function in healthy older people. METHODS: We conducted a two-year, double-blind, placebo-controlled, randomized clinical trial involving 276 healthy participants, 65 years of age or older, with plasma homocysteine concentrations of at least 13 micromol per liter. Homocysteine-lowering treatment was a daily supplement containing folate (1000 microg) and vitamins B12 (500 microg) and B6 (10 mg). Tests of cognition were conducted at baseline and after one and two years of treatment. Treatment effects were adjusted for baseline values, sex, and education. RESULTS: On average, during the course of the study, the plasma homocysteine concentration was 4.36 micromol per liter (95 percent confidence interval, 3.81 to 4.91 micromol per liter) lower in the vitamin group than in the placebo group (P<0.001). Overall, there were no significant differences between the vitamin and placebo groups in the scores on tests of cognition. CONCLUSIONS: The results of this trial do not support the hypothesis that homocysteine lowering with B vitamins improves cognitive performance. (Australian Clinical Trials registry number, ACTR NO 12605000030673.).

Aged↗
PubMed2006

The enigma of hypertensive ESRD: observations on incidence and trends in 18 European, Canadian, and Asian-Pacific populations, 1998 to 2002.

BACKGROUND: Despite improved treatment of hypertension and decreasing rates of stroke and coronary heart disease, the reported incidence of hypertensive end-stage renal disease (ESRD) increased during the 1990s. However, bias, particularly from variations in acceptance into ESRD treatment (ascertainment) and diagnosis (classification), has been a major source of error when comparing ESRD incidences or estimating trends. METHODS: Age-standardized rates were calculated in persons aged 30 to 44, 45 to 64, and 65 to 74 years for 15 countries or regions (separately for the Europid and non-Europid populations of Canada, Australia, and New Zealand), and temporal trends were estimated by means of Poisson regression. For 10 countries or regions, population-based estimates of mean systolic blood pressures and prevalences of hypertension were extracted from published sources. RESULTS: Hypertensive ESRD, comprising ESRD attributed to essential hypertension or renal artery occlusion, was least common in Finland, non-Aboriginal Australians, and non-Polynesian New Zealanders; intermediate in most European and Canadian populations; and most common in Aboriginal Australians and New Zealand Maori and Pacific Island people. Rates correlated with the incidence of all other nondiabetic ESRD, but not with diabetic ESRD or community rates of hypertension. Between 1998 and 2002, hypertensive ESRD did not increase in Northwestern Europe or non-Aboriginal Canadians, although it did so in Australia. CONCLUSION: Despite the likelihood of classification bias, the probability remains of significant variation in incidence of hypertensive ESRD within the group of Europid populations. These between-population differences are not explained by community rates of hypertension or ascertainment bias.

Aged↗
PubMed2006

Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting.

OBJECTIVES: To observe the behavior of infants sleeping in the natural physical environment of home, comparing the 2 different sleep practices of bed sharing and cot sleeping quantifying to factors that have been identified as potential risks or benefits. METHODS: Forty routine bed-sharing infants, aged 5-27 weeks were matched for age and season of study with 40 routine cot-sleeping infants. Overnight video and physiologic data of bed-share infants and cot-sleep infants were recorded in the infants' own homes. Sleep time, sleep position, movements, feeding, blanket height, parental checks, and time out of the bed or cot were logged. RESULTS: The total sleep time was similar in both groups (bed-sharing median: 8.6 hours; cot-sleeping median: 8.2 hours). Bed-sharing infants spent most time in the side position (median: 5.7 hours, 66% of sleep time) and most commonly woke at the end of sleep in this position, whereas cot-sleeping infants most commonly slept supine (median: 7.5 hours, 100%) and woke at the end of sleep in the supine position. Prone sleep was uncommon in both groups. Head covering above the eyes occurred in 22 bed-sharing infants and 1 cot-sleeping infant. Five of these bed-sharing infants were head covered at final waking time, but the cot-sleeping infant was not. Bed-sharing parents looked at or touched their infant more often (median: 11 vs 4 times per night) but did not always fully wake to do so. Movement episodes were shorter in the bed-sharing group as was total movement time (37 vs 50 minutes respectively), whereas feeding was 3.7 times more frequent in the bed-sharing group than the cot-sleeping group. CONCLUSIONS: Bed-share infants without known risk factors for sudden infant death syndrome (SIDS) experience increased maternal touching and looking, increased breastfeeding, and faster and more frequent maternal responses. This high level of interaction is unlikely to occur if maternal arousal is impaired, for example, by alcohol or overtiredness. Increased head covering and side sleep position occur during bed-sharing, but whether these factors increase the risk of SIDS, as they do in cot sleeping, requires further investigation.

Arousal↗
PubMed2005

Variation in the cholesteryl ester transfer protein (CETP) gene does not influence individual plasma cholesterol response to changes in the nature of dietary fat.

BACKGROUND AND AIMS: Some individuals respond to a greater extent than others to changes in dietary fat and cholesterol even when dietary intake is consistent. A prospective study has been undertaken in which two groups of individuals according to cholesteryl ester transfer protein (CETP) genotype were compared in terms of plasma lipid response to altering the nature of dietary fat in a free-living situation. METHODS AND RESULTS: Following genotyping, 35 individuals with the CETP Taq1 B1B1 genotype were paired with age and sex-matched individuals with one or two CETP B2 alleles, to undertake a single crossover trial with a diet high in saturated fat and a diet high in polyunsaturated fat. There was no washout period between the two 4-week phases. Plasma lipoproteins were measured at the beginning and end of each phase. The difference (95% CI) in plasma LDL-cholesterol concentration at the end of the PUFA and SAFA diets was 0.95 (0.71, 1.19) mmol/l in the CETP B1B1 group and 0.80 (0.57, 1.04) mmol/l in the group with at least one CETP B2 allele. The dietary induced changes in the two genotype groups were not significantly different (p=0.38) from each other. Comparable results were observed for plasma total cholesterol. The high PUFA and SAFA diets did not significantly alter plasma HDL concentration in either of the CETP genotype groups. Response was also similar according to apolipoprotein E genotype (E3E3 vs E4+) and lipoprotein lipase genotype (S447X). CONCLUSIONS: The results of this study do not support previous studies in which CETP genotype predicted plasma LDL-cholesterol response to diet. CETP genotype does not significantly affect the change in plasma total and LDL-cholesterol concentrations that occur when altering the nature of dietary fat. These data suggest that the influence of genetic factors on total and LDL-cholesterol may be relatively small in comparison with the effect of dietary manipulation.

Adult↗
PubMed2005

Insulin resistance and impaired glucose metabolism in a predominantly Maori community.

We sought to identify lifestyle behaviours which influence risk of impaired glucose metabolism, IGM (newly diagnosed type 2 diabetes, impaired glucose tolerance [IGT] or impaired fasting glycemia [IFG]) or insulin resistance (IR) in a predominantly Maori community, and applied the McAuley formula to determine whether it predicts high risk individuals amongst this community. Three hundred and seventy one participants completed a lifestyle and dietary behaviour questionnaire and oral glucose tolerance test. Clinical variables, microalbuminuria, fasting glucose, insulin and lipids were measured. Diabetes, IFG and IGT were defined according to WHO criteria. IR was defined using the McAuley formula. Those with IGM and those with IR showed similar risk factor attributes. Odds ratios (95% CI) for development of IGM and IR were 0.43 (0.21-0.88) and 0.51 (0.33-0.80), respectively, for regular physical activity, and 0.55 (0.26-1.15) and 0.59 (0.37-0.96), respectively, for two or more dietary behaviours characterized by a high intake of fibre. Regular physical activity and a diet characterized by a high intake of dietary fibre were found to reduce risk of newly diagnosed IGM or IR. The McAuley formula appears to predict high-risk individuals in a predominantly Maori population as it does in European populations.

Blood Glucose↗
PubMed2005

Bone and body composition of children and adolescents with repeated forearm fractures.

UNLABELLED: DXA measurements in 90 children and adolescents with repeated forearm fractures showed reduced ultradistal radius BMC and BMD values and elevated adiposity, suggesting site-specific bone weakness and high body weight increase fracture risk. Symptoms to cow milk, low calcium intakes, early age of first fracture, and overweight were over-represented in the sample. INTRODUCTION: Although many apparently healthy children fracture their forearms repeatedly during growth, no previous studies of their bone health and body composition have been undertaken. Nor has the prevalence of established risk factors for fracture in such a population been assessed. MATERIALS AND METHODS: Ninety children and adolescents (47 girls and 43 boys) 5-19 years of age, who had experienced at least two fractures of the forearm, were studied. Bone size and mineralization were assessed using DXA at the ultradistal radius, one-third radius, neck of femur, hip trochanter, lumbar spine, and total body. Total body lean mass and fat mass were also determined. The prevalence of six risk factors for fracture were also examined, and their influence on ultradistal BMC Z scores was assessed. RESULTS: Participants experienced 295 fractures (74.9% forearm). Children with an early age of first fracture had higher rates of fracture per l00 years of exposure than those fracturing later. Four risk factors for fracture were over-represented in observed versus expected percentages: early age of first fracture (27.7% versus 11.3%), adverse symptoms to cow milk (22.2% versus 6.7%), low dietary calcium intake (20% versus 4.5%), and overweight (33.3% versus 15.5%). However, physical activity levels were similar to the reference population. Z scores for BMC and BMD were reduced, particularly at the ultradistal radius, whereas Z scores for weight, body mass index, fat mass, and body fat percentage were increased. Mean (SD) BMC Z scores were lowest at the ultradistal radius, -0.66 (1.22), where symptoms to milk were associated with reduced values (p < 0.009) and overweight with increased values (p < 0.003). CONCLUSIONS: Our results suggest site-specific weakness and high body weight contribute to fracture risk in children and adolescents who fracture their forearms repeatedly. These findings are consonant with work showing adult Colles fractures increase as ultradistal radius BMD falls and with evidence that overweight children and adolescents are fracture prone.

Absorptiometry, Photon↗
PubMed2005

Weight and height growth rate and the timing of adiposity rebound.

OBJECTIVE: Adiposity rebound occurs when the ratio of the velocities of log(weight) to log(height) changes from <2 to >2. This study examined the timing of adiposity rebound in the context of the velocities of weight and height in early childhood because it is not known whether faster weight gain or slower gain in stature is the more important determinant. RESEARCH METHODS AND PROCEDURES: This was a longitudinal study of 406 boys and 397 girls born in Dunedin, New Zealand, in 1972 and 1973. Each child's height and weight were measured at 3 years of age and at least twice more as part of their two yearly assessments until 11 years of age. RESULTS: The mean age of adiposity rebound was 6.6+/-1.10 years (SD) for boys and 6.0+/-1.21 years for girls. After adjusting for sex, the correlations between the timing of rebound and z-scores for BMI, weight, and height at rebound were -0.35, -0.30, and -0.14, respectively. Correlations between the timing of rebound and estimated values of weight and height velocities at 3 years were -0.48 and -0.00. The correlations with BMI and waist girth at 26 years were -0.39 and -0.35. DISCUSSION: Children with an earlier adiposity rebound were heavier and had above average BMIs. Early rebound is the result of higher rates of weight gain, measured in percentage terms, rather than slower than average accrual of stature. This suggests that restraining weight gain could delay adiposity rebound and prevent obesity in early adulthood.

Adipose Tissue↗
PubMed2005

Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5-14 y.

New Zealand children, particularly those of Māori and Pacific ethnicity, may be at risk for low vitamin D status because of low vitamin D intakes, the country's latitude (35-46 degrees S), and skin color. The aim of this study was to determine 25-hydroxyvitamin D concentrations and their determinants in a national sample of New Zealand children aged 5-14 y. The 2002 National Children's Nutrition Survey was designed to survey New Zealand children, including oversampling of Māori and Pacific children to allow ethnic-specific analyses. A 2-stage recruitment process occurred using a random selection of schools, and children within each school. Serum 25-hydroxyvitamin D concentration [mean (99% CI) nmol/L] in Māori children (n = 456) was 43 (38,49), in Pacific (n = 646) 36 (31,42), and in New Zealand European and Others (NZEO) (n = 483) 53 (47,59). Among Māori, Pacific, and NZEO, the prevalence (%, 99% CI) of serum 25-hydroxyvitamin D deficiency (<17.5 nmol/L) was 5 (2,12), 8 (5,14), and 3 (1,7), respectively. The prevalence of insufficiency (<37.5 nmol/L) was 41 (29,53), 59 (42,75), and 25 (15,35), respectively. Multiple regression analysis found that 25-hydroxyvitamin D concentrations were lower in winter than summer [adjusted mean difference (99% CI) nmol/L; 15 (8,22)], lower in girls than boys [5 (1,10)], and lower in obese children than in those of "normal" weight [6 (1,11)]. Relative to NZEO, 25-hydroxyvitamin D concentrations were lower in Māori [9 (3,15)] and Pacific children [16 (10,22)]. Ethnicity and season are major determinants of serum 25-hydroxyvitamin D. There is a high prevalence of vitamin D insufficiency in New Zealand children, which may or may not contribute to increased risk of osteoporosis and other chronic disease. There is a pressing need for more convincing evidence concerning the health risks associated with the low vitamin D status in New Zealand children.

Adolescent↗
PubMed2005

Early adiposity rebound: review of papers linking this to subsequent obesity in children and adults.

PURPOSE OF REVIEW: Improving our understanding of factors driving fat gain in young children should increase our ability to manage the rising problem of obesity. Accordingly, studies associating timing of adiposity rebound with later obesity are reviewed. RECENT FINDINGS: Investigations in many countries have confirmed that early adiposity rebound increases risk of high blood pressure and obesity in young adults. The magnitude of the effect can be substantial (>3 body mass index units at 18-21 years) for those undergoing early (<5 years of age) compared with late (>7 years of age) rebound. Early rebound is also associated with impaired glucose tolerance and diabetes in adulthood. Because adiposity rebound is determined using serial measurements of body mass index, the actual changes in body composition occurring during this time are obscured. Recent data show that changing body mass index during adiposity rebound is due to higher than average deposition of weight rather than slowing of the rate of height gain. Moreover, this increased weight gain occurs because of rapid deposition of fat rather than lean tissue, with early rebounders gaining fat mass at almost three times the rate of late rebounders. SUMMARY: Future work is needed to identify reasons for early adiposity rebound. Because high physical activity and low inactivity are associated with lower body fat during the period of adiposity rebound, studies should be undertaken to see whether stepping up activity can slow fat gain, delay the onset of adiposity rebound and lower adult obesity.

Adipose Tissue↗
PubMed2004

Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study.

Little information exists on risk factors associated with bone fractures during childhood and adolescence. This 1972/1973-1990/1991 New Zealand study examined the influence of birth size, height and weight throughout growth, smoking, breastfeeding, and sports participation on the risk of fracture in participants of the Dunedin Multidisciplinary Health and Development Study. Information on height, weight, fracture status, and lifestyle was collected at birth and at ages 3, 5, 7, 9, 11, 13, 15, and 18 years from parents and/or participants. Study members sustained 229 (girls) and 393 (boys) fractures between birth and age 18 years. Fracture risk was elevated (per standard deviation unit increase) in relation to birth length (prepubertal fractures only) (risk ratio (RR) = 1.28, 95% confidence interval (CI): 1.04, 1.58), weight at age 3 years (RR = 1.14, 95% CI: 1.03, 1.27), weight from ages 5 to 18 years (RR = 1.15, 95% CI: 1.03, 1.28), height at age 3 years (RR = 1.13, 95% CI: 1.01, 1.26), and height from ages 5 to 18 years (RR = 1.13, 95% CI: 1.02, 1.24). Birth weight, maternal smoking, breastfeeding, and sports participation had no significant effect on fracture risk. However, for teenagers, personal daily smoking increased the risk of fracture (RR = 1.43, 95% CI: 1.05, 1.95). The authors concluded that tall and heavy children had an increased risk of fracture, as did adolescents who smoked regularly.

Adolescent↗
PubMed2004

Children who avoid drinking cow's milk are at increased risk for prepubertal bone fractures.

The full fracture histories of 50 children (30 girls and 20 boys, age range 3 to 13 years) who had avoided drinking cow's milk for prolonged periods were compared with those in a birth cohort of more than 1,000 children from the same city. Children who avoided milk did not use calcium-rich food substitutes appropriately and had low dietary calcium intakes and low bone mineral density values. Many were overweight (22 of 50). Significantly more of the children who avoided milk reported fractures (16 observed vs 6 expected, chi(2)=31.0, P<.001, df=5). They also experienced more total fractures than the birth cohort population (22 observed vs 8 expected, chi(2)=33.6, P<.001, df=5). All of the fractures occurred before puberty, the majority (18 of 22) being associated with only slight trauma. Forearm fractures were especially common (12 fractures). We conclude that young children avoiding milk are prone to fracture.

Adolescent↗
PubMed2004

Rate of fat gain is faster in girls undergoing early adiposity rebound.

OBJECTIVE: To determine the changes in body composition (fat and lean mass) occurring in children during adiposity rebound (AR). RESEARCH METHODS AND PROCEDURES: Thirty-nine girls, 3 to 6 years of age at baseline, underwent yearly DXA scans for 2 years. An additional DXA scan was obtained 4 to 5 years after baseline. Age at AR was determined by modeling, and the velocity of change in height, weight, fat mass, and lean mass was estimated for each child using random coefficient models. Girls with an AR <5 years of age were classified as having an early AR, and those having an AR > or =5 years were classified as late AR. RESULTS: Although body composition was similar at age 5, by age 9, girls with an early AR were significantly taller (3.5% more) and heavier (14.4%), with greater fat mass (50%) and percentage body fat (27%) than girls with a later AR. In addition, more girls were overweight according to BMI (18% vs. 6%) or percentage body fat (29% vs. 11%) at this time, despite no differences at baseline. Annual velocity of fat mass gain was over 2-fold higher in early compared with late rebounders (17.1% vs. 6.5%, p < 0.0001), with no difference in lean mass velocity (13.1% vs. 12.5%, p = 0.116). DISCUSSION: Differences in BMI during AR were caused specifically by alterations in body fat and not by alterations in lean mass or height. Children undergoing early AR gained fat at a faster rate than children who rebounded at a later age.

Absorptiometry, Photon↗
PubMed2004

Development of auditory sensitivity in children who stutter and fluent children.

OBJECTIVE: The purpose of this study was to establish whether there are any differential changes in auditory sensitivity over ages in a variety of peripheral and central auditory tasks between participants who stutter and participants who do not stutter. DESIGN: The auditory sensitivity of 37 participants who stutter and 44 participants who do not stutter, ages between 8 and 19 yr, assigned to three age categories, were obtained in five listening conditions: Pure tone threshold, simultaneous masking, backward masking, notched backward masking, and simple dichotic (simultaneous) masking. RESULTS: Across all listening conditions and both talker groups, thresholds decreased over age. The thresholds of participants who do not stutter decreased for simultaneous, backward, and notched backward masking conditions over the 8- to 19-year age range. Analysis of each condition only showed significant improvement over age groups for backward masking for the participants who stutter. CONCLUSIONS: These results indicate that auditory sensitivity for sounds in noise continues to develop through to teenage, and a different pattern of auditory development exists for the participants who stutter compared with participants who do not stutter.

Adolescent↗
PubMed2004

Web-based screening and brief intervention for hazardous drinking: a double-blind randomized controlled trial.

BACKGROUND: Strong evidence exists for the efficacy of screening and brief intervention for reducing hazardous drinking. However, problems have been highlighted with respect to its implementation in health-care systems, not least of which is a reluctance of some doctors to discuss alcohol proactively with their patients. AIMS: To determine the efficacy of a novel web-based screening and brief intervention (e-SBI) to reduce hazardous drinking. DESIGN: A double-blind randomized controlled trial. SETTING: A university student health service. PARTICIPANTS: A total of 167 students (17-26 years) were recruited in the reception area and completed a 3-minute web-based screen including the Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Of these, 112 tested positive, and 104 (52 females) who consented to follow-up were included in the trial. MEASUREMENTS: Drinking frequency, typical occasion quantity, total volume, heavy episode frequency (females > 80 g ethanol, males > 120 g ethanol), number of personal problems, an academic problems score. INTERVENTION: Participants were randomized to 10-15 minutes of web-based assessment and personalized feedback on their drinking (intervention, n = 51) or to a leaflet-only control group (n = 53). FINDINGS: Mean baseline AUDIT scores for control and intervention groups were 16.6 (SD = 6.0) and 16.6 (SD = 5.7). At 6 weeks, participants receiving e-SBI reported significantly lower total consumption (geometric mean ratio = 0.74; 95% confidence interval: 0.56-0.96), lower heavy episode frequency (0.63; 0.42-0.92) and fewer personal problems (0.70; 0.54-0.91). At 6 months personal problems remained lower (0.76; 0.60-0.97), although consumption did not differ significantly. At 6 months, academic problems were lower in the intervention group relative to controls (0.72; 0.51-1.02). CONCLUSIONS: e-SBI reduced hazardous drinking among university students, to an extent similar to that found for practitioner-delivered brief interventions in the general population. e-SBI offers promise as a strategy to reduce alcohol-related harm in a way that is non-intrusive, appealing to the target group, and capable of being incorporated into primary care. Research is required to replicate the findings, to determine the duration of intervention effects, and to investigate the mechanisms by which the intervention operates.

Adolescent↗