This Library bulletin provides further reading to support the ‘Making Every Contact Count’ programme.
There are links to recent research papers and articles in each of the MECC areas to give you further background information and evidence to consolidate what you have learned in your training, and to give you ideas and confidence for practising MECC in your day-to-day encounters. The section on smoking cessation includes a Cochrane review about interventions to increase adherence to medications for tobacco dependence and what PHE says about e-cigarettes. There are peer-reviewed articles about different diets for weight loss and a study exploring alcohol intake and cancer risk, as well as articles on how to start a MECC conversation.
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Public Health England have published a report on service user involvement in drug and alcohol treatment programmes, designed to help commissioners, service providers and service users explore and develop service user involvement in their area. It also includes a series of ‘inspirational’ case studies outlining how different organisations have approached service user involvement.
Public Health England has launched a new guide showing the benefits of involving recovering alcohol and drug users in the design and development of their own, and others treatment and recovery.
PHE’s Service User Involvement guide describes 4 different levels of service user involvement, from co-developing one’s own care plan through to initiating and running recovery-focused enterprises. The guide showcases a number of examples of unique services from across the country that have been set-up by, or run by, former alcohol and drug users.
Click here for further information and to download the guide.
This study, incorporating two US prospective cohort studies, aims to quantify risk of overall cancer across all levels of alcohol consumption among women and men separately, with a focus on light to moderate drinking and never smokers; and assess the influence of drinking patterns on overall cancer risk.
This study aims to quantify the association between long working hours and alcohol use through a systematic review and meta-analysis of published studies and unpublished individual participant data.
Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.
The study concludes that individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.
Cannabis use has been examined as a predictor of psychosis in clinical high-risk (CHR) samples, but little is known about the impact of other substances on this relationship.
Substance use was assessed in a large sample of CHR participants (N = 370, mean age = 18.3) enrolled in the multisite North American Prodrome Longitudinal Study Phase 1 project. Three hundred and forty-one participants with cannabis use data were divided into groups: No Use (NU, N = 211); Cannabis Use without impairment (CU, N = 63); Cannabis Abuse/Dependence (CA/CD, N = 67). Participants (N = 283) were followed for ≥2 years to determine psychosis conversion.
Alcohol (45.3%) and cannabis (38.1%) were the most common substances. Cannabis use groups did not differ on baseline attenuated positive symptoms. Seventy-nine of 283 participants with cannabis and follow-up data converted to psychosis. Survival analysis revealed significant differences between conversion rates in the CA/CD group compared with the No Use (P = 0.031) and CU group (P = 0.027). CA/CD also significantly predicted psychosis in a regression analysis, but adjusting for alcohol use weakened this relationship.
The cannabis misuse and psychosis association was confounded by alcohol use. Non-impairing cannabis use was not related to psychosis. Results highlight the need to control for other substance use, so as to not overstate the cannabis/psychosis connection.
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