michael fleming - Academia.edu (original) (raw)

Uploads

Papers by michael fleming

Nicotine & Tobacco Research, Dec 17, 2009

Journal of Studies on Alcohol and Drugs, 2007

Alcoholism, clinical and experimental research, Apr 14, 2017

Alcohol dependent liver transplantation (LT) patients who resume alcohol are at risk for a number... more Alcohol dependent liver transplantation (LT) patients who resume alcohol are at risk for a number of alcohol related problems including liver injury and liver failure. Post LT patients are strongly advised to remain abstinent. However, we don't know how well this population complies due to a lack of valid methods (self-report and/or biomarkers) to identify alcohol use. Studies suggest as many as 50% resume alcohol use within 5 years. Phosphatidylethanol (PEth) is a new cell-membrane phospholipid biomarker to identify alcohol use in the past 28 days. This prospective study followed 213 LT recipients at two US liver transplant centers. Sample included 213 LT subjects. 70.9% (n=151/213) had a history of alcohol dependence prior to transplantation and 29.1% (n=62/213) served as non-alcohol dependent controls. Subjects participated in face-to-face interviews to assess alcohol use using a 30-day calendar. The protocol called for collecting blood samples at baseline, 6- and 12-month fo...

Addiction (Abingdon, England), 2015

To assess the effect of a multi-component primary care delivered brief intervention for reducing ... more To assess the effect of a multi-component primary care delivered brief intervention for reducing risky psychoactive drug use (RDU) among patients identified by screening. Multicenter single-blind two-arm randomized controlled trial of patients enrolled from February 2011 to November 2012 with 3-month follow-up. Randomization and allocation to trial group were computer-generated. Primary care waiting rooms of five federally qualified health centers in Los Angeles County (LAC), USA. A total of 334 adult primary care patients (171 intervention; 163 control) with RDU scores (4-26) on the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) self-administered on tablet computers. 261 (78%) completed follow-up. Mean age was 41.7 years; 62.9% were male; 37.7% were Caucasian. Intervention patients received brief (typically 3-4 minutes) clinician advice to quit/reduce their drug use reinforced by a video doctor message, health education booklet an...

Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 1999

Primary health care providers identify and treat many patients who are at risk for or are already... more Primary health care providers identify and treat many patients who are at risk for or are already experiencing alcohol-related problems. Brief interventions--counseling delivered by primary care providers in the context of several standard office visits--can be a successful treatment approach for many of these patients. Numerous trials involving a variety of patient populations have indicated that brief interventions can reduce patients' drinking levels, regardless of the patients' ages and gender. In clinical practice, brief interventions can help reduce the drinking levels of nondependent drinkers who drink more than the recommended limits, facilitate therapy and abstinence in patients receiving pharmacotherapy, and enhance the effectiveness of assessment and treatment referral in patients who do not respond to brief interventions alone. Despite the evidence for their usefulness, however, brief interventions for alcohol-related problems have not yet been widely implemented...

Journal of Studies on Alcohol and Drugs, 2010

MCN. The American journal of maternal child nursing

To report on secondary results from the Healthy Moms Study, a clinical trial to test the efficacy... more To report on secondary results from the Healthy Moms Study, a clinical trial to test the efficacy of brief intervention on reducing alcohol use and alcohol-related harms in postpartum women. Data from a randomized clinical trial conducted between 2002 and 2005 with a sample of Wisconsin women was analyzed. This report presents comparison data on depressive symptomatology between postpartum women drinking above recommended levels who received a brief alcohol intervention and those who received no intervention. At 6-month follow-up, there was a significant reduction in mean depression scores compared to baseline in the women who received the alcohol intervention (p < .001). There was no significant reduction in depressive symptomatology in the control group. Mean level of depression at 6 months was significantly predicted by baseline depression and the alcohol intervention (p = .018). Alcohol use at either baseline or follow-up was not a predictive factor in determining mean depres...

Substance Abuse, 2010

Brief primary care interventions structured around patient workbooks have been shown to be effect... more Brief primary care interventions structured around patient workbooks have been shown to be effective in modifying hazardous drinking behavior. However, the critical ingredients of such interventions are not well understood, possibly contributing to their underutilization. Seventeen campus-based clinicians trained in a brief, workbook-based alcohol intervention participated in a qualitative study to identify the most promising clinician-patient interaction components within this shared approach, utilizing a focus group with the clinicians and ranking of the 24 workbook ingredients. Based on the clinicians’ collective experience, consensus emerged around the perceived strength of 5 main components: ( 1 ) providing a summary of the patient's drinking level, ( 2 ) discussing drinking likes and dislikes, ( 3 ) discussing life goals, ( 4 ) encouraging a risk-reduction agreement, and ( 5 ) asking patients to track their drinking (on cards provided for this purpose). This is the first p...

Nicotine & Tobacco Research, 2009

Introduction: While most college students and other young adults who smoke fall into the light an... more Introduction: While most college students and other young adults who smoke fall into the light and intermittent smoking (LITS) category, they remain at risk for tobacco dependence and other adverse health effects from their smoking. This study examines smoking patterns, tobacco dependence, and other health variables among students at five universities to better understand how to identify and address tobacco use and related risks in a college health clinic setting. Methods: A health screening survey was completed by 2,091 college and graduate student volunteers seeking routine care at their university health centers or participating in a health class. Independent health variables were analyzed descriptively and in regression analyses with three levels of smoking (none, nondaily, and daily) and tobacco dependence to determine predictors and associated risks. Results: Nearly a quarter of students reported any current smoking, 41% of whom reported smoking less than 1 cigarette/ day (cpd). Of the daily smokers, 80% smoked less than 10 cpd but 45% met criteria for tobacco dependence. Any smoking was associated with high-risk alcohol use, risky driving, relational abuse, depression, less exercise, and utilization of emergency and mental health services. In regression analyses, students who experienced depression had more than double the odds of being dependent smokers (odds ratio [OR] = 2.32), as did those who reported abuse (OR = 2.07) or sought mental health counseling (OR = 2.09). Discussion: Student health providers should be alerted to the multiple risks and comorbidities that occur among all smokers, including LITS, and intervene concurrently to help prevent or mitigate adverse outcomes that result from these conditions and behaviors.

The Journal of the American Board of Family Medicine, 2004

The Journal of the American Board of Family Medicine, 2009

Journal of Cognitive Psychotherapy, 2005

Cognitive-behavioral approaches to alcohol and drug use disorders have received considerable empi... more Cognitive-behavioral approaches to alcohol and drug use disorders have received considerable empirical support over the past 20 years. One cognitive-behavioral treatment, relapse prevention, was initially designed as an adjunct to existing treatments. It has also been extensively used as a stand-alone treatment and serves as the basis for several other cognitive and behavioral treatments. After a brief review of relapse prevention, as well as the hypothesized mechanisms of change in cognitive and behavioral treatments, we will describe a “new” approach to alcohol and drug problems called mindfulness-based relapse prevention. Preliminary data in support of mindfulness-meditation as a treatment for addictive behavior are provided and directions for future research are discussed.

Journal of American College Health, 2009

Journal of American College Health, 2010

JAMA: The Journal of the American Medical Association, 1997

Objective.-Project T rEAT (T rial for Early Alcohol T reatment) was designed to test the efficacy... more Objective.-Project T rEAT (T rial for Early Alcohol T reatment) was designed to test the efficacy of brief physician advice in reducing alcohol use and health care utilization in problem drinkers. Design.-Randomized controlled clinical trial with 12-month follow-up. Setting.-A total of 17 community-based primary care practices (64 physicians)