Does daily activity overlap of seven mesocarnivores vary based on human development?

Many species of wildlife alter their daily activity patterns in response to co-occurring species as well as the surrounding environment. Often smaller or subordinate species alter their activity patterns to avoid being active at the same time as larger, dominant species to avoid agonistic interactions. Human development can complicate interspecies interactions, as not all wildlife respond to human activity in the same manner. While some species may change the timing of their activity to avoid being active when humans are, others may be unaffected or may benefit from being active at the same time as humans to reduce predation risk or competition. To further explore these patterns, we used data from a coordinated national camera-trapping program (Snapshot USA) to explore how the activity patterns and temporal activity overlap of a suite of seven widely co-occurring mammalian mesocarnivores varied along a gradient of human development. Our focal species ranged in size from the large and often dominant coyote (Canis latrans) to the much smaller and subordinate Virginia opossum (Didelphis virginiana). Some species changed their activity based on surrounding human development. Coyotes were most active at night in areas of high and medium human development. Red fox (Vulpes vulpes) were more active at dusk in areas of high development relative to areas of low or medium development. However, because most species were primarily nocturnal regardless of human development, temporal activity overlap was high between all species. Only opossum and raccoon (Procyon lotor) showed changes in activity overlap with high overlap in areas of low development compared to areas of moderate development. Although we found that coyotes and red fox altered their activity patterns in response to human development, our results showed that competitive and predatory pressures between these seven widespread generalist species were insufficient to cause them to substantially alter their activity patterns.

Long-term temporal trends in gastrointestinal parasite infection in wild Soay sheep.

Monitoring the prevalence and abundance of parasites over time is important for addressing their potential impact on host life histories, immunological profiles and their influence as a selective force. Only long-term ecological studies have the potential to shed light on both the temporal trends in infection prevalence and abundance and the drivers of such trends, because of their ability to dissect drivers that may be confounded over shorter time scales. Despite this, only a relatively small number of such studies exist. Here, we analysed changes in the prevalence and abundance of gastrointestinal parasites in the wild Soay sheep population of St. Kilda across 31 years. The host population density (PD) has increased across the study, and PD is known to increase parasite transmission, but we found that PD and year explained temporal variation in parasite prevalence and abundance independently. Prevalence of both strongyle nematodes and coccidian microparasites increased during the study, and this effect varied between lambs, yearlings and adults. Meanwhile, abundance of strongyles was more strongly linked to host PD than to temporal (yearly) dynamics, while abundance of coccidia showed a strong temporal trend without any influence of PD. Strikingly, coccidian abundance increased 3-fold across the course of the study in lambs, while increases in yearlings and adults were negligible. Our decades-long, intensive, individual-based study will enable the role of environmental change and selection pressures in driving these dynamics to be determined, potentially providing unparalleled insight into the drivers of temporal variation in parasite dynamics in the wild.

Novel Trauma Composite Score is a more reliable predictor of mortality than Injury Severity Score in pediatric trauma.

BACKGROUND: The equivalent Injury Severity Score (ISS) cutoffs for severe trauma vary between adult (ISS, >16) and pediatric (ISS, >25) trauma. We hypothesized that a novel injury severity prediction model incorporating age and mechanism of injury would outperform standard ISS cutoffs. METHODS: The 2010 to 2016 National Trauma Data Bank was queried for pediatric trauma patients. Cut point analysis was used to determine the optimal ISS for predicting mortality for age and mechanism of injury. Linear discriminant analysis was implemented to determine prediction accuracy, based on area under the curve (AUC), of ISS cutoff of 25 (ISS, 25), shock index pediatric adjusted (SIPA), an age-adjusted ISS/abbreviated Trauma Composite Score (aTCS), and our novel Trauma Composite Score (TCS) in blunt trauma. The TCS consisted of significant variables (Abbreviated Injury Scale, Glasgow Coma Scale, sex, and SIPA) selected a priori for each age. RESULTS: There were 109,459 blunt trauma and 9,292 penetrating trauma patients studied. There was a significant difference in ISS (blunt trauma, 9.3 ± 8.0 vs. penetrating trauma, 8.0 ± 8.6; p < 0.01) and mortality (blunt trauma, 0.7% vs. penetrating trauma, 2.7%; p < 0.01). Analysis of the entire cohort revealed an optimal ISS cut point of 25 (AUC, 0.95; sensitivity, 0.86; specificity, 0.95); however, the optimal ISS ranged from 18 to 25 when evaluated by age and mechanism. Linear discriminant analysis model AUCs varied significantly for each injury metric when assessed for blunt trauma and penetrating trauma (penetrating trauma-adjusted ISS, 0.94 ± 0.02 vs. ISS 25, 0.88 ± 0.02 vs. SIPA, 0.62 ± 0.03; p < 0.001; blunt trauma-adjusted ISS, 0.96 ± 0.01 vs. ISS 25, 0.89 ± 0.02 vs. SIPA, 0.70 ± 0.02; p < 0.001). When injury metrics were assessed across age groups in blunt trauma, TCS and aTCS performed the best. CONCLUSION: Current use of ISS in pediatric trauma may not accurately reflect injury severity. The TCS and aTCS incorporate both age and mechanism and outperform standard metrics in mortality prediction in blunt trauma. LEVEL OF EVIDENCE: Retrospective review, level IV.

Interactions of Dimethylarsinic Acid, Total Arsenic and Zinc Affecting Rice Crop Management and Human Health in Cambodia.

BACKGROUND: In parts of Cambodia and in many other parts of the world, irrigation of rice with groundwater results in arsenic (As) accumulation in soil and rice, leading to health concerns associated with rice consumption. At times, some As is present as relatively nontoxic, non-regulated, dimethylarsinic acid (DMA). Low levels of zinc (Zn) have been found in rice from Bangladesh, Cambodia, and China where As levels in rice are high. Furthermore, there have been claims that Zn deficiency is responsible for stunting the growth of children in Cambodia and elsewhere, however in rural Asia, rice is the major source of Zn. Current data are inadequate for both Zn and DMA in Cambodian rice. OBJECTIVES: The present study aimed to provide a preliminary evaluation of the relationship between the content of Zn and DMA in rice grain in Preak Russey, an area with elevated levels of As in groundwater and to improve the management of Zn deficiency in rice. METHODS: Rice agriculture was evaluated along the Mekong River in Cambodia. Analyses for metals, total As, and As species in rice and water were conducted by inductively coupled plasma mass spectrometry. Analysis of total Zn and As in soils and total Zn in rice were analyzed using X-ray fluorescence (XRF) spectrometry. RESULTS: Rice in Preak Russey had Zn concentrations less than a third the level recommended by the United Nations World Food Programme. There was a significant (p < 0.05) negative correlation between the Zn content of rice and DMA in rice with the lowest Zn and highest DMA levels occurring near irrigation wells, the source of As. CONCLUSIONS: The highest levels of DMA in rice were associated with Zn deficiency in rice. COMPETING INTERESTS: The authors declare no competing financial interests.

Environmental and Health Implications of the Correlation Between Arsenic and Zinc Levels in Rice from an Arsenic-Rich Zone in Cambodia.

BACKGROUND: In parts of Cambodia, irrigation of rice with groundwater results in arsenic accumulation in soils and rice, leading to health concerns associated with rice consumption. In Bangladesh and China, low zinc levels in rice have been found in regions where arsenic levels in rice are high. Furthermore, there have been claims that zinc deficiency is responsible for stunting of children in Cambodia. There are limited data on zinc in Cambodian rice, but in rural Asia, rice is the major source of zinc. OBJECTIVES: To provide a preliminary evaluation of the zinc content in rice grain in Preak Russey, an area with elevated levels of arsenic. The importance of zinc in rice for infants was also assessed. METHODS: Rice cultivation was evaluated in sixty farms along the Mekong River in Cambodia. Analyses for metals, total arsenic, and arsenic species in the water and rice were conducted at the University of Ottawa, Canada by inductively coupled plasma - mass spectrometry. Analysis of total zinc and arsenic in soils were analyzed in Phnom Penh using X-ray fluorescence spectrometry (XRF). Total zinc in rice was also measured by XRF analysis. RESULTS: Rice in the Preak Russey area contained zinc with ½ to » of the 1987 Codex standard for rice in Infant Formula. Moreover, our average zinc concentration in rice samples was less than a third that recommended for zinc fortification in rice by the United Nations World Food Programme. There was a significant (α=0.05) negative correlation between the arsenic and zinc content of rice with the lowest zinc levels occurring near the irrigation wells, the source of arsenic. There was a significantly higher content of zinc in rice from farms that fertilized with cow manure. CONCLUSIONS: Handheld XRF spectrometers are useful tools for detection of zinc levels in rice. The potential for zinc deficiency in farmers in areas of Cambodia with arsenic toxicity is high. COMPETING INTERESTS: The authors declare no competing financial interests.

Groundwater Irrigation and Arsenic Speciation in Rice in Cambodia.

BACKGROUND: Arsenic bioaccumulation in rice is a global concern affecting food security and public health. OBJECTIVE: The present study examined arsenic species in rice in Cambodia to characterize health risks with rice consumption and to clarify uncertainties with Codex guidelines. METHODS: The present study collected 61 well water samples, 105 rice samples, 70 soil samples, and conducted interviews with 44 families in Preak Russey near the Bassac River and Kandal Province along the Mekong River in Cambodia. Analyses of metals, total arsenic and arsenic species were conducted in laboratories in Canada, Cambodia and Singapore. RESULTS: Unlike in Bangladesh, rice with the highest total arsenic concentrations in Cambodia contains mostly organic arsenic, dimethylarsinic acid (DMA), which is unregulated and much less toxic than inorganic arsenic. The present study found that storing surface runoff in ditches prior to irrigation can significantly reduce the arsenic concentration in rice. It is possible to remove > 95% of arsenic from groundwater prior to irrigation with natural reactions. CONCLUSIONS: The provision of high quality drinking water in 2015 to Preak Russey removed about 95% of the dietary inorganic arsenic exposure. The extremes in arsenic toxicity that are still obvious in these farmers should become less common. Rice from the site with the highest documented levels of arsenic in soils and water in Cambodia passes current Codex guidelines for arsenic. INFORMED CONSENT: Obtained. COMPETING INTERESTS: The authors declare no competing financial interests.

Effects of Arsenic, Iron and Fertilizers in Soil on Rice in Cambodia.

BACKGROUND: In parts of Cambodia, irrigation with groundwater results in arsenic accumulation in soils and rice, leading to health concerns associated with rice consumption. A high concentration of iron in groundwater can precipitate arsenic and reduce its bioavailability, however high concentrations of arsenic and iron can also reduce rice production. Furthermore, concerns have been raised about chemical contamination from inorganic fertilizers used to grow rice. The relationship between soil geochemistry and arsenic concentrations in rice is not yet fully understood. OBJECTIVES: The primary objective of this project was to investigate the relationship between arsenic concentrations in irrigation water, soil and rice collected from different sites in Cambodia. A secondary objective was to explore arsenic and phosphorus levels in fertilizer samples obtained from the study area in Cambodia. METHODS: The present study collected 61 well water samples, 105 rice samples, 70 soil samples, 11 inorganic fertilizer samples and conducted interviews with 44 families along the Mekong River in Cambodia. Analyses for metals, total arsenic, and arsenic species in the water and rice were conducted in Canada by inductively coupled plasma mass spectrometry. Analyses for metals, total arsenic and phosphorus in soils and inorganic fertilizers were conducted in Cambodia and Singapore by X-ray fluorescence. RESULTS: The concentration of arsenic in rice paddy soils was highly variable and as much as 20 times higher near the irrigation wells than in more distal areas of the paddy. Two farmers in Preak Russey had integrated soil samples with arsenic levels above the concentration associated with toxicity to rice in Taiwan (40 mg/kg) and above the Dutch concentration requiring intervention or remediation (55 mg/kg). The highest total arsenic measured in soil was 95 mg/kg. In Preak Russey, the loading of arsenic from irrigation water was 3710 times greater than the loading of arsenic from inorganic fertilizers. Half of the commercial inorganic fertilizers had less than 50% of the labelled content of phosphorus. CONCLUSIONS: Emphasis should be placed on improving the management of irrigation water, not on inactivation of arsenic in soil. The high levels of iron in groundwater mitigate arsenic toxicity, but the accumulation of iron could later result in lower rice productivity. Irrigation of rice with groundwater is not likely sustainable. To improve rice productivity, the content of phosphorus in local inorganic fertilizers must be improved to world standards. X-ray fluorescence analysis can quickly identify poor quality fertilizers. INFORMED CONSENT: Obtained. COMPETING INTERESTS: The authors declare no competing financial interests.

Hospital-based, Multidisciplinary, youth mentoring and medical exposure program positively influences and reinforces health care career choice: "The Reach One Each One Program early Experience".

BACKGROUND: According to the National Center for Educational Statistics, underrepresented minorities (URMs) are more likely to leave science, technology, engineering and mathematics (STEM) fields at higher rates than their peers during undergraduate studies. Many institutions of higher learning have implemented pipeline programs aimed at preparing and inspiring high school and college aged students in select careers in health sciences with varying levels of success. Research has shown that a health care workforce that mirrors the community they serve is more effective in reducing health disparities and increasing positive health outcomes. We hypothesize that a hospital-based, multidisciplinary youth mentoring and medical exposure program will enhance the decision of URM high school students to choose healthcare careers. MATERIALS AND METHOD: A retrospective analysis of the Reach One Each One Program (ROEO) was performed. ROEO is a hospital based, 11-week multidisciplinary youth mentoring and medical exposure program for inner-city high school students. The analysis was based on a phone survey of the twenty-six (26) seniors who completed the program and subsequently graduated from high school between May 2013 and May 2015 to assess the following: 1) College enrollment/attendance, 2) Health profession majors, and 3) Pre-med status. The study was approved by the Morehouse School of Medicine Institutional Review Board. RESULTS: Of the twenty-six students, 23 were female and 3 were male; 25 (96%) of the students were African American and one student was a Caucasian female. Twenty-four (92.3%) of the students were enrolled in college and 2 (7.7%) were scheduled to begin in the spring semester of 2016. Twenty-one of the 24 attending college at the time of the survey (87.5%) were enrolled in a health science degree program and 16 (66.7%) confirmed that they were enrolled in pre-medical (Pre-med) curriculum. CONCLUSION: Hospital-based, multidisciplinary medical mentoring programs can have a positive impact on the lives and health care career decisions of aspiring URM high school students. Further study will be necessary to validate the most influential components needed for the success of such programs.

Vitamin D3 Suppresses Class II Invariant Chain Peptide Expression on Activated B-Lymphocytes: A Plausible Mechanism for Downregulation of Acute Inflammatory Conditions.

Class II invariant chain peptide (CLIP) expression has been demonstrated to play a pivotal role in the regulation of B cell function after nonspecific polyclonal expansion. Several studies have shown vitamin D3 helps regulate the immune response. We hypothesized that activated vitamin D3 suppresses CLIP expression on activated B-cells after nonspecific activation or priming of C57BL/6 mice with CpG. This study showed activated vitamin D3 actively reduced CLIP expression and decreased the number of CLIP(+) B-lymphocytes in a dose and formulation dependent fashion. Flow cytometry was used to analyze changes in mean fluorescent intensity (MFI) based on changes in concentration of CLIP on activated B-lymphocytes after treatment with the various formulations of vitamin D3. The human formulation of activated vitamin D (calcitriol) had the most dramatic reduction in CLIP density at an MFI of 257.3 [baseline of 701.1 (P value = 0.01)]. Cholecalciferol and alfacalcidiol had no significant reduction in MFI at 667.7 and 743.0, respectively. Calcitriol seemed to best reduce CLIP overexpression in this ex vivo model. Bioactive vitamin D3 may be an effective compliment to other B cell suppression therapeutics to augment downregulation of nonspecific inflammation associated with many autoimmune disorders. Further study is necessary to confirm these findings.

A Randomized Controlled Trial of Extended Brief Intervention for Alcohol-Dependent Patients in an Acute Hospital Setting.

AIMS: To determine whether alcohol-dependent patients in a hospital setting benefit from extended brief interventions (EBI) delivered by an Alcohol Specialist Nurse. METHODS: Alcohol-dependent patients recruited via screening at the emergency department (ED) (n = 267), whether or not admitted to hospital, were randomized to EBI (up to six counselling sessions offered) or control. At 6 months, 84.2% of patients were assessed by a researcher blinded to the intervention. The primary outcome was a fall in Severity of Alcohol Dependence Questionnaire. RESULTS: There was no difference between groups in the primary outcome [odds ratio (OR) 1.02; 95% confidence interval (CI): 0.38, 2.75, P = 0.97]. Secondary outcomes including alcohol consumption and readiness to change did not show a significant difference between groups. However, all secondary outcome measures improved, on average, in both arms. CONCLUSIONS: Although EBI can be delivered in an ED or inpatient setting, it was not shown to be an advantage over screening and usual management (which included advice on alternative services), with patients in both groups showing an average improvement. TRIAL REGISTRATION: ISRCTN78062794.

FRIENDLY regulates mitochondrial distribution, fusion, and quality control in Arabidopsis.

Mitochondria are defining components of most eukaryotes. However, higher plant mitochondria differ biochemically, morphologically, and dynamically from those in other eukaryotes. FRIENDLY, a member of the CLUSTERED MITOCHONDRIA superfamily, is conserved among eukaryotes and is required for correct distribution of mitochondria within the cell. We sought to understand how disruption of FRIENDLY function in Arabidopsis (Arabidopsis thaliana) leads to mitochondrial clustering and the effects of this aberrant chondriome on cell and whole-plant physiology. We present evidence for a role of FRIENDLY in mediating intermitochondrial association, which is a necessary prelude to mitochondrial fusion. We demonstrate that disruption of mitochondrial association, motility, and chondriome structure in friendly affects mitochondrial quality control and leads to mitochondrial stress, cell death, and strong growth phenotypes.

Thinking positively about chronic illness: An exploration of optimism, illness perceptions and well-being in patients with Parkinson's disease.

OBJECTIVES: Holding positive beliefs about illness and having an optimistic outlook have been associated with increased well-being across a range of health conditions. However, research has indicated that being very optimistic may not actually be beneficial, and holding a realistic attitude is more adaptive in some forms of chronic illness, for example, Parkinson's disease (PD). This study aimed to explore the nature of relationships between illness perceptions, optimism and well-being: specifically, whether a linear or non-linear relationship best described the data. Additionally, the proposed moderating effect of optimism on the relationship between illness perceptions and well-being was tested. DESIGN: A total of 109 participants with idiopathic PD completed questionnaire measures of illness perception, optimism, mood and health-related quality of life (HRQoL). METHODS: Multiple regression analyses were used to explore relationships between illness perceptions, optimism, mood and HRQoL. The potential curvilinear effects of illness perceptions and optimism were modelled using squared variables and linear and quadratic curve estimation. RESULTS: Holding positive illness perceptions predicted better well-being. Some evidence for a non-linear relationship between optimism and mood was found. Optimism had a significant moderating effect on the relationship between specific illness perceptions and outcome. CONCLUSIONS: Optimism appears to provide protection against some negative perceptions of illness and was associated with better mood and HRQoL. The findings indicate that specific illness perceptions may be beneficial targets for therapy. Therapeutic interventions should focus on enhancing positive perceptions of PD but potentially more importantly general optimistic attitude to maximize well-being. STATEMENT OF CONTRIBUTION: What is already known on this subject? Positive illness perceptions and high optimism are associated with better well-being in a range of conditions, both chronic and acute. Preliminary studies suggest that in chronic degenerative diseases, marked positive optimism confers no additional benefit over medium levels of optimism for well-being and is associated with less use of adaptive coping. What does this study add? Optimism moderates the effects of specific negative illness perceptions on well-being in Parkinson's disease. No evidence was found that unrealistic positive illness perceptions are detrimental to well-being. Adaptive illness perceptions may be condition specific.

The Turn the Tables Technique (T(3)): A Program Activity to Provide Group Facilitators Insight into Teen Sexual Behaviors and Beliefs.

The Turn the Tables Technique (T(3)) is an activity designed to provide group facilitators who lead HIV/STI prevention and sexual health promotion programs with detailed and current information on teenagers' sexual behaviors and beliefs. This information can be used throughout a program to tailor content. Included is a detailed lesson plan of T(3), a description of the purpose of T(3), how it was implemented, the context in which it was used, how T(3) addressed common challenges in HIV prevention with teenagers, and future implications for its use.

Cognition, coping, and outcome in Parkinson's disease.

BACKGROUND: Cognitive impairment and depression are common and disabling non-motor symptoms of Parkinson's disease (PD). Previous studies have shown associations between them but the nature of the relationship remains unclear. In chronic illness, problem- or task-oriented coping strategies are associated with better outcome but often require higher level cognitive functioning. The present study investigated, in a sample of patients with PD, the relationships between cognitive function, choice of coping strategies, and a broad index of outcome including depression, anxiety, and health-related quality of life (QoL). It was hypothesized that the coping strategy used could mediate the association between cognition and outcome. METHODS: 347 participants completed the Coping Inventory for Stressful Situations, the Hospital Anxiety and Depression Scale, the Parkinson's Disease Questionnaire-8, the Unified Parkinson's Disease Rating Scale, and the Addenbrooke's Cognitive Examination-Revised. Structural Equation Modeling was used to test the hypothesized model of cognition, coping, and outcome based on a direct association between cognition and outcome and an indirect association mediated by coping. RESULTS: Overall, poorer cognition predicted less use of task-oriented coping, which predicted worse outcome (a latent variable comprised of higher depression and anxiety and lower QoL). The analyses suggested a small indirect effect of cognition on outcome mediated by coping. CONCLUSIONS: The findings suggest that patients who fail to employ task-oriented coping strategies may be at greater risk of depression, anxiety, and poor health-related QoL. Even mild to moderate cognitive impairment may contribute to reduced use of task-oriented coping. Suitably adapted cognitive-behavioral approaches may be useful to enable the use of adaptive coping strategies in such patients.

A multicentre community-based study of dementia cases and subcases in older people in China--the GMS-AGECAT prevalence and socio-economic correlates.

BACKGROUND: Previous studies indicated overall relatively low prevalence of dementia in older people in China, which may be biased by studied samples or methods. We determined the prevalence of dementia cases and subcases in China and examined their socio-economic correlates. METHODS: Using the Geriatric Mental State interview, we examined random samples of 2917 participants aged ≥ 65 years in urban and rural Anhui, China in 2001-2003, and 3327 in four other provinces in 2008-2009. Dementia cases and subcases were diagnosed by Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy. RESULTS: Age-standardised prevalence for cases and subcases of dementia in the Anhui elders was 7.20% (95%CI 6.29%-8.20%) and 10.5% (9.38%-11.6%), and in the four provinces, 9.86% (8.80%-10.9%) and 8.51% (7.51%-9.52%). The matched figures among the participants who were literate were 3.05% (2.08%-4.02%) and 10.0% (8.38%-11.6%), and 4.92% (3.89%-5.96%) and 6.76% (5.55%-7.96%), respectively. There were higher prevalence rates of dementia cases and subcases in the rural elders than in the urban. Both the Anhui and four-province studies showed an obvious association of dementia with higher and lower incomes among elders who had lower educational levels or had the lowest occupational class. The highest risk of dementia was found in those who were illiterate but had the highest income or had the job of business/nonmanual labouring. CONCLUSIONS: People in China have a higher prevalence of dementia than previously reported. Its U-shaped relationship with income and the excess subcases prevalence predicates a significant burden of disease, both now and for the future, suggesting preventive strategy for dementia in China.

A randomised controlled trial of extended brief intervention for alcohol dependent patients in an acute hospital setting (ADPAC).

BACKGROUND: Alcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity. Only 5.6% of alcohol-dependent individuals ever access specialist treatment and only a small percentage ever seek treatment. As people who are alcohol dependent are more likely to have experienced health problems leading to frequent attendance at acute hospitals it would seem both sensible and practical to ensure that this setting is utilised as a major access point for treatment, and to test the effectiveness of these treatments. METHODS/DESIGN: This is a randomised controlled trial with a primary hypothesis that extended brief interventions (EBI) delivered to alcohol-dependent patients in a hospital setting by an Alcohol Specialist Nurse (ASN) will be effective when compared to usual care in reducing overall alcohol consumption and improving on the standard measures of alcohol dependence. Consecutive patients will be screened for alcohol misuse in the Emergency Department (ED) of a district general hospital. On identification of an alcohol-related problem, following informed written consent, we aim to randomize 130 patients per group. The ASN will discharge to usual clinical care all control group patients, and plan a programme of EBI for treatment group patients. Follow-up interview will be undertaken by a researcher blinded to the intervention at 12 and 24 weeks. The primary outcome measure is level of alcohol dependence as determined by the Severity of Alcohol Dependence Questionnaire (SADQ) score. Secondary outcome measures include; Alcohol Use Disorders Identification Test (AUDIT) score, quantity and frequency of alcohol consumption, health-related quality of life measures, service utilisation, and patient experience. The trial will also allow an assessment of the cost-effectiveness of EBI in an acute hospital setting. In addition, patient experience will be assessed using qualitative methods. DISCUSSION: This paper presents a protocol for a RCT of EBI delivered to alcohol dependent patients by an ASN within an ED. Importantly; the trial will also seek to understand patients' perceptions and experiences of being part of a RCT and of receiving this form of intervention. TRIAL REGISTRATION NUMBER: ISRCTN: ISRCTN78062794.