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Introduction: Elaborated intrusion theory suggests that imagery is central to craving; however, the possibility that cue-elicited multisensory imagery produces such urges has not been studied enough in the literature. Thus, we investigated the role of cue-elicited multisensory imagery on alcohol craving in individuals who are hazardous and social drinkers compared to mental and neutral imagery conditions. Methods: In an online experiment, hazardous and social drinkers (N = 348) between 18 and 45 years old were randomised to multisensory, mental, and neutral imagery exposure. The level of craving intensity was measured before and after imagery exposure. Also, participants rated vividness and sensory features scales after the exposure. Results: The level of craving was significantly higher in multisensory imagery condition compared to neutral condition (b = 1.94, p < 0.001, SE = 0.30, t(344) = 6.52, standardised mean difference [SMD] = 0.89) and in mental imagery condition compared to neutral condition (b = 1.82, SE = 0.30, t(344) = 6.52, p < 0.001, SMD = 0.83). The difference between the level of craving intensity between the multisensory and mental was not significant (b = 0.12, SE = 0.22, t(344) = 0.53, p = 0.594, SMD = 0.06). Moreover, craving intensity in response to multisensory versus neutral imagery was significantly stronger among hazardous drinkers (b = -2.90, SE = 0.83, t(341) = -3.50, p < 0.001). The level of vividness was not significantly different between any conditions. The difference between levels of sensory features was higher in multisensory imagery condition compared to neutral (b = 0.95, SE = 0.30, t(345) = 3.17, p = 0.002, SMD = 0.49) and mental imagery condition (b = 0.67, SE = 0.23, t(345) = 2.36, p = 0.004, SMD = 0.35). Conclusion: Results suggest that cue-elicited multisensory imagery may be a useful tool for eliciting alcohol craving responses and provide an additional means for better understanding the multi-layered mechanism of c

This report presents an analysis of the statistics concerning the status of education for students with special needs in member nations of the Organization for Economic Cooperation and Development. Special needs students are defined as those who have disabilities with clear biological causes, or who are experiencing learning difficulties, or who have difficulties arising from disadvantages. Following an introductory chapter, Chapter 2 reports on the development of the data collection instrument, a questionnaire. Chapter 3 discusses the qualitative data analysis conducted, including data on the use of categories of students and national educational legislation. Chapter 4 presents a comparative analysis of quantitative data based on national categories of disabilities. Chapter 5 offers analysis of the quantitative data broken down into the three cross-national categories of special needs students. This is followed by a chapter providing additional analyses of the quantitative data, which includes special schools and classes, regular classes, and student/staff ratios. The final chapter offers discussion and conclusions, noting the lack of consistency in terminology used by different countries, implications of the resources model, and a consistent gender effect with more males receiving special education services across all three categories. Five annexes include additional data tables, the questionnaire used, and definitions of educational levels. (Author/DB)

Introduction and objectiveThe ODHIN trial found that training and support and financial reimbursement increased the proportion of patients that were screened and given advice for their heavy drinking in primary health care. However, the impact of these strategies on professional accuracy in delivering screening and brief advice is underresearched and is the focus of this paper. MethodFrom 120 primary health care units (24 in each jurisdiction: Catalonia, England, the Netherlands, Poland, and Sweden), 746 providers participated in the baseline and the 12-week implementation periods. Accuracy was measured in 2 ways: correctness in completing and scoring the screening instrument, AUDIT-C; the proportion of screen-negative patients given advice, and the proportion of screen-positive patients not given advice. Odds ratios of accuracy were calculated for type of profession and for intervention group: training and support, financial reimbursement, and internet-based counselling. ResultsThirty-two of 36711 questionnaires were incorrectly completed, and 65 of 29641 screen-negative patients were falsely classified. At baseline, 27% of screen-negative patients were given advice, and 22.5% screen-positive patients were not given advice. These proportions halved during the 12-week implementation period, unaffected by training. Financial reimbursement reduced the proportion of screen-positive patients not given advice (OR=0.56; 95% CI, 0.31-0.99; Pamp;lt;.05). ConclusionAlthough the use of AUDIT-C as a screening tool was accurate, a considerable proportion of risky drinkers did not receive advice, which was reduced with financial incentives., Funding Agencies|Lundbeck; Abbvie; DA Pharm

Developed by the Special Education Supervisor Training (SEST) Project at the University of Texas at Austin, the document examines two instruments and basic procedures for observing and analyzing individualized instruction. Guidelines are provided for self training and training others in the use of the Individualization of Instruction Inventory (III) and the Descriptive Observation Record for Individualization of Instruction (DORII). The DORII is said to be composed of five sections concerning intraclass grouping, materials, pupil autonomy, student assignments, and tutoring. Intended to be used as a supplement to the DORII, the III is a rating scale which permits quantification of observed behavior. Ten procedures for using the two instruments are listed, problems in recording and scaling responses are discussed, and feedback practices are considered. Training aspects are examined in terms of preliminary activities (with three sample sessions described), and in-classroom observation training. Additional information is provided on inter-observer reliability, data storage, retrieval and display for feedback. Among nine appendixes are sample DORII and III forms, and a profile for individualization. (CL)

This self-instructional learning packet is one part of a competency-guided program for instructional supervisor preparation developed by the Special Education Supervisor Training (SEST) project. This packet deals with the task of promoting a favorable public image of school programs through effective use of the news media. The packet consists of five sections that focus in turn on dealing with the news media, preparing news releases, planning television interviews, preparing newsletters and other informational publications, and planning and writing speeches for delivery by school officials. Each section begins with a list of specific learning objectives, then presents a number of simulated inbasket materials that illustrate the various responsibilities of the public information coordinator for a school district. Included at the end of each section is a short quiz designed to assess the user's grasp of the key concepts presented in that section. (JG)

This self-instructional learning packet is one part of a competency-guided program for instructional supervisor preparation developed by the Special Education Supervisor Training (SEST) project. Training supervisors to formulate a coherent policy and procedure governing the evaluation and selection of learning materials is the goal of this learning packet. The focus of this packet is on selecting school library materials, including a variety of instructional media in addition to books and printed matter. A materials selection policy must include methods of assessing costs versus potential usage, of estimating the durability and timeliness of material, of material review, and of dealing with controversial materials. An effective selection procedure must provide for the utilization of selection aids (such as those listed in this packet's annotated bibliography), for the handling of donations, for selection periods, and for a committee to implement selection policy. As in the other training packets in this series, this one requires the user to develop his own program, providing him with a self-evaluation checklist and posttest to measure his progress. (DS)

This guide was prepared to support a program of training for community specialists in contemporary and practical techniques of home energy conservation. It is designed to assist professionals in efficient operation of energy conservation programs and to provide ideas for expanding education operations. Eight major sections are presented: (1) Energy in Perspective; (2) Heat Transfer; (3) Weatherization; (4) Heating Systems; (5) Energy and Home Appliances; (6) Energy Efficient Design; (7) Energy in the Apartment; and (8) Energy in the Mobile Home. Each section contains subsections with discussions pertinent to the section topic. Graphs and figures supplement discussions. Primer study guides and a bibliography conclude the document. (Author/RE)

This learning packet was designed by the Special Education Supervisor Training Project (SEST) to develop professional supervisory competency in establishing a set of evaluative criteria and procedures to determine the quality, utility, and availability of learning materials, and to organize and conduct review sessions where teachers and other personnel can apply these criteria to new materials and make acquisitions in needed areas. Developed as a competency guided, self-training tool, the packet provides information on (1) contents of a selection tool, (2) sources of media information (selection tools), (3) development of a selection policy, (4) media evaluation procedures, (5) development of selection procedures, and (6) controversial materials and censorship. A post-test, post-test answer sheet, and bibliography are included to supplement the other information in the packet. Appended are a self-evaluation worksheet, a post-test worksheet, and a list of other independent study materials developed by the SEST. (MJB)

One consequence of teaching British literature far away from British shores is the loss of intimacy that comes from a shared culture. American teachers can help bring Britain into their classrooms by requesting audiovisual aids from the various museums and galleries in Britain that are willing to supply material. Among such sources are (1) Walton Films (specializing in districts and cities in the British Isles); (2) Pictorial Colour Slides (archeological and historical subjects); (3) the Imperial War Museum (Britain's wars since 1914); (4) The Museum of London; (5) The National Portrait Gallery; (6) The Museum of Costume (late Elizabethan era to the present); (7) The Shakespeare Birthplace Trust; (8) The Royal Shakespeare Theatre Gallery; (9) Jane Austen's House; (10) The Samuel Johnson Birthplace Museum; (11) Burns Cottage; (12) The Keats House; (13) The Bronte Parsonage; (14) The Dickens House Museum (London); and (15) The Dickens House Museum (Kent). Materials offered by these sources include slide sets, postcards, posters, cut-out models, publications, specific items, catalogs, cassettes, and brochures. (The paper also provides a description of each museum, a listing of materials available, and prices for some items.) (HOD)

Contains fulltext : 182502.pdf (publisher's version ) (Open Access), BACKGROUND: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. OBJECTIVES: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline. METHODS: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised. RESULTS: Nurses tended to screen more patients than doctors (OR = 3.1; 95%CI: 1.9, 4.9). Screen-positive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95%CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95%CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status. CONCLUSIONS: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552.

Item does not contain fulltext, AIM: To test if training and support, financial reimbursement and option of referring screen-positive patients to an internet-based method of giving advice (eBI) can increase primary health-care providers' delivery of Alcohol Use Disorders Identification Test (AUDIT)-C-based screening and advice to heavy drinkers. DESIGN: Cluster randomized factorial trial with 12-week implementation and measurement period. SETTING: Primary health-care units (PHCU) in different locations throughout Catalonia, England, the Netherlands, Poland and Sweden. PARTICIPANTS: A total of 120 PHCU, 24 in each of Catalonia, England, the Netherlands, Poland and Sweden. INTERVENTIONS: PHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR) and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI. MEASUREMENTS: The primary outcome measure was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures were proportion of screen-positive patients advised; and proportion of consulting adult patients given an intervention (screening and advice to screen-positives) during the same 12-week implementation period. FINDINGS: During a 4-week baseline measurement period, the proportion of consulting adult patients who were screened for their alcohol consumption was 0.059 per PHCU (95% CI 0.034 to 0.084). Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI = 1.13-1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was 2.00 (95% CI = 1.56-2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was 2.34 (95% CI = 1.77-3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI = 1.11-2.53). CONCLUSIONS: Providing primary health-care units with training, support and financial reimbursem

Contains fulltext : 172760.pdf (publisher's version ) (Open Access), BACKGROUND: Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation. METHODS: In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. RESULTS: Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups. CONCLUSIONS: The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01501552.

Item does not contain fulltext, AIMS: To determine the relation between existing levels of alcohol screening and brief intervention rates in five European jurisdictions and role security and therapeutic commitment by the participating primary healthcare professionals. METHODS: Health care professionals consisting of, 409 GPs, 282 nurses and 55 other staff including psychologists, social workers and nurse aids from 120 primary health care centres participated in a cross-sectional 4-week survey. The participants registered all screening and brief intervention activities as part of their normal routine. The participants also completed the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), which measure role security and therapeutic commitment. RESULTS: The only significant but small relationship was found between role security and screening rate in a multilevel logistic regression analysis adjusted for occupation of the provider, number of eligible patients and the random effects of jurisdictions and primary health care units (PHCU). No significant relationship was found between role security and brief intervention rate nor between therapeutic commitment and screening rate/brief intervention rate. The proportion of patients screened varied across jurisdictions between 2 and 10%. CONCLUSION: The findings show that the studied factors (role security and therapeutic commitment) are not of great importance for alcohol screening and BI rates. Given the fact that screening and brief intervention implementation rate has not changed much in the last decade in spite of increased policy emphasis, training initiatives and more research being published, this raises a question about what else is needed to enhance implementation.

Background: Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. Methods and Findings: Pragmatic multicentre cluster randomized controlled trial of SBI for hazardous and harmful drinkers presenting to ED. Nine EDs were randomized to three conditions: a patient information leaflet (PIL), 5 minutes of brief advice (BA), and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling (BLC). The primary outcome measure was the Alcohol Use Disorders Identification Test (AUDIT) status at 6 months. Of 5899 patients aged 18 or more presenting to EDs, 3737 (63·3%) were eligible to participate and 1497 (40·1%) screened positive for hazardous or harmful drinking, of whom 1204 (80·4%) gave consent to participate in the trial. Follow up rates were 72% (n = 863) at six, and 67% (n = 810) at 12 months. There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis. At month 6, compared to the PIL group, the odds ratio of being AUDIT negative for brief advice was 1·103 (95% CI 0·328 to 3·715). The odds ratio comparing BLC to PIL was 1·247 (95% CI 0·315 to 4·939). A per protocol analysis confirmed these findings. Conclusions: SBI is difficult to implement in typical EDs. The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information, which is likely to be easier and less expensive to implement than more complex interventions. Trial Registration: Current Controlled Trials ISRCTN 93681536 © 2014 Drummond et al.

Electronic screening and brief intervention (eSBI) has been shown to reduce alcohol consumption, but its effectiveness over time has not been subject to meta-analysis.

Introduction: Approximately 33% of 15–16 year olds in England report alcohol intoxication in the past month with adolescents in the UK being amongst the heaviest young drinkers in Europe leading to high social and economic costs. Methods: A three arm pilot feasibility cRCT to assess the feasibility of a future definitive cRCT of brief alcohol intervention (ASBI) in a school setting with an integrated qualitative component (randomisation at school level). Feasibility of trial processes, recruitment and retention and a qualitative evaluation examined facilitators and barriers to the use of ASBI approaches in the school setting in this age group. Interventions: Young people aged 14–15 (Year 10) in 7 schools in the North East of England who screened positive on a single alcohol screening question and consented to take part were randomised to either provision of an advice leaflet (control condition, n=2 schools); a 30-minute brief interactive session which combined structured advice and motivational interviewing techniques delivered by the school learning mentor (Intervention 1, n=2 schools); a 60-minute session involving family members delivered by the school learning mentor (Intervention 2, n=3 schools). Young people were followed-up at 12-months. Objectives: To assess the feasibility and acceptability of a future definitive cRCT of ASBI in a school setting. Results: Two hundred and twenty-two young people were eligible for the trial. 182 (82%) were randomised (control n=53; Intervention 1 n=54; Intervention 2 n=75). Of the 75 randomised to Intervention 2, 67 received Intervention 1 (89%). Eight received both Intervention 1 and Intervention 2 (11%). 160/182 were successfully followed up at 12 months (88%). Interviews were carried out with 6 school lead liaisons; 13 learning mentors; 27 young people and seven parents (n=53). Outcomes/conclusions: Analysis shows that the school setting is a feasible and acceptable place to carry out ASBI with learning mentors seen as sui

The purpose of this research was to develop a topical microsphere delivery system in a thermosensitive 20% poloxamer 407 gel (Pluronic F127) to control release of KSL-W, a cationic antimicrobial decapeptide, for a period of 4 7 days for potential application in combat related injuries. KSL-W loaded microsphere formulations were prepared by a solvent extraction-evaporation method (water-oil-water), with poly (D,L-lactic-co-glycolic acid) (PLGA) (50 : 50, low-weight, and hydrophilic end) as the polymeric system. After optimization of the process, three formulations (A, B, and C) were prepared with different organic to water ratio of the primary emulsion while maintaining other components and manufacturing parameters constant. Formulations were characterized for surface morphology, porous nature, drug loading, in vitro drug release, and antimicrobial activity. Microspheres containing 20% peptide with porous surfaces and internal structure were prepared in satisfactory yields and in sizes varying from 25 to 50 microm. Gels of 20% Pluronic F127, which were liquid at or below 24.6 deg C and formed transparent films at body temperature, were used as carriers for the microspheres. Rheological studies showed a gelation temperature of 24.6 deg C for the 20% Pluronic F127 gel alone. Gelation temperature and viscosity of formulations A, B, and C as a function of temperature were very close to those of the carrier. A Franz diffusion cell system was used to study the release of peptide from the microspheres suspended in both, phosphate-buffered saline (PBS) and a 20% Pluronic F127 gel. In vitro release of greater than 50% peptide was found in all formulations in both PBS and the gel, and in one formulation there was a release of 75% in both PBS and the gel., Published in BioMed Research International, v2013 article ID 387863, 2013.

Contains fulltext : 118617.pdf (publisher's version ) (Open Access), BACKGROUND: The European level of alcohol consumption, and the subsequent burden of disease, is high compared to the rest of the world. While screening and brief interventions in primary healthcare are cost-effective, in most countries they have hardly been implemented in routine primary healthcare. In this study, we aim to examine the effectiveness and efficiency of three implementation interventions that have been chosen to address key barriers for improvement: training and support to address lack of knowledge and motivation in healthcare providers; financial reimbursement to compensate the time investment; and internet-based counselling to reduce workload for primary care providers. METHODS/DESIGN: In a cluster randomized factorial trial, data from Catalan, English, Netherlands, Polish, and Swedish primary healthcare units will be collected on screening and brief advice rates for hazardous and harmful alcohol consumption. The three implementation strategies will be provided separately and in combination in a total of seven intervention groups and compared with a treatment as usual control group. Screening and brief intervention activities will be measured at baseline, during 12 weeks and after six months. Process measures include health professionals' role security and therapeutic commitment of the participating providers (SAAPPQ questionnaire). A total of 120 primary healthcare units will be included, equally distributed over the five countries. Both intention to treat and per protocol analyses are planned to determine intervention effectiveness, using random coefficient regression modelling. DISCUSSION: Effective interventions to implement screening and brief interventions for hazardous alcohol use are urgently required. This international multi-centre trial will provide evidence to guide decision makers.

Background: While the overall proportion of young people (YP) drinking alcohol in the UK has been shown to have decreased in recent years, YP who drink appear to drink more frequently and at a larger amount. This pilot feasibility trial aimed to explore the feasibility of delivering brief alcohol intervention using MI principles in a school setting. Methods and Design: Seven schools across one small geographical area in North East England were recruited. Participants were UK Year 10 pupils (aged 14-15) who screened positive for alcohol misuse using an alcohol screening questionnaire and who consented to take part in the trial. Trial participants will be followed up at 12 months (feb 2013). Each school was randomly allocated to one of three intervention conditions: provision of an advice leaflet (control condition); a 30-minute session of structured advice using MI principles L1 (level 1 condition) and the level 1 condition followed by a 60-minute session usingMI principles involving family members L2 (level 2 condition). Results: 87% (1280) YP completed the screening questionnaire. Of these 60% were negative (772). A further 21%were positive but the YP did not leave their name. 229 were invited to take part in the trial (control 60; L1 79; L2 90). 181 consented and took part in the trial [79%](control 53; L1 53; L2 75). All those in the L1 condition received the intervention. For the 75 in the L2 condition all received the L1 intervention and 25 (33%) agreed to their parents being contacted. Parent meetings were held with 8 families (32%). Qualitative work showed that the intervention was acceptable in the school environment and that alcohol use by YP was not always viewed as a problem by the YP themselves, their parents or staff. Discussion: Results from this feasibility trial will inform the development of a definitive RCT to evaluate the effectiveness and cost-effectiveness of screening and brief alcohol intervention to reduce hazardous drinking in adolescents in

This paper summarises the conclusions of a working group established jointly by the International Atomic Energy Agency (IAEA) and the International Commission on Radiation Units and Measurements (ICRU) to address some of the relative biological effectiveness (RBE) issues encountered in ion-beam therapy. Special emphasis is put on the selection and definition of the involved quantities and units. The isoeffective dose, as introduced here for radiation therapy applications, is the dose that delivered under reference conditions would produce the same clinical effects as the actual treatment in a given system, all other conditions being identical. It is expressed in Gy. The reference treatment conditions are: photon irradiation, 2 Gy per fraction, 5 daily fractions a week. The isoeffective dose D-IsoE is the product of the physical quantity absorbed dose D and a weighting factor W-IsoE. W-IsoE is an inclusive weighting factor that takes into account all factors that could influence the clinical effects like dose per fraction, overall time, radiation quality (RQ), biological system and effects. The numerical value of W-IsoE is selected by the radiation-oncology team for a given patient (or treatment protocol). It is part of the treatment prescription. Evaluation of the influence of RQ on W-IsoE raises complex problems because of the clinically significant RBE variations with biological effect (late vs. early) and position in depth in the tissues which is a problem specific to ion-beam therapy. Comparison of the isoeffective dose with the equivalent dose frequently used in proton- and ion-beam therapy is discussed.