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Aim: To test whether a single session of motivational interviewing (discussing alcohol, tobacco and illicit drug use) would lead successfully to reduction in use of these drugs or in perceptions of drug-related risk and harm among young people., Design: Cluster randomized trial, allocating 200 young people in the natural groups in which they were recruited to either motivational interviewing (n=105) or non-intervention education-as-usual control condition (n=95)., Setting: Ten further education colleges across inner London., Participants: Two hundred young people (age range 16-20 years) currently using illegal drugs, with whom contact was established through peers trained for the project., Intervention: The intervention was adapted from the literature on motivational interviewing in the form of a 1-hour single-session face-to-face interview structured by a series of topics., Measurements: Changes in self-reported cigarette, alcohol, cannabis and other drug use and in a range of drug-specific perceptions and other indicators of risk and harm. Measurement at recruitment and follow-up interview 3 months later., Findings: A good follow-up rate (89.5%; 179 of 200) was achieved. In comparison to the control group, those randomized to motivational interviewing reduced their of use of cigarettes, alcohol and cannabis, mainly through moderation of ongoing drug use rather than cessation. Effect sizes were 0.37 (0.15-0.6), 0.34 (0.09-0.59) and 0.75 (0.45-1.0) for reductions in the use of cigarettes, alcohol and cannabis, respectively. For both alcohol and cannabis, the effect was greater among heavier users of these drugs and among heavier cigarette smokers. The reduced cannabis use effect was also greater among youth usually considered vulnerable or high-risk according to other criteria. Change was also evident in various indicators of risk and harm, but not as widely as the changes in drug consumption., Conclusions: This study provides the first substantial evidence of non-treatment benefit to be derived among young people involved in illegal drug use in receipt of motivational interviewing. The targeting of multiple drug use in a generic fashion among young people has also been supported.

Brief applications of Motivational Interviewing (MI) emerged around 15 years ago to target problematic alcohol and other drug use. Interventions which specifically target illicit drug use, young people, or which are delivered in settings other than health-care services have, however, been relatively slow to develop. The needs of young people for interventions distinct from those offered to adults are considered, as a precursor to an outline of the structure of a newly adapted intervention targeting drug use in general among young people. Based upon earlier topic-based approaches developed by Rollnick et al. this intervention is innovative in simultaneously targeting a range of drugs in pursuit of secondary prevention objectives, while also seeking to manifest the spirit of MI. The intervention consists of a single-session face-to-face conversation of up to 60 minutes duration. Data are presented which describe the development and conduct of this intervention during the course of an efficacy trial, with promising efficacy data themselves reported elsewhere. Observations are made on intervention delivery and consideration is given to implications for further novel targeting of young people and within the field of addiction interventions more generally. [McCambridge J, Strang J. Development of a structured generic drug intervention model for public health purposes: a brief application of motivational interviewing with young people.

This preliminary test of a brief intervention designed to stimulate GP incorporation of cannabis enquiry was followed up after 2-3 months. Intervention comprised face-to-face discussion based on principles of motivational interviewing, with informational adjunct. Substantially more positive attitudes and greater clinical activity were observed following receipt of intervention.

Policy makers have repeatedly placed emphasis on the role of primary care in screening for at-risk alcohol consumption and delivering public health messages to the general population. Research has pointed to primary care staff holding negative attitudes towards alcohol misusing patients. Training has traditionally been seen as the key to increasing the capacity of the medical field to engage with alcohol misusing patients but little work has been undertaken to examine the potential barriers to training take up. Consequently, the aim of this study was to explore the willingness of practice nurses to be trained in alcohol screening and brief intervention, and whether identifiable barriers to training exist and how they may be overcome. All practice nurses (n = 82) in an outer London (UK) Health Authority Area were twice mailed an invitation to an alcohol training seminar and a telephone invitation was made to all of those who did not reply to the mailings. Those who did not attend (n = 66) were contacted to take part in a short structured telephone interview - 89% (59/66) were contacted successfully and interviewed. Respondents were experienced in primary care and viewed health promotional activity as a valid part of their role. Few had undertaken previous alcohol training and as a group they were highly active in attending training events with training undertaken tending to be related directly to perceived practice needs and priorities: thus this group could not be characterized as unwilling to be trained. Barriers to training at alcohol events were found to be either personal or work-related, with most nurses interested in receiving further training or information. These data imply that the ways in which training is organized and delivered require sensitivity to identifiable barriers if it is to reach and effect changing practice among practice nurses successfully. A range of possibilities are identified as alternative approaches to the provision of elective training events which may be more acceptable to the target population of health-care staff.

The effect of solar radiation and predacious microorganisms on the survival of bacteria of fecal and plant origin was studied. The decline in the numbers of Escherichia coli cells in estuarine water samples was found to be significantly greater in the presence of both naturally occurring microbial predators and solar radiation than when each of these factors was acting independently. The effect of solar radiation on microbial predators was negligible, whereas the susceptibility of bacteria to light-induced decay varied from one organism to another, as follows: Klebsiella pneumoniae greater than E. coli greater than Salmonella typhimurium, Streptococcus faecium, Enterobacter aerogenes, Erwinia herbicola.

The relative effect of protozoan and bacterial predators on the survival of Escherichia coli in estuarine water samples was examined. Predacious protozoa exerted their major influence on E. coli destruction during the first 2 days of a 10-day-decline period. Inhibition of protozoa after day 2 had little effect on E. coli survival. Bacterial predators also contributed to E. coli destruction but in natural estuarine water samples were maintained at lower levels due to "grazing" by predacious protozoa.