Search

Effectiveness of a web-based acceptance and commitment therapy intervention for wellbeing of parents whose children have chronic conditions : A randomized controlled trial

Evaluation of the Cognitive Intervention Programme "A New Direction" Targeting Young Offenders in Sweden

The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health-related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism.

Tourism produces an increasing share in global greenhouse gas (GHG) emissions. These are mostly derived from transport emissions, and long-haul air travel in particular. Short-haul domestic tourism is believed by some to be a potential substitute for long-haul tourism. Using the example of Finland this paper examines the extent to which domestic second home tourism can substitute for other leisure trips and therefore contribute to reductions of travel-generated GHG emissions. Survey data are used to evaluate the CO2 emissions caused by travel to domestic second homes, and to create statistical models that verify if the owners of domestic second homes travel to other leisure destinations less frequently than others, and if they cause less emissions by their leisure mobility than others with comparable economic and demographic background. We find that although the owners and users of domestic second homes travel for other leisure purposes less frequently than others, this does not mean their leisure mobility generates less emissions. Overall, owners of second homes produce significantly more CO2 by their leisure mobility than non-owners. The use of second homes does not seem to be a substitute for high emission long-haul travels, but rather a part of an overall highly mobile leisure lifestyle. It is therefore necessary to better understand and influence the entire range of individual mobility behaviours in order to reduce travel-related GHG emissions.

The purpose of this study was to investigate the affect, as measured by “Positive and Negative Affect Schedule” (PANAS), its influence on psychopathology, and to examine the effect of changing affect during cognitive behavioral therapy (CBT). The study was carried out at the psychotherapy training center, Karlstad University. The hypothesis was whether clients with mental disorders have a self-destructive affective personality (low PA and high NA) and healthy individuals have a self-actualizing personality (high PA and low NA). Thirty-two healthy participants and 44 clients participated in the study. The clients were asked to fill in the PANAS once throughout CBT, either during evaluation, treatment or finishing phase, accordingly there were three different groups at different therapy phases. The healthy subjects were also asked to fill in the self-report scale once. The comparison of the three phases of therapy and the four affective personality types showed a significant difference between the phases of therapy and the four affective personality types: totally 16 (of 22) and eight (of nine) clients measured at the evaluation and treatment phases, respectively, had a self-destructive personality. However, at the end of therapy five (of 13) clients had a self-actualizing personality characteristics, while only three of them were self-destructive. Furthermore, the results indicate that affective personality does not seem to be a basic and stable personality trait, which could be altered by therapy. The affections measured by PANAS may be influenced by psychopathology and CBT, when conducted by candidate therapists it can be effective in terms of affect changes.

Experiencing nature and enjoying natural amenities have long been identified as key motives for rural second home tourism. However, the more people travel and spend time in the natural environment, the more it is disturbed by their actions and activities. In this paper, we examine how people perceive the environmental impacts of rural second home tourism and how they justify their views. The study focuses on Finland where rural second homes are widespread. Analysis is based on a questionnaire survey conducted among Finns in 2012 (n = 1189). Responses from different groups of respondents (second home owners, regular users of second homes and non-users) are quantitatively and qualitatively analysed. The results indicate that the Finnish respondents generally think that second home tourism poses some degree of harmful environmental impacts. However, it is the second home owners who are least worried about these environmental impacts. They generally justify their opinions using a “place-related” persp...

The cognitive intervention programme 'New Challenges' targeting adult men with a criminal lifestyle was evaluated in a pilot study. The participants were divided into a cognitive treatment group (n = 32) and a control group (n = 11). In the control group, six participants had no treatment and five participated in 12-step treatment. The participants were measured pre and post using the Psychological Inventory of Criminal Thinking Styles (PICTS), the abridged version of sense of coherence (SOC), Positive and Negative Affect Scale, and Bergström's quality of programme delivery (QPD). The results of the treatment group showed that criminal thinking patterns dropped significantly from high values to close to normal level. SOC and positive affect increased significantly in the treatment group. Both SOC and positive affect showed positive correlation with QPD. Regarding the possible influence of the 12-step treatment, there was no difference in the control group between participants receiving 12-step treatment and those not receiving treatment. The main conclusion is that the cognitive treatment programme 'New Challenges' can contribute to reduced criminal thinking and increased SOC and positive affect, which may prove to be important precursors of reduced criminality. Ingick i licentiatuppsatsen som manuskript med titeln: Evaluation of the Swedish Cognitive Intervention Programme "New Challenges" Targeting Adult Men with a Criminal Lifestyle

In recent studies it has been suggested that Cognitive Behavior Therapy (CBT) is beneficial to people with Autism Spectrum Disorder (ASD) but that the method needs to be modified in relation to their cognitive profile. The aim of this study is to measure the effect of modified CBT, that is, using visualized language throughout the entire session for clients with ASD and anxiety and avoidance behavior. The modification of CBT in this study consists of focusing on CBT protocols for anxiety disorders and depression, while visualizing and systematizing “the invisible” in the conversation, in order for the clients to understand the social, cognitive and emotional context of self and others and how they should interact to avoid misunderstandings. ASD clients may need help to detect the invisible code of social interaction and communication. The level of anxiety and the frequency of target behavior were measured. Four assessments were made, two at the pre-assessment, and one in mid-therapy and end of therapy respectively. Generally, results suggest no improvement during pre-treatment period but a significant improvement during treatment. The values of the clients’ psychological, social and occupational ability to function improved on the Global Function Rating scale. The preliminary conclusion of this pilot study indicates that the use of visualized language throughout the CBT therapy sessions is a promising modification of current CBT protocols for individuals with ASD. After manualization, larger studies with randomized controlled study designs can replicate or challenge these results.

Background Immunization to biological drugs can reduce the treatment efficacy and increase the risk of adverse events. Objectives To determine the drug trough concentrations and anti-drug antibody (ADAb) levels of self-injected TNF-inhibitors, in non-selected patients with ankylosing spondylitis (AS) attending the rheumatological outpatient clinic, and to study the patient related factors affecting the immunization to antiTNF drugs. Methods A total of 313 patients with AS were recruited. A blood sample, taken 1–2 days prior to next drug injection, was obtained from 273 patients. Trough concentration of the anti-TNF drugs were measured with capture-ELISA (Promonitor EIA, Progenica), the levels of ADAb with radioimmunoassay (Sanquin Laboratories, The Netherlands), and the serum TNF-blocking capacity by using an in-house reporter gene assay. The clinical activity of AS was assessed using the Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI), and the Maastricht AS Entheses Score (MASES). Results ADAbs were observed in 21% of patients on adalimumab (n=99), in 0% of those on etanercept (n=83), in 3% of those on golimumab (n=79) and in 50% of those on certolizumab pegol (n=12). The BASDAI in ADAb positive patients was 1.4 (sd 1.4) and in the ADAb negative patients 2.0 (sd 1.8 p=0.060). Factors affecting the immunization to biological drug could be further analyzed in patients using adalimumab. Trough drug concentrations of adalimumab correlated with the presence of ADAb (r=-0.54, rp Conclusions The disease activity of AS patients using self injected antiTNF drugs was low. The immunization to adalimumab was relatively common in nonselected AS patient population. However, no clear association was observed between the presense of ADAb and the disease activity. Acknowledgements The study was financially supported by Pfizer Disclosure of Interest J. Hiltunen: None declared, P. Parmanne: None declared, T. Sokka-Isler: None declared, T. Lamberg: None declared, O. Kaipiainen-Seppanen: None declared, P. Isomaki: None declared, M. Kauppi: None declared, L. Pirila: None declared, T. Uutela: None declared, R. Tuompo: None declared, H. Relas: None declared, T. Yli-Kerttula: None declared, H. Valleala: None declared, M. Romu: None declared, T. Rannio: None declared, K. Paalanen: None declared, A. Juha: None declared, P. Ekman: None declared, K. Tadesse: None declared, J. Borodina: None declared, P. Elfving: None declared, R. Peltomaa: None declared, M. Leirisalo-repo: None declared, H. Kautiainen: None declared, S. Jokiranta: None declared, K. Eklund Grant/research support from: Pfizer has supported the study financially, Consultant for: Advisory board meetings BMS, MSD, Pfizer, Abbvie, Speakers bureau: Lectures: BMS, Roche, Pfizer, Novartis

At the psychotherapy training center at Karlstad University, a study was carried out to examine the levels of symptom change and satisfaction with therapy in a heterogeneous population of clients treated using cognitive behavioral therapy (CBT) by less experienced trainee therapists with limited theoretical education. The clients received an average of 11 therapy sessions. The results suggested that CBT performed by less experienced trainee therapists can be effective. According to client estimations, a statistically significant reduction in symptoms, measured using the Symptoms Checklist, was achieved for seven of nine variables (p ≤ .006), as well as a significant increase in satisfaction with life (p ≤ .001). Also, the pre- and posttherapy measurements using the Montgomery–Åsberg Depression Rating Scale showed a statistically significant improvement in the clients’ condition. According to the therapists’ estimations, 64% (SD = 32.01) of the clients experienced a significant improvement in their condition. In addition, the results of a survey of client satisfaction demonstrated that the clients were very pleased with the therapy received. Also the therapists were, to a great extent, satisfied with the treatment process itself, including the supervision received, and very satisfied with the client alliance. A correlation analysis between the clients’ perceived level of improvement and therapist satisfaction showed a strong correlation between the two variables (r = .50, p

This case study illustrates the treatment of an adult woman who was diagnosed with anorexia nervosa (AN). For approximately 10 years, the client had suffered from various forms of eating disorders and had had several unsuccessful encounters with the health care services. In this study, she was treated with a modification of enhanced cognitive behavioral therapy (CBT-E). CBT-E is a relatively new treatment guide with a transdiagnostic perspective on eating disorders. In all, the treatment consisted of 14 sessions where most sessions were held on a weekly basis. Thereafter, a maintenance and follow-up was conducted via email and with the aid of self-help literature. Treatment time lasted for 8 months followed by a follow-up of 4 months. In this study, the content of each session is described, as are the modifications that were made. The modifications were made to increase motivation and self-esteem, as well as perceived control of eating, which, in itself, is a contribution to increased efficiency and a clarification of important treatment components. Apart from a description of treatment interventions, the study shows the weight gain and other clinically significant components regarding eating disorders that concern, among other things, self-esteem and general mental health. The results of this study demonstrate that this treatment, with the proposed modifications, has been highly effective for this client and hence provides a positive anticipation that this might be a more effective treatment in general for people with AN.

The present study investigated the first 38 methadone maintenance treatment (MMT) patients in Stockholm. The aim was: (i) to investigate the possible predictive factors for successful treatment termination, and (ii) the long-term outcome effects and life situation of MMT patients and those who terminated the treatment.The patients were interviewed at the start and approximately 15 years later, and divided into four groups: (1) no withdrawal attempts, (2) forced to stop the treatment, (3) successful tapering and (4) non-successful tapering.The predictive factor found that Group 1 showed a lower life quality compared with Groups 3 and 4. Fifteen years later, the life situations of Groups 3 and 4 were significantly more stable. Also the subjective well-being in Group 3 was significantly higher. Over all, Group 2 showed significantly more illicit drug use compared with Group 3. The social life situation was significantly improved for all patients during the 15 years.This study confirms our earlier findings that the ultimate goal of MMT for the motivated patients with good progress should be an opiate-free life. The life situation and subjective well-being seems to be higher after successful termination of MMT.

The present study was intended to investigate personality characteristics and mental health of severe driving under influence (DUI) offenders in a Swedish cohort. More specifically the aim was to investigate the personality traits as assessed by The NEO personality inventory (NEO-PI-R) and aspects of mental health as assessed by the symptom checklist (SCL-90) as compared to the general population. The subjects were 162 severe DUI offenders (with the BAC >0.099%) with an age range of 18-88 years, 143 males and 19 females. It was found that the openness to experience and conscientiousness scales of NEO-PI-R differentiated Swedish DUI offenders from Swedish norm population. The differences between the DUI group and the general population on the on SCL-90 scales were all significant except on the Hostility scale. Two main subtypes of DUI offenders identified were roughly comparable to types I and II alcoholics, as in Cloninger's typology. Among all the scales used (personality traits, psychiatric comorbidity and alcohol use), the only factor that was predictive for future relapses to drunk driving was the factor of depression.

Typically in pulp and paper processes raw material quality variation due to seasonal deviations as well as measurement drifts cause difficulties in setting the tight alarm thresholds for quality and control measurements. By using adaptive thresholds, more sensitive measurement range and thus reduced quality variation can be achieved. In this paper, new adaptive classification algorithm is proposed and validated using simulated and real mill data.

The rapidly increasing therapeutic applications of 188Re in nuclear medicine, oncology and interventional cardiology require routine production of large, multi-Curie levels of the 188W parent. The capability and effective coordination of back-up production sites is important to insure that high level 188W/188Re generators are continually available. We have coordinated 188W production at the High Flux Isotope Reactor (HFIR - Oak Ridge, US) with production at the BR2 Reactor (Mol, Belgium) characterized by peak thermal neutron fluxes of 2.51·015 (HFIR) and 1·1015 (BR2) neutrons/cm2·sec, respectively. The long 69-day physical half-life permits receipt of 188W from BR2 within 0.25 T 1/2's, even after the 12-day post irradiation cooling required for 187W decay (T 1/2 = 24 hours). Since 188W production by double neutron capture of enriched 186W is a function of the square of the thermal neutron flux, HFIR production (4-5 Ci 188W/g 186W/cycle) is higher than at the BR2 (1.0-1.1 Ci/g 186W/cycle). However, the specific activity (SA) of BR2-produced 188W is still about 0.8-0.9 Ci/g after processing at ORNL following shipment from Belgium. This SA is sufficiently high to permit fabrication of 1 Ci generators suitable for clinical use, since simple post elution concentration of the saline bolus (30-50 ml) obtained from the generator can provide samples with high specific volume (1 ml volume). The time periods from reactor ‘push’ in Mol and completion of processing, fabrication and shipment of generators from Oak Ridge have been 19-21 days. Six ‘campaigns’ have been successfully completed since 1998, with processed levels of 188W in Oak Ridge from 8-26 Curies/campaign. 188W has been provided to MAP Medical technologies Oy (Tikkakoski, Finland) for fabrication and distribution of generators for use at IAEA-supported research projects in developing countries. We have thus established and demonstrated an effective collaboration between the Studiecentrum voor Kernenergie-Centre d'Etude de l'Energie Nucleaire (SCK·CEN) and ORNL for back-up production of 188W. This collaboration continues to be especially helpful during periods when interruption of HFIR operation is necessary for maintenance and upgrades.

A novel isothermal pulse reactor was used to study the kinetics of gas oil cracking on a FCC equilibrium catalyst with short contact times. The feed was a lighter gas oil than typically used in FCC-units. Experiments were carried out by varying the catalyst-to-oil ratio, volume of the oil pulse, temperature and residence time. After each hydrocarbon pulse the catalyst was regenerated by introducing several oxygen/nitrogen pulses through the catalyst bed. The amounts of carbon monoxide and carbon dioxide formed were measured and the amount of coke on the catalyst was calculated. The reproducibility of the experiments was excellent. A kinetic model that included five lumps, namely, gas oil, gasoline, liquefied petroleum gas (LPG), dry gas and coke with five cracking reactions was developed first and its kinetic parameters were determined from the experimental results. The data could be best described by the model wherein the rate of cracking of gas oil to gasoline and to LPG were both approximated as second order dependency and the rate of cracking of gas oil to dry gas and to coke as first order dependency on the gas oil concentration. The five-lump model was further enlarged by dividing the gasoline fraction into paraffins, olefins, naphthenes and aromatics resulting in an eight-lump model with eight reactions. In addition, changes in the activity of the catalyst during one experiment was accounted for by using two exponential activity functions, one for catalytic cracking reactions and the other for coke formation. The formation of dry gas was considered to be the product of a thermal reaction only. The kinetic parameters of the Arrhenius’ law and the deactivation parameters were estimated by a non-linear regression program. In the five-lump model 12 parameters and in the eight-lump model 18 parameters (rate coefficients, activation energies and deactivation parameters) were obtained. The kinetic parameters of the Arrhenius’ law were statistically significant in both models.

Although factors associated with successful termination of methadone maintenance treatment (MMT) have been well studied, the question of why certain methadone patients try to taper off methadone while others do not is still unanswered. Those patients who wish to continue MMT should of course be allowed to stay in treatment. However, even if only a small portion of the MMT patients wish to quit maintenance treatment, they should be offered all possible support by the treatment staff to maximize the possibility of a successful outcome. In the present study, we compared two groups of well-functioning MMT patients with respect to background factors, methadone-related factors, drug-related factors and psychological characteristics: one group consisted of patients who were trying to terminate their MMT (group 1) and the other group consisted of patients who were not trying (group 2). Each of the groups contained 25 well-rehabilitated subjects matched by age, gender and the number of years in MMT. The results show that the patients who were not trying to terminate MMT (in comparison to group 1) were not influenced by others to try to quit methadone, had a long history of opiate use as well as mixed drug use prior to MMT, had a higher methadone dose and reported a lower degree of anticipated abstinence symptoms. According to the statements of the subjects in group 2, the most important reason for not quitting treatment was the belief that they needed the methadone. The fact that they knew others who had failed to quit MMT and low confidence in succeeding were other common answers. Further, our results suggest that patients who were satisfied with their overall drug situation were less inclined to make a withdrawal attempt.

The paper focuses on leisure oriented mobile lifestyle between urban home and rural second home in Finland which is one of the world’s leading countries in terms of second home ownership and tourism. Spatial patterns and social practices of physical mobility related to second home use are revealed by using triangulation of research methods and data. Analysis is based on GIS data, questionnaire survey results and national statistics. A relational approach is applied to conceptualise and contextualise second home mobility which is influenced by many bio-physical and socio-cultural processes and changes. Relational elements and processes interlinked to past, present and future of second home related physical mobility are identified. Natural amenities form the physical geographical basis for rural second home distribution which correlates with length of shoreline, distance to urban areas and local land use in second home environments. Second home related spatial mobility patterns differ and depend on size of the urban region of origin. Helsinki metropolitan dwellers have the longest trips to second homes which is explained not merely by environmental but by historical, societal and social reasons as well. Second home related social mobility practices are dependent on cottage owners’ and users’ life phase and standard of second homes. Retiring baby boom generation is the largest and most active cottager group and after retirement the use of second homes increases remarkably. The vast majority of second home owners and users travel the cottage trips by private cars and wish to spend at least as much time at rural second home as present. However, they do not intend to give up the urban home which leads to the conclusion that leisure related lifestyle mobility in between urban and rural living environments will continue to characterise second home owners’ and users’ way of life.

Regeneration kinetics of a cracking catalyst was studied by temperature programmed oxidation (TPO) in a microreactor system. The CO and CO2 responses were detected as a function of time while heating the sample at a constant rate. Different oxygen concentrations (0.5–2.0%) and heating rates (5 and 10 K / min ) were applied. Three kinetic models were tested and the parameters were estimated by non-linear regression. The models were capable of describing the experimental data adequately and the parameters were physically acceptable.

Rationale: Benzodiazepines have dependency-producing properties, and the majority of patients who are prescribed benzodiazepines and are treated for benzodiazepine dependency are women. Inability to cope with withdrawal symptoms may lead to continued consumption of benzodiazepines, often with the development of tolerance and dose escalation as a consequence. Objective: In the present study we analyzed gender-related differences in reactions to placebo injections in a placebo-controlled study of the effects of the benzodiazepine antagonist flumazenil among patients previously treated for benzodiazepine dependency and healthy controls. Methods: Ten patients and ten controls (five males and five females in each group) received two placebo injections (separated by 15 min) on two separate occasions (1–13 weeks apart). The patients had been benzodiazepine free for 47 (4–266) weeks on the first occasion. Subjective ratings of symptoms, thought to be important during/after withdrawal of benzodiazepines, were made before and after each injection, as well as registrations of blood pressure and heart rate. Results: An overall difference existed between previously benzodiazepine-dependent subjects and healthy controls, with patients scoring higher on negative and somatic aggregates and lower on a positive aggregate. A four-way interaction (group×gender×occasion×time) was found for negative and somatic aggregates, which could mainly be explained by the reactions of female patients. Thus, females had the highest base-line ratings and were the only group that showed a significant reduction in symptom ratings after placebo injections on the first occasion. Gender differences were also found for systolic and diastolic blood pressure. There was no significant response to placebo among male patients or for controls (males or females) for ratings of any variable. Conclusions: The results suggest that there might be gender-specific differences in reactions to placebo injections, with female patients being more affected. Arguments for and against explanatory factors such as expectation, provider factors, habituation, regression toward the mean, and reduction of anxiety are presented.

A new piece of equipment was developed for testing catalytic cracking and catalyst regeneration, particularly for short contact times. The gas oil to be cracked is injected into the upper section of the reactor, which can be operated in the temperature range 400–800°C, catalyst-to-oil ratios from 0 to 300 g cat /g oil and residence times between 0.01 and 2.3 s. The product is led directly into the analysis section where hydrocarbons from C 1 to C 12 (in total 350 compounds) are separated by a capillary column. In catalyst regeneration studies oxygen/nitrogen pulses are fed into the reactor via a gas-loop. The carbon monoxide and carbon dioxide formed are first separated in a packed column after which they are converted to methane by hydrogen on a Ni/γ-Al 2 O 3 catalyst ensuring the determination of even small amounts of coke. The reproducibility of the experiments has proved to be excellent. With this new reactor system, accurate information can be obtained on the initial activity of the catalyst and product distribution.

The main problem when burning inhomogeneous fuels like peat and wood is the changes in fuel quality, which are usually not detected until after they affect the drum pressure. With combustion power control (CPC) based on oxygen consumption in the furnace these disturbances can be detected earlier, giving opportunities stabilize the burning conditions. At the same time more stable burning conditions give a possibility to decrease the excess-air ratio causing lower flue-gas emissions and increased thermal efficiency of the boiler. The combustion power control is developed and implemented by Matlah and Simulink environment, allowing good testing facilities of the CPC strategy in different automation systems. The CPC strategy using external PC as a controller has been tested by connecting PC to Damatic XD system (DCS) in a 300 MW circulating fluidized bed boiler.

HOGSTROM BRANDT, A.-M., D. THORBURN, A. J. HILTUNEN AND S. BORG. Prediction of single episodes of drinking during the treatment of alcohol-dependent patients. ALCOHOL 18 (1) 35–42, 1999.—Drinking episodes during the treatment (relapses or lapses) of alcohol-dependent patients is predicted from clinical ratings of patients and individual background data such as alcohol drinking history and social status. The probability of these relapses (or lapses) is determined up to three days in advance using a logistic regression procedure. The study group consisted of 33 male alcohol-dependent persons, who participated in a treatment program. Clinical ratings were performed three times a week by a trained person during a visit to the clinic. The questionnaire contained 23 different items about irritation, craving for alcohol, sleep disturbances, etc. The relapses were either self-reported or detected by a biochemical marker in a urine sample that was taken daily. The most important factor for a relapse in alcohol drinking was shown to be if the patient already had had one relapse during the treatment. Other important clinical factors were the levels of irritation and autonomic disturbances. None of the variables measuring mood shifts was significant. Family conditions during childhood were the most important background variables. The predictions turned out to have a rather high specificity, but the sensitivity was lower. Half of the relapses were not predicted by an increased probability for relapse. Self-reported relapses were predictable from preceding interviews and were also less frequent compared to those detected objectively by the biochemical markers.

Personality charasteristics in primary benzodiazepine-dependent patients: comparison with controls and polydrug users

Using subjective ratings of the degree of alcohol intoxication, the interaction between the drinking history of the subjects, the alcohol dose, and acute alcohol tolerance were examined in light and moderate alcohol consumers (N = 10). Both groups of subjects were tested with doses of alcohol corresponding to 0.5 and 1.0 g/kg. Dose order was random and tests were carried out with an interval of 1 week. Reports of the subjects' previous experience with these doses of alcohol indicated that the moderate consumers ingested the lower (but not the higher) of the doses quite regularly, whereas light consumers were rather inexperienced with both of the doses. Comparison of blood alcohol concentrations as measured by breath and blood analysis yielded slightly different results, the concentrations being significantly higher as measured by breath analysis. This result was mainly associated with the initial phases, where this difference was greatest. Acute tolerance was assessed by comparing the ratings at equal concentrations of alcohol on the ascending and the descending limbs of the alcohol concentration curve. Due to the lag in the measurements of breath and blood alcohol concentrations, the outcome of the evaluations of acute tolerance was also influenced by whether breath or blood alcohol concentrations were used to obtain similar concentrations in both phases. Results based on the breath alcohol concentrations showed that in light alcohol consumers, acute tolerance was demonstrated for both of the doses. In moderate alcohol consumers only the higher of the doses produced evidence for acute tolerance. However, if comparisons are based on blood alcohol concentrations, moderate alcohol consumers also show an apparent acute tolerance for the lower of the doses tested. The present results clearly demonstrate the complexity of the acute tolerance phenomenon, and emphasize the fact that the results are dependent on the dose of alcohol, the subjects' prior experience with alcohol as well as the procedure used for measuring alcohol concentration.

Psychological and physiological withdrawal symptoms and some positive factors were studied in 10 methadone maintenance treatment patients during methadone dose reduction. The subjective ratings were made during a period of 10 days around each reduction occasion, 3 days before dose reduction and 7 days after (i.e., within the periods). To permit comparisons of the subjects' ratings between earlier and later stages of the dose reduction process, a division has been made between the first half and the second half of the total reduction occasions (i.e., between the periods). Three of the patients completed the dose reduction, while the others interrupted their withdrawal attempts. The results show that the aggregate psychological symptoms were rated low, but that, as expected, they increased significantly from the first to the second half of the dose reduction. A significant increase of the psychological symptoms also occurred from the days before each reduction to the days after. The aggregate physiological symptoms were rated very low. A significant increase in rated withdrawal intensity is found within the reduction occasions. There were no significant changes with regard to the aggregate positive factors, either within or between the reduction occasions.

The present study attempts to shed light on methadone maintenance patients expectations regarding withdrawal symptoms during voluntary methadone detoxification. The study includes two groups of subjects; one group who have tried on their own initiative to terminate their methadone maintenance treatment (Group 1) and one group that contains rehabilitated patients who have not tried to quit using methadone (Group 2). Two main results have emerged. Group 1 has negative expectations beforehand about the intensity of withdrawal which significantly exceed the later, actual experience. Group 2 has negative expectations about the intensity of withdrawal that significantly exceed the negative expectations of Group 1. The clinical implications of these results are discussed.

Using a prospective longitudinal design, differences between abstinent alcohol-dependent patients ( n = 15) and abstinent healthy volunteers ( n = 11) were determined with respect to their psychological functioning and alcohol consumption patterns following abstinence. Results showed no differences in alcohol consumption. In 20% of the patients and 9% of the controls more than 10% of protocols indicated alcohol intake, and in 27% of the patients and 27% of the controls less than 10% of protocols indicated alcohol intake. Total abstinence was reported by 53% of the patients and by 64% of the controls. For patients, validation of self-reported alcohol consumption was carried out via biological markers. Patients and controls differed in terms of: increased sleep, euphoria, concentration, initiative, anxiety, negative and positive craving, pessimistic thoughts, autonomic disturbances, and humour. A gradual normalization back to baseline levels was observed for some symptoms. These results suggest that affective/mood states may be unstable for alcoholics, and further, that these symptoms may be related to the protracted withdrawal syndrome or may represent residual symptomatology.

Oxidative coupling of methane to C2+ hydrocarbons over a Zr/La/Sr catalyst was investigated in an atmospheric-pressure shallow fluidized-bed reactor (i.d. = 5 cm; Hmf = 1.4−3.2 cm) at temperatures between 800 and 880 °C. The catalyst was mechanically and catalytically stable, but its fluidizability was limited; agglomeration and channeling occurred. The highest C2+ yield amounted to 18.0% (XCH4 = 36.5%, SC2+ = 49.4%) and 17.2% (XCH4 = 36.6%, SC2+ = 46.9%) for the diluted (pO2 = 17 kPa, pCH4 = 41.5 kPa, pN2 = 41.5 kPa) and undiluted feed (pO2 = 28 kPa, pCH4 = 72 kPa), respectively. These yields are among the highest ones reported in the open literature for OCM in fluidized beds. In the whole investigated temperature range higher selectivities and yields were obtained upon reducing partial pressures of methane and oxygen but keeping their ratio constant (pCH4/pO2 = 2.5). An increased gas velocity (from u/umf = 6 to 10) or bed height (from 1.4 to 3.2 cm) resulted in a drop of C2+ selectivity.

Two groups have been compared with each other with respect to the possible influence of a number of possible predictors of success in voluntary methadone withdrawal-one group that succeeded in terminating their methadone maintenance treatment and one group that did not manage to quit, despite serious attempts. Each of the groups contains 25 subjects. The possible predictors were subdivided into Conditions and Interventions. The results show that few Conditions exhibit any predictive value, while a larger proportion of the studied Interventions are associated with success.

Of 59 subjects who have undergone voluntary and serious attempts to terminate methadone maintenance treatment (MMT) within the framework of the Swedish methadone program, 50 could be reached for an interview. Of these, 25 were classified--with some reservations--as successful (Group 1), i.e., they lived opiate-free and to all appearances well-ordered lives. The other 25 had failed in their attempts (Group 2) and were all in methadone treatment, most functioning well. A comparison was made between the two groups with regard to change in perceived quality of life and actual life situation from the time before the detoxification attempts were begun (Period 1) until the time preceding the interview (Period 2). The results indicate that Group 1 has achieved a higher quality of life and a more stable actual life situation compared with Group 2.

Imaging by scintigraphy the serotonin transporter (5-HTT) in the living human brain would be of great value in research on the pathophysiology and treatment of neuropsychiatric disorders such as depression. For that reason, and in order to obtain a selective radiotracer applicable to PET, we report here the carbon-11 labelling of a selective 5-HTT radioligand: N, N-dimethyl-2-(2-amino-4-methylphenylthio)benzylamine or MADAM in two different positions: [p-11C-methyl]MADAM and [N-11C-methyl]MADAM. The synthesis of Bu3Sn-ADAM and N-dimethyl-MADAM is described. [p-11C-methyl]MADAM was obtained by a Stille coupling reaction between Bu3Sn-ADAM and [11C]methyl iodide using palladium (0) as a catalyst without (Ia) or with copper chloride as a co-catalyst (Ib). [N-11C-methyl]MADAM was obtained by an N-methylation reaction between N-demethyl-MADAM and [11C]methyl iodide (II). The carbon-11 incorporation yield in [p-11C-methyl]MADAM was 10–30% (Ia and Ib) and in [N-11C-methyl]MADAM was 75-80% (II). The final product in each case was obtained in 30 min total synthesis time, including HPLC purification and with >99% radiochemical purity. Copyright © 2001 John Wiley & Sons, Ltd.

Benzodiazepines (BZD) are the most widely used sedative-hypnotics, and evidence is rapidly accumulating suggesting potential BZD dependence, association of chronic use with adverse effects and a definite abstinence syndrome produced by withdrawal.The present investigation followed prospectively long-term BZD users over 1 year following graded BZD withdrawal in terms of clinical and withdrawal symptoms.Clinical symptoms were measured by the Comprehensive Psychopathological Rating Scale (CPRS) and by the Newcastle Anxiety and Depression Diagnostic Index (NADDI) in a sample of BZD users over a 50-week period following graded BZD withdrawal.The results showed that the frequency and severity of clinical symptomatology measured by both scales significantly decreased over time. A detailed analysis of possible patterns of symptoms on both scales revealed four patterns: 1) a gradual decrease over the 50-week time period; 2) an increase in the severity of symptoms at the onset of tapering and a decrease in severity post-tapering; 3) an increase in the severity of symptoms 4 weeks after the cessation of BZD tapering; and 4) no change over the 50-week time period. Rate of BZD withdrawal was associated with CPRS ratings of global illness at admission and at end of treatment, but was not associated with duration or dosage of BZDs, type of BZD, prescriptive and/or non-prescriptive drug use prior to admission, marital status, sex or age.The results of the present study provide a detailed picture of the pattern of symptoms, their time course and multidimensional determinants of the BZD withdrawal symptoms.

Medium range order is analysed for Ni62Nb38 and Ni65B35 metallic glasses from the total and partial atomic pair correlation functions. A new fitting procedure is introduced to determine the extent of atomic correlations and the corresponding value for the structural disorder parameter (in a continuous form) as a function of the chosen window. The partial atomic pair correlation functions in the investigated medium range r-space behave differently and the medium range order is stronger in Ni62Nb38 than in Ni65B35.

The relationship between tolerance to ethanol and acute tolerance to ethanol was examined. One group of rats was given 1.8 g/kg ethanol, and another group was administered 18 ml/kg saline for 26 days after sessions. Animals responded under a fixed ratio ten (FR-10) schedule of food reinforcement. Thereafter, various doses of ethanol (1.3-2.5 g/kg) were examined to assess the influence of the ethanol treatment on the expression of acute tolerance. Acute tolerance was assessed by comparing the performance at equal concentrations of ethanol on the ascending and the descending limbs of the ethanol concentration curve. This was achieved by varying the time between behavioural tests since ethanol administration. Ethanol concentrations were estimated using a rebreathed air procedure. Equal concentrations of ethanol were achieved with doses of i) 1.3 g/kg (10 min post-injection, PI), and 1.8 g/kg (60 min PI), as well as with doses of ii) 2.0 g/kg (10 min PI), and 2.5 g/kg (60 min PI). Acute tolerance was demonstrated for the initially ethanol naive animals. For the animals given ethanol chronically, only doses of ethanol higher than the chronically administered dose produced evidence for acute tolerance. When the chronically dosed animals had been off ethanol for 67 days, there was evidence for acute tolerance. The present data add to the generality of the acute ethanol tolerance phenomenon, and emphasize both the appearance as well as the loss of tolerance for this effect.

In this study, alcohol was administered intravenously to study whether its effects on mood should preferably be studied as a bi- or unipolar phenomenon. This was studied in a double-blind, placebo-balanced, design on six healthy male volunteers. Of the three bipolar aspects of mood (calmness, activity, and pleasantness), only calmness was significantly affected by intravenous alcohol. In contrast, there were significant differences between alcohol and placebo for five of the six unipolar indexes. This support the hypothesis that subjective effects of alcohol on mood are preferably studied with self-ratings that allows positive and negative aspects to be analyzed separately. Further, our data suggest that the effects of alcohol are primarily on negative aspects of mood rather than on positive.

Benzodiazepine withdrawal has been associated with hostile and aggressive behavior. The benzodiazepine antagonist flumazenil has reduced, increased or not affected hostility and aggression in animal and human studies. In the present study we analyzed data collected in a placebo-controlled study of the effects of the benzodiazepine antagonist flumazenil in patients previously treated for benzodiazepine dependency, and healthy controls. The aim was to analyze the effects of flumazenil on hostility and aggression. Ten patients and 10 controls received, on two separate occasions, cumulative doses of flumazenil (0.05, 0.1, 0.25, 0.5 and 1mg at 15min intervals) or placebo. Withdrawal symptoms were rated after each injection. Patients had been free from benzodiazepines for 47 (4-266) weeks on the first occasion. A three-way interaction (groupxtreatmentxdose) was found, and was explained by: 1) patients rating aggression and hostility higher than controls at all times during placebo, while 2) during the flumazenil provocation i) the initial significant difference between patients and controls was no longer significant above the 0.5mg dose, and ii) patients rated aggression and hostility significantly lower above the 0.5mg dose compared to base-line. The results suggest that self-rated aggression and hostility in patients treated for benzodiazepine dependency was reduced by the partial benzodiazepine agonist flumazenil.

An important challenge that remains to date in board level optical interconnects is the coupling between the optical waveguides on printed wiring boards and the packaged optoelectronics chips, which are preferably surface mountable on the boards. One possible solution is the use of Ball Grid Array (BGA) packages. This approach offers a reliable attachment despite the large CTE mismatch between the organic FR4 board and the semiconductor materials. Collimation via micro-lenses is here typically deployed to couple the light vertically from the waveguide substrate to the optoelectronics while allowing for a small misalignment between board and package. In this work, we explore the fabrication issues of an alternative approach in which the vertical photonic connection between board and package is governed by a micro-optical pillar which is attached both to the board substrate and to the optoelectronic chips. Such an approach allows for high density connections and small, high-speed detector footprints while maintaining an acceptable tolerance between board and package. The pillar should exhibit some flexibility and thus a high-aspect ratio is preferred. This work presents and compares different fabrication methods and applies different materials for such high-aspect ratio pillars. The different fabrication methods are: photolithography, direct laser writing and deep proton writing. The selection of optical materials that was investigated is: SU8, Ormocers, PU and a multifunctional acrylate polymer. The resulting optical pillars have diameters ranging from 20um up to 80um, with total heights ranging between 30um and 100um (symbol for micron). The aspect-ratio of the fabricated structures ranges from 1.5 to 5.

This study examined the phenomenon of acute tolerance to ethanol (ETOH) using drug discrimination learning (DDL), and open-field (OF) procedures. In DDL, rats were trained to discriminate between ETOH (1.2 g/kg) and saline. Doses of ETOH lower (0.6 and 0.9 g/kg), or higher (1.8 and 2.4 g/kg) than the training dose were tested to examine possible influence of ETOH pretreatment doses on the expression of acute tolerance. To assess concentrations of ETOH in the organism, a rebreathed air procedure was used. Equal concentrations after different ETOH doses were achieved by postponing the tests until sufficient time had elapsed. Only doses of ETOH higher than the training dose produced acute tolerance in the DDL procedure. For the response-time data no acute tolerance was observed. In the OF experiment, the occurrence of acute tolerance was examined for different spontaneous behaviours in drug-naive animals. At equal ETOH concentrations, the group examined during the descending phase of intoxication (1.8 g/kg, 60 min post-injection), reared significantly more than the group tested during the ascending phase (1.5 g/kg, 10 min post-injection). Other OF behaviours did not differ significantly between the two time intervals. Thus, it is suggested that acute tolerance is seen both in ETOH naive and in ETOH pre-exposed rats. However, in DDL acute tolerance was observed only when doses higher than the training dose of ETOH were evaluated.

We construct some geometrically dense matrix lattices with good minimum determinants for 4 transmit antenna MISO applications. The construction is based on the theory of rings of algebraic integers and related subrings of the Hamiltonian quaternions. Simulations in a quasi-static Rayleigh fading channel show that our dense quaternionic constructions outperform the earlier rectangular lattices as well as the DAST-lattice

Rate one full-diversity orthogonal designs for four transmit antennas are known not to exist so either rate, orthogonality or diversity is compromised. Use of algebraic number theory has lead to full-diversity, rate one code constructions. The use of regular representations of certain rings of algebraic integers and their Hamiltonian quaternionic counterparts to construct lattices of rank 8 that yield rate one full-diversity lattice constellation codes for four transmitting antennas is presented in this paper. The resulting codes require less transmission power per bit. Using number theoretic tools a general lower bound to the minimum Euclidean distance within the received constellation is computed

ML-decoding significant savings can be achieved by taking advantage of the common parts of the different codewords. This idea underlying the construction of the so called BCJR-trellis of a block code. By design, whenever the paths corresponding to two different elements, share an edge between splitting points and have identical components at positions for any channel vector. Thus this trellis can be used for efficient ML-decoding.

Isoolefins can be used for production of environmentally preferred gasoline components. It is possible to increase the available C 4 -C 6 isoolefins by skeletal isomerization of the corresponding linear olefins. High activities and selectivities to isoolefins can be obtained with zeolites. The drawback of the zeolite catalyst is the limited catalyst life due to coke formation. Continuous reaction and catalyst regeneration can be performed in a CFB (Circulating Fluidized Bed) unit. Experiments were made in a pilot unit at 300°C with refinery FCC light naptha feed. Continuous regeneration was made at 400–600°C both with nitrogen and air. Stable conversion of about 40 wt-% and selectivity of 90 wt-% could be maintained during the test. The selectivity was dependent of the carbon content on the catalyst and an optimum yield was reached with about 5-wt% carbon on the catalyst. The CFB unit data was compared to fixed bed unit data.

The concentration and histological distribution of hyaluronan, a tumor promoting extracellular matrix polysaccharide, and the activity of hyaluronidase, a potential source of angiogenic hyaluronan oligosaccharides, were analyzed in malignant epithelial (n = 24), borderline (n = 8), benign epithelial (n = 20), functional cyst (n = 21), and normal (n = 5) tissue samples of human ovary. Hyaluronan concentration increased specifically in cancers (P = 0.001), particularly in grade 3 tumors (49-fold) and in metastases (89-fold). Hyaluronan staining in the tissues correlated with hyaluronan concentration (P = 0.002). Hyaluronidase activity slightly decreased from semimalignant through low grade to high grade tumors (P = 0.041). Therefore, hyaluronan accumulation, but not hyaluronidase activation, is associated with the aggressiveness of ovarian epithelial cancer.

Automated methods are required for the analysis of brain single photon emission tomography images. We applied an automated method to assess the benzodiazepine receptor distribution in the brain. Images of 19 patients with mild traumatic brain injury who had received 123 I NNC 13-8241 were compared with a mean brain template accumulated from 18 healthy volunteers. To obtain more information, we calculated the neuronal benzodiazepine receptor binding in the brain by using pre-defined anatomical regions and a voxel-by-voxel technique. The group of patients with mild traumatic brain injury differed significantly (P=0.015) from the group of healthy volunteers in the distribution of benzodiazepine receptors. This methodological work suggests that a reference based template and a three-dimensional brain model help in regional analysis and quantification and could be useful in demonstrating permanent neuronal damage after head injury.