Guidance for the pharmacological management of substance misuse among young people.

Until now there has been no formal guidance to help clinicians to manage substance dependence among young people. This has left practitioners concerned that their practice may not accord with the developing evidence base. This guidance document describes good practice on the best ways to manage a clinically complex condition

Stable distribution in fragmentation processes

We introduce three models of fragmentation in which the largest fragment in the system can be broken at each time step with a fixed probability, p. We solve these models exactly in the long time limit to reveal stable time invariant (scaling) solutions which depend on p and the precise details of the fragmentation process. Various features of these models are compared with those of conventional fragmentation models. To get Figures e-mail to G.J. [email protected]

An evaluation of alternative techniques for automatic detection of shot boundaries in digital video

The application of image processing techniques to achieve substantial compression in digital video is one of the reasons why computer-supported video processing and digital TV are now becoming commonplace. The encoding formats used for video, such as the MPEG family of standards, have been developed primarily to achieve high compression rates, but now that this has been achieved, effort is being concentrated on other, content-based activities. MPEG-7, for example is a standard intended to support such developments. In the work described here, we are developing and deploying techniques to support content-based navigation and browsing through digital video (broadcast TV) archives. Fundamental to this is being able to automatically structure video into shots and scenes. In this paper we report our progress on developing a variety of approaches to automatic shot boundary detection in MPEG-1 video, and their evaluation on a large test suite of 8 hours of broadcast TV. Our work to date indicates that different techniques work well for different shot transition types and that a combination of techniques may yield the most accurate segmentation

Alcohol Screening and Brief Interventions for Offenders in the Probation Setting (SIPS Trial): a Pragmatic Multicentre Cluster Randomized Controlled Trial

Aim - To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in the probation setting. Offender managers were randomized to three interventions, each of which built on the previous one: feedback on screening outcome and a client information leaflet control group, 5 min of structured brief advice and 20 min of brief lifestyle counselling. Methods - A pragmatic multicentre factorial cluster randomized controlled trial. The primary outcome was self-reported hazardous or harmful drinking status measured by Alcohol Use Disorders Identification Test (AUDIT) at 6 months (negative status was a score of <8). Secondary outcomes were AUDIT status at 12 months, experience of alcohol-related problems, health utility, service utilization, readiness to change and reduction in conviction rates. Results - Follow-up rates were 68% at 6 months and 60% at 12 months. At both time points, there was no significant advantage of more intensive interventions compared with the control group in terms of AUDIT status. Those in the brief advice and brief lifestyle counselling intervention groups were statistically significantly less likely to reoffend (36 and 38%, respectively) than those in the client information leaflet group (50%) in the year following intervention. Conclusion - Brief advice or brief lifestyle counselling provided no additional benefit in reducing hazardous or harmful drinking compared with feedback on screening outcome and a client information leaflet. The impact of more intensive brief intervention on reoffending warrants further research

An analytic model of the Gruneisen parameter at all densities

We model the density dependence of the Gruneisen parameter as gamma(rho) = 1/2 + gamma_1/rho^{1/3} + gamma_2/rho^{q}, where gamma_1, gamma_2, and q>1 are constants. This form is based on the assumption that gamma is an analytic function of V^{1/3}, and was designed to accurately represent the experimentally determined low-pressure behavior of gamma. The numerical values of the constants are obtained for 20 elemental solids. Using the Lindemann criterion with our model for gamma, we calculate the melting curves for Al, Ar, Ni, Pd, and Pt and compare them to available experimental melt data. We also determine the Z (atomic number) dependence of gamma_1. The high-compression limit of the model is shown to follow from a generalization of the Slater, Dugdale-MacDonald, and Vashchenko-Zubarev forms for the dependence of the Gruneisen parameter.Comment: 14 Pages, LaTeX, 5 eps figues; changes in the tex

Melting of crystalline solids

It is suggested that at the melting temperature the thermal phonon vibration is in self-resonance with the lattice vibration of the surface atomic/molecular layer. This self resonance occurs at a well defined temperature and triggers the detachment of the atomic/molecular sheet or platelets from the surface of the crystal. Thermodynamic data of five substances is used to test this hypothesis. The calculated average phonon vibrational wavelengths are equal with or harmonics of the d-spacing of the atomic/molecular sheets. The proposed model is able to explain all of the features of melting.Comment: supercooling and ultra-fast speed of the phase transition is added as requirements for the explanation of meltin

The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial

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

Melting of tantalum at high pressure determined by angle dispersive x-ray diffraction in a double-sided laser-heated diamond-anvil cell

The high pressure and high temperature phase diagram of Ta has been studied in a laser-heated diamond-anvil cell (DAC) using x-ray diffraction measurements up to 52 GPa and 3800 K. The melting was observed at nine different pressures, being the melting temperature in good agreement with previous laser-heated DAC experiments, but in contradiction with several theoretical calculations and previous piston-cylinder apparatus experiments. A small slope for the melting curve of Ta is estimated (dTm/dP = 24 K/GPa at 1 bar) and a possible explanation for this behaviour is given. Finally, a P-V-T equation of states is obtained, being the temperature dependence of the thermal expansion coefficient and the bulk modulus estimated.Comment: 31 pages, 8 figures, to appear in J.Phys.:Cond.Matte

Understanding people's experiences of the formal health and social care system for co-occurring heavy alcohol use and depression through the lens of relational autonomy:A qualitative study

BACKGROUND AND AIMS: Heavy alcohol use and depression commonly co-occur. However, health and social care services rarely provide coordinated support for these conditions. Using relational autonomy, which recognizes how social and economic contexts and relational support alter people's capacity for agency, this study aimed to (1) explore how people experience formal care provision for co-occurring alcohol use and depression, (2) consider how this context could lead to adverse outcomes for individuals and (3) understand the implications of these experiences for future policy and practice.DESIGN: Semi-structured qualitative interviews underpinned by the methodology of interpretive description.SETTING: North East and North Cumbria, UK.PARTICIPANTS: Thirty-nine people (21 men and 18 women) with current or recent experience of co-occurring heavy alcohol use ([Alcohol Use Disorders Identification Test [AUDIT] score ≥ 8]) and depression ([Patient Health Questionnaire test ≥ 5] screening tools to give an indication of their current levels of alcohol use and mental score).MEASUREMENTS: Semi-structured interview guide supported in-depth exploration of the treatment and care people had sought and received for heavy alcohol use and depression.FINDINGS: Most participants perceived depression as a key factor contributing to their heavy alcohol use. Three key themes were identified: (1) 'lack of recognition' of a relationship between alcohol use and depression and/or contexts that limit people's capacity to access help, (2) having 'nowhere to go' to access relevant treatment and care and (3) 'supporting relational autonomy' as opposed to assuming that individuals can organize their own care and recovery. Lack of access to appropriate treatment and provision that disregards individuals' differential capacity for agency may contribute to delays in help-seeking, increased distress and suicidal ideation.CONCLUSIONS: Among people with co-occurring heavy alcohol use and depression, lack of recognition of a relationship between alcohol use and depression and formal care provision that does not acknowledge people's social and economic context, including their intrinsic need for relational support, may contribute to distress and limit their capacity to get well.</p