Predicting the early therapeutic alliance in the treatment of drug misuse

Aims - To predict the early therapeutic alliance from a range of potentially relevant factors, including clients' social relationships, motivation and psychological resources, and counsellors' professional experience and ex-user status. Design - The study recruited 187 clients starting residential rehabilitation treatment for drug misuse in three UK services. Counsellor and client information was assessed at intake, and client and counsellor ratings of the alliance were obtained during weeks 1, 2 and 3. Measurements - The intake assessment battery included scales on psychological wellbeing, treatment motivation, coping strategies and attachment style. Client and counsellor versions of the Working Alliance Inventory (WAI-S) were used for weekly alliance measurement. Hierarchical linear models were used to examine the relationship between alliance and predictor variables. Findings - Clients who had better motivation, coping strategies, social support and a secure attachment style were more likely to develop good alliances. Findings with regard to counsellor characteristics were not clear cut: clients rated their relationships with ex-user counsellors, experienced counsellors and male counsellors as better, but more experienced counsellors rated their alliances as worse. Conclusions - The findings offer important leads as to what interventions might improve the therapeutic alliance. Further work will need to establish whether the therapeutic alliance and ultimately treatment outcomes can be enhanced by working on improving clients' motivation and psychosocial resources

Blockade of microglial KATP-channel abrogates suppression of inflammatory-mediated inhibition of neural precursor cells

Microglia positively affect neural progenitor cell physiology through the release of inflammatory mediators or trophic factors. We demonstrated previously that reactive microglia foster KATP-channel expression and that blocking this channel using glibenclamide administration enhances striatal neurogenesis after stroke. In this study, we investigated whether the microglial KATP-channel directly influences the activation of neural precursor cells (NPCs) from the subventricular zone using transgenic Csf1r-GFP mice. In vitro exposure of NPCs to lipopolysaccharide and interferon-gamma resulted in a significant decrease in precursor cell number. The complete removal of microglia from the culture or exposure to enriched microglia culture also decreased the precursor cell number. The addition of glibenclamide rescued the negative effects of enriched microglia on neurosphere formation and promoted a ~20% improvement in precursor cell number. Similar results were found using microglial-conditioned media from isolated microglia. Using primary mixed glial and pure microglial cultures, glibenclamide specifically targeted reactive microglia to restore neurogenesis and increased the microglial production of the chemokine monocyte chemoattractant protein-1 (MCP-1). These findings provide the first direct evidence that the microglial KATP-channel is a regulator of the proliferation of NPCs under inflammatory conditions

On-site primary care and mental health services in outpatient drug abuse treatment units

Providing health services to drug abuse treatment clients improves their outcomes. Using data from a 1995 national survey of 597 outpatient drug abuse treatment units, this article examines the relationship between these units' organizational features and the degree to which they provided onsite primary care and mental health services. In two-stage models, Joint Commission on Accreditation of Healthcare Organizations-certified and methadone programs delivered more on-site primary care services. Units affiliated with mental health centers provided more on-site mental health services but less direct medical care. Units with more dual-diagnosis clients provided more on-site mental health but fewer on-site HIV/AIDS treatment services. Organizational features appear to influence the degree to which health services are incorporated into drug abuse treatment. Fully integrated care might be an unattainable ideal for many such organizations, but quality improvement across the treatment system might increase the reliability of clients' access to health services.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45768/1/11414_2005_Article_BF02287796.pd

THE INFLUENCE OF PRODUCT PREFERENCES UPON DISSONANCE REDUCTION

Abstract not availabl

Evaluating E-textbooks in a Business Curriculum

Given the growing popularity of electronic textbooks (e-textbooks) in academia, it is important to evaluate the educational value of such textbooks and whether users can interact with the interface. The problem identified in this study is how to effectively use e-textbooks in a four-year undergraduate business curriculum to facilitate student learning. The primary goal of this study was to evaluate the educational usefulness of etextbooks. The secondary goal was to evaluate the user interface usability of e-textbooks. Two methods of evaluation were used in this study. A web-based survey was used and the sample included current student users of e-textbooks in a variety of business topics in four-year undergraduate business schools. Survey requests were provided to instructors identified as using e-textbooks, who forwarded the survey to the students. There were 166 student responses to the web-based survey. A user review was used and included a think-aloud method of evaluation in which participants were asked to perform tasks with one business e-textbook and complete a questionnaire. The participants used included seven undergraduate business students enrolled at Southern Oregon University in a business course in which an e-textbook was used and presented in the Adobe Acrobat Reader 7.0 format. The investigator expected to provide insight to what ways e-textbooks enable students to meet learning objectives. The web-based survey results showed students are satisfied with the criteria presented and deemed important in evaluating the educational usefulness of e-books. A key finding in the web-based survey was the dissatisfaction that users reported on the ability to edit, mark and annotate when using e-textbooks. These features are considered to be important assets in promoting the use of e-books. The investigator also expected to provide insight to what ways e-textbook interfaces make possible the performance of the tasks required of students. The user review results showed students are satisfied with the criteria presented and deemed important in evaluating the user interface usability of e-books. A key finding in the user review was that users sought paper book metaphors for finding information in the e-textbook that were not available

Automatic phase detector for digital communications

Peer ReviewedPostprint (published version

Automatic phase detector for digital communications

Peer Reviewe