24 research outputs found
Learning How to Ask - Does a one-day training increase trauma inquiry in routine substance use disorder practice? Results of a cluster-randomized controlled trial
Aims
To examine the effectiveness of a one-day skills training program for increasing trauma inquiry in routine substance use disorder treatment.
Design
Cluster-randomized two-armed controlled trial, with 12 substance use disorder (SUD) organizations operating 25 counseling centers, randomly assigned to training in trauma inquiry (13 counseling centers of 8 SUD organizations) or no training (12 counseling centers of 4 SUD organizations).
Setting
SUD counseling centers in Northern Germany.
Cases
N = 5204 SUD counseling services.
Intervention
The professionals assigned to the intervention group received a one-day training in trauma inquiry plus a 1.5-hour refresher session 3 months later. Professionals in the control group received no training.
Measures
Over a 12-month period, professionals documented for each counseling service whether they asked the client about four traumatic events: physical abuse, emotional abuse, sexual abuse and neglect.
Analysis
Primary outcomes were rates of asking about physical abuse, sexual abuse, emotional abuse and neglect in the 6 months after training. These were compared across conditions, while adjusting for baseline probabilities in the 6 months before the intervention, using mixed-effects logistic regression.
Findings
In the 6 months after training, the rate of asking about physical abuse was 18% higher in the SUD counseling services of trained professionals, relative to services of untrained professionals (OR = 1.18, 95% CI = [1.01–1.37, p = .035]). No effect was found for asking about sexual abuse, emotional abuse and neglect.
Conclusion
A one-day training program in trauma inquiry, combined with a brief refresher session, was effective in increasing inquiries about physical abuse in routine counseling practice. The training was ineffective in increasing inquiries about sexual abuse, emotional abuse and neglect. The effectiveness of a one-day training of trauma inquiry might be increased by a longer training, or by combining it with additional elements, such as ongoing supervision
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Research and Design of a Routing Protocol in Large-Scale Wireless Sensor Networks
无线传感器网络,作为全球未来十大技术之一,集成了传感器技术、嵌入式计算技术、分布式信息处理和自组织网技术,可实时感知、采集、处理、传输网络分布区域内的各种信息数据,在军事国防、生物医疗、环境监测、抢险救灾、防恐反恐、危险区域远程控制等领域具有十分广阔的应用前景。 本文研究分析了无线传感器网络的已有路由协议,并针对大规模的无线传感器网络设计了一种树状路由协议,它根据节点地址信息来形成路由,从而简化了复杂繁冗的路由表查找和维护,节省了不必要的开销,提高了路由效率,实现了快速有效的数据传输。 为支持此路由协议本文提出了一种自适应动态地址分配算——ADAR(AdaptiveDynamicAddre...As one of the ten high technologies in the future, wireless sensor network, which is the integration of micro-sensors, embedded computing, modern network and Ad Hoc technologies, can apperceive, collect, process and transmit various information data within the region. It can be used in military defense, biomedical, environmental monitoring, disaster relief, counter-terrorism, remote control of haz...学位:工学硕士院系专业:信息科学与技术学院通信工程系_通信与信息系统学号:2332007115216
Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples
Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts
Individual, social and cultural factors shaping the use of amphetamine-type stimulants in Europe
Background: Amphetamine-type stimulants (ATS) encompass a varied assortment of substances that possess comparable pharmacological effects and stimulant characteristics. ATS display diversity in patterns of use among different substances and users' sociodemographic characteristics. The utilization of ATS is associated with both favorable and unfavourable outcomes. The biopsychosocial model of substance use provides a comprehensive framework for understanding ATS use. Aims: The primary objective of this study is to cultivate a thorough comprehension of the motivating factors driving individuals to initiate, cease, escalate, and/or curtail their ATS use. Material and methods: In a mixed methods approach, qualitative interviews were conducted to explore distinct groups of ATS users and one group of non-ATS users. These qualitative interviews then informed standardized quantitative computer-assisted personal interviews that utilized a range of (standard) instruments. The interviews were carried out in five European Union member states, and a minimum of five years had to elapse between the first usage of or exposure to ATS and the conducted interview. In the qualitative study arm, a total of 279 individuals were interviewed. Among them, 17% were identified as currently dependent on ATS, 20% were formerly..
Civil society involvement in drug policy in EU Member States. Assessment report.
On the European Union level, the issue of how to strengthen the civil society involvement (CSI) in drug policy has increasingly attracted attention over the last few years, starting with the presentation of the “Green Paper on the role of Civil Society in Drugs Policy in the European Union” by the European Commission (2006) and the subsequent establishment of the “Civil Society Forum on Drugs” as a platform for regular dialogue on policy development and implementation between the Commission and representatives of European civil society. How the Civil Society Forum on Drugs is to be involved in EU drugs policy is further defined in the current EU Action Plan on Drugs 2017-2020 (Council of Europe 2017). However, the current action plan does not only refer to civil society involvement on the EU level, but also calls for action on the national level to “promote and strengthen dialogue with, and involvement of, civil society and the scientific community in the formulation, implementation, monitoring and evaluation of drug policies”. The successful implementation of best practice in drug demand reduction in the member states, is further hinged (among other indicators) on the “involvement of civil society in the implementation of the standards, including in planning and introduction”.
This assessment report will focus on the involvement of civil society in the national drug policies of the EU member states. Its objective is to gain a better insight and create a better understanding of the nature and extent of civil society involvement in drug policy at the national level. The assessment will reflect the status of CSI as condensed in national drug policy documents, analyse the levels of CSI in different drug policy fields, identify and quantify different type of civil society stakeholders in the member states and size up the impact of civil society participation in the decision making process.
Furthermore it will analyse barriers and facilitators for CSI and give conclusions and recommendations for promoting and strengthening CSI in the member states. This introduction will be followed by a description of the methods used to reach the above mentioned objectives. Subsequently, the limitations of these methods will be declared before the results of the assessment will be presented. Finally, the main results of the assessment will be discussed against the background of the EUs call for strengthening civil society involvement in the member states
Factors shaping different trajectories of amphetamine-type-stimulant use: a systematic review of qualitative research
Background
Amphetamine-type stimulants, including amphetamine, methamphetamine, MDMA, and some novel psychoactive substances, are increasingly popular drugs in the UK and globally. Yet there is limited evidence on what shapes use of amphetamine-type stimulants across the life course. We aimed to systematically review and synthesise recent qualitative literature examining users' perspectives on which factors influence different trajectories of amphetamine-type-stimulant consumption.
Methods
We searched MEDLINE, PsycINFO, EMBASE, and ProQuest Social Sciences Premium Collection, between Jan 1, 2000, and Oct 31, 2016, for qualitative research exploring the views of amphetamine-type-stimulant users aged 13 years and older on factors shaping their drug use careers. Only peer-reviewed articles, readily available in the public domain, were retrieved for further review. Two reviewers independently screened potential papers and extracted key data. Thematic synthesis focused on identifying individual, social, and environmental factors relating to initiation, continuation, escalation, and desistance of amphetamine-type-stimulant use. The Critical Appraisal Skills Programme checklist was used to assess methodological quality.
Findings
We identified 1694 records, of which 42 papers met our inclusion criteria. 31 studies were rated as being of moderate methodological quality, nine high quality, and two low quality. The literature was internationally diverse, covering North and South America, Europe, Australasia, and southeast Asia. Participants were aged 14–58 years and from varied socioeconomic and demographic groups. Reasons for initiation included: to help manage the transition from opioids; to boost performance at work, college, in sexual relationships, or the home; to promote a sense of social belonging; and to help manage stress. Similar reasons motivated continued use of amphetamine-type stimulants, combined with the challenge of managing withdrawal effects in long-term users. Increased tolerance, experiencing a critical life event, or both contributed to an escalation in use. Reasons for desistance focused on: increased awareness of the negative health impacts of long-term use, particularly during pregnancy; disconnecting from social networks or relationships; and financial instability.
Interpretation
To our knowledge, this is the first review of qualitative international literature on amphetamine-type-stimulant use trajectories. The findings underline both the heterogeneous nature of these users, and the diverse social, economic, and individual factors that shape different patterns of use. This information will support the development of more tailored, evidence-based treatment and prevention services in the future.
Funding
This report is independent research commissioned and funded by the Department of Health's Policy Research Programme (Grant ATTUNE: Understanding the pathways for stimulant use; ref ST-0416-10001)
Using life course charts to assess and compare trajectories of amphetamine type stimulant consumption in different user groups: a cross-sectional study.
BACKGROUND: Amphetamine-type stimulants (ATS) are the second most commonly used illicit drugs in Europe and globally. However, there is limited understanding of what shapes patterns of ATS use over the life course. The ATTUNE project "Understanding Pathways to Stimulant Use: a mixed methods examination of the individual, social and cultural factors shaping illicit stimulant use across Europe" aims to fill this gap. Here we report initial findings from the life course chart exercise conducted as part of qualitative interviews with ATS users and nonusers.
METHODS: Two hundred seventy-nine in-depth qualitative interviews were conducted with five ATS user groups (current and former dependent users;current and former frequent users;non-frequent users) and one group of exposed non-ATS users in five European countries (Germany, UK, Poland, Netherlands and Czech Republic). As part of the interviews, we used life course charts to capture key life events and substance use histories. Life events were categorised as either positive, neutral or negative, and associated data were analysed systematically to identify differences between user groups.
RESULTS: Out of 3547 life events documented, 1523 life events were categorised as neutral, 1005 life events as positive and 1019 life events as negative. Current and formerly dependent ATS users showed more negative life events for the entire life course after age adjustment. Although some group differences could be attributed to the individuals' life course prior to first ATS use, most negative life events were associated with periods of ATS usage. A detailed analysis of the specific life domains reveals that dominantly, the social environment was affected by negative life events.
CONCLUSIONS: For non-dependent, frequent and non-frequent ATS users, negative life events from the period of ATS use do not become obvious in our analysed data. Besides preventing a pathway into ATS dependency, the aim of an intervention should be to reduce the harm by for example drug testing which offers also the opportunity for interventions to prevent developing a substance use dependency. For the group of dependent ATS users, our study suggests holistic, tailored interventions and specialist treatment services are needed, as a single, simple intervention is unlikely to cover all the life domains affected
Assessment of health services for people who use drugs in Central Asia: findings of a quantitative survey in Kazakhstan and Kyrgyzstan
Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples
The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts.The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that -80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAFPeer reviewe
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Sex differences in oncogenic mutational processes
Funder: Canadian Network for Research and Innovation in Machining Technology, Natural Sciences and Engineering Research Council of Canada (NSERC Canadian Network for Research and Innovation in Machining Technology); doi: https://doi.org/10.13039/501100002790Funder: Genome Canada (Génome Canada); doi: https://doi.org/10.13039/100008762Funder: Canada Foundation for Innovation (Fondation canadienne pour l'innovation); doi: https://doi.org/10.13039/501100000196Funder: Terry Fox Research Institute (Institut de Recherche Terry Fox); doi: https://doi.org/10.13039/501100004376Abstract: Sex differences have been observed in multiple facets of cancer epidemiology, treatment and biology, and in most cancers outside the sex organs. Efforts to link these clinical differences to specific molecular features have focused on somatic mutations within the coding regions of the genome. Here we report a pan-cancer analysis of sex differences in whole genomes of 1983 tumours of 28 subtypes as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium. We both confirm the results of exome studies, and also uncover previously undescribed sex differences. These include sex-biases in coding and non-coding cancer drivers, mutation prevalence and strikingly, in mutational signatures related to underlying mutational processes. These results underline the pervasiveness of molecular sex differences and strengthen the call for increased consideration of sex in molecular cancer research