Drinking Goal Trajectories and Their Association with Client Characteristics and Outcomes among Clients in Outpatient Alcohol Treatment.

BACKGROUND: Drinking goal preferences could change over time in alcohol treatment and during follow up. OBJECTIVES: To examine the stability of drinking goals over time, types of drinking goal trajectory, and the associations between drinking goal trajectories and baseline client characteristics and treatment outcomes. METHODS: We performed secondary analysis of a dataset from a multicenter longitudinal study on the effectiveness of outpatient alcohol treatment (n = 543). Drinking goals (abstinence, controlled drinking, nonrestricted drinking, undecided) and alcohol use were assessed at treatment admission, discharge, and 6- and 12-month follow up. RESULTS: At admission, 32% of the subjects aimed for abstinence and 57% for controlled drinking, while 10% were undecided, and 1% did not want to restrict themselves. The proportions of clients aiming for abstinence and controlled drinking were relatively stable across the four assessments, and the proportion of clients who changed their drinking goal from abstinence to controlled drinking did not differ significantly from the number who changed in the opposite direction. Clients with abstinence-focused trajectories reported higher baseline alcohol use than those focused primarily on controlled drinking. Meanwhile, attaining nonhazardous drinking and reduced alcohol use at 12-month follow up were more likely among clients with abstinence-focused trajectories than those focused on controlled drinking. CONCLUSIONS: Since the majority of clients maintain their initially selected drinking goal, counsellors might inform them at treatment admission about the various probabilities of achieving nonhazardous drinking depending on their selected drinking goal.

Drinking Goals and Their Association With Treatment Retention and Treatment Outcomes Among Clients in Outpatient Alcohol Treatment.

BACKGROUND: Few studies have compared characteristics of clients entering alcohol treatment who differ in their drinking goal preferences or have investigated the relevance of drinking goals as a predictor of treatment outcomes. OBJECTIVES: To investigate associations between baseline drinking goal preferences and client characteristics as well as treatment retention and outcomes among clients in outpatient alcohol treatment. METHODS: Secondary data analyses on a longitudinal multicenter study investigating the effectiveness of outpatient alcohol treatment in Switzerland among 805 clients. Assessments were conducted at treatment admission, discharge, and at 6- and 12-month follow ups. At-risk drinking was assessed through the alcohol use disorders identification test. Treatment retention was defined as regular discharge with or without transition into another institution. RESULTS: Clients aiming to abstain from drinking were more likely to be in retreatment, to be assigned to treatment by a health institution, to have no at-risk alcohol use, and to be already alcohol abstinent at the time of admission relative to clients who aimed to control their drinking. Clients without at-risk alcohol use at admission showed higher treatment retention when aiming for controlled drinking than for abstinence, while there was no difference in treatment retention among clients with at-risk use. Clients with at-risk use at admission were more likely to reach not-at-risk alcohol use status when aiming for alcohol abstinence than for controlled drinking. CONCLUSIONS: Drinking goals are associated with variables of alcohol use and treatment assignment. They have different effects on treatment retention and treatment outcomes according to alcohol use at the time of admission.

Drinking episodes during abstinence-oriented inpatient treatment: dual perspectives of patients and therapists--a qualitative analysis.

AIMS: Treatment programs are frequently confronted with the consumption of alcohol by patients during therapy. This is in conflict with the abstinence agreement upon admission, which is considered to be instrumental for positive treatment outcomes. This qualitative analysis aims, first, to identify the range of patients' causal attributions, addiction concepts and control strategies detected in the narratives of off-site consumption episodes and, secondly, to compare this inventory with the response of the therapists. METHODS: A total of 42 semi-structured face-to face interviews were conducted with patients and their therapists (n = 22) from two major Swiss inpatient alcohol clinics in 2010/2011. Interviews were conducted shortly after the detection of a patient's off-premises alcohol consumption. Textual exploration and systematic coding used ATLAS.ti to identify themes, interpretative categories and prevention strategies shared by the therapists. RESULTS: Elements of outpatient-controlled drinking programs are mirrored in the patients' lay strategies, and similarities with self-change mechanisms can be observed. The dimensionality of therapists' views of the consumption incidents-illustrated by their prevention recommendations-proves to be less differentiated than the control strategies and situational framing of the patients. CONCLUSIONS: The focus on abstinence only and the adoption of the loss-of-control concept limits therapists' ability to feed patients' reports of their drinking episodes and coping efforts into a strength-based approach including a wider range of treatment outcomes.

Augmented reality endoscopic system (ARES): preliminary results.

OBJECTIVES: During endoscopic surgery, it is difficult to ascertain the anatomical landmarks once the anatomy is fiddled with or if the operating area is filled with blood. An augmented reality system will enhance the endoscopic view and further enable surgeons to view hidden critical structures or the results of preoperative planning. METHOD: The skull and endoscope are fixed with optical markers that are used as dynamic reference bases for tracking. A small optical tracking device, the easyTrack 200, which is connected to a computer, calculates the positions of the markers. The endoscope is calibrated and registered for augmenting its video with a 3D model. Images of a black and white checkerboard pattern, with 2.5 mm sized squares, are used for calibration with a Matlab based calibration toolbox. Standard modalities of overlay have been developed, including a CT viewer displaying it as an overlay in the endoscopic video stream, and a 3D viewer to render 3D models of preoperatively segmented structures. The accuracy of the augmented reality system was assessed on a plastic skull. RESULTS: The accuracy is calculated by looking at the difference in pixels of several contours in both a real and an overlay image, obtaining a mean of 3-4 pixels that correspond to sub-millimeter accuracy (pixel to mm ratio calculated previously). Mean error was consistently 1-2 [+/- 0.3] mm. CONCLUSIONS: A novel augmented reality system for endoscopic surgery is presented. Highlighting hidden structures or CT overlays in the endoscope will give more information in difficult situations and enhance the operation quality.

On the postnatal development of the striate cortex (V1) in the tree shrew (Tupaia belangeri).

Histological serial sections, three-dimensional reconstructions and morphometry served to study the postnatal development of V1 in tree shrews. The main objectives were to evaluate the expansion of V1, the implications of its growth on the occipital cortex and, vice versa, the effects of the expanding neocortex on the topography of V1. The future V1 was identified on postnatal day 1 by its granular layer IV, covering the superior surface of the occipital cortices including the poles. A subdivision of layer IV, distinctive for the binocular part, was evident in the central region. V1 expanded continuously with age into all directions succeeded by the maturation of layering. The monocular part was recognized from day 15 onward, after the binocular part had reached its medial border. In reference to the retinotopic map of V1, regions emerged in a coherent temporo-spatial sequence delineating the retinal topography in a central to peripheral gradient beginning with the visual streak representation. The growth of V1 was greatest until tree shrews open their eyes, culminated during adolescence, and completed after a subsequent decrease in the young adult. Simultaneous expansion of the neocortex induced a shifting of V1. Translation and elongation of V1 entailed that the occipital cortex covered the superior colliculi along with a downward rotation of the poles. The enlargement of the occipital part of the hemispheres was in addition associated with the formation of a small occipital horn in the lateral ventricles, indicating an incipient 'true' occipital lobe harbouring mainly cortices involved in visual functions.

A new microbiopsy system enables rapid preparation of tissue for high-pressure freezing.

A microbiopsy system was developed to overcome long sampling times for tissues before they are cryo-fixed by high-pressure freezing. A commercially available biopsy gun was adapted to the needs of small-organ excisions, and biopsy needles were modified to allow small samples (0.6 mm x 1.2 mm x 0.3 mm) to be taken. Specimen platelets with a central slot of the same dimensions as the biopsy are used. A self-made transfer device (in the meantime optimized by Leica-Microsystems [Vienna, Austria]) coordinates the transfer of the excised sample from the biopsy needle into the platelet slot and the subsequent loading in a specimen holder, which is then introduced into a high-pressure freezer (Leica EM PACT; Leica Microsystems, Vienna, Austria). Thirty seconds preparation time is needed from excision until high-pressure freezing. Brain, liver, kidney and muscle excisions of anesthetised rats are shown to be well frozen.

Localised depletion of polymerised actin at the front of Walker carcinosarcoma cells increases the speed of locomotion.

Spontaneously migrating Walker carcinosarcoma cells usually form lamellipodia at the front. Combined treatment with 10(-5)M colchicine and 10(-7)M latrunculin A produces large defects in the cortical F-actin layer at the leading front and suppresses lamellipodia. However, the cortical actin layer at the rear is intact and shows myosin IIA accumulation. These cells, showing no or little detectable cortical F-actin at the front and no morphologically recognisable protrusions, migrate faster than control cells with lamellipodia and an intact cortical actin layer. This documents that the cortical actin layer or actin-powered force generation at the front is redundant for locomotion. Colchicine and latrunculin A have synergistic effects in compromising the cortical layer at the front and in increasing the speed of locomotion, but antagonistic effects on the relative amount of F-actin per cell. Colchicine but not latrunculin A, can increase the proportion of polarised and locomoting cells under appropriate conditions. Locomotion and polarity of cells treated with latrunculin A and colchicine is inhibited at latrunculin A concentrations >10(-7)M, by the myosin inhibitor BDM or the ROCK inhibitor Y-27632. Colchicine and Y-27632 have antagonistic effects on polarity and the speed of locomoting cells. The data show that locomotion of metazoan cells, which normally form lamellipodia, can be driven by actomyosin contraction behind the front (cell body, uropod). They are best compatible with a cortical contraction/frontal expansion model, but they are not compatible with models implying that actin polymerisation or actomyosin contraction at the front drive locomotion of the cells studied.