bluuebunny/crossref_metadata_2025 huggingface dataset:
Phoneme recognition with elliptic discrimination neural units
Authors: Kanedera Noboru , Funada Tetsuo
Published: July 2007

Many researchers achieved high phoneme recognition rates by multilayered neural networks with linear discrimination neural (LDN) units. However, it is difficult to analyze which components of the input are important to each unit in those LDN networks.

This paper proposed a multilayer neural network with elliptic discrimination neural (EDN) units so that the functions of each unit in the network may be interpreted more definitely. The center of the elliptic discrimination boundary of a neural unit corresponds to a typical point in an input space. The radii of the ellipse express the extent of the corresponding components in the input space, hence it becomes clear which components of the input space are important to each unit in the EDN network.

To compare the performance of EDN and LDN networks, recognition experiments of phonemes /b, d, g/ in 5240 tokens of a Japanese speech database were carried out. In the experiments, recognition rates were obtained by EDN networks as high as the rate by an LDN network. Also, it was confirmed which components of the input space are important to each unit in the EDN network.
Graph representation of logic functions to design two‐level MOS networks
Authors: Nishitani Yasuaki , Shimizu Kensuke , Nagumo Masahiko
Published: July 2007

The design problem of two‐level MOS networks with a minimum number of cells is reduced to the covering problem of graphs with a minimum number of cliques.

When every node of the graph corresponds to a minterm, an algorithm which generates an MOS network with a minimum number of cells is presented. The time complexity of this algorithm is O(M)2, where M is the number of minterms.

When every node of the graph corresponds to a prime implicant, a procedure which generates near optimum solutions by selecting prime implicants with special properties is presented. About 2 percent of designed networks for four‐variable functions are not minimal ones.
A searching method of the most similar string in the file of a document retrieval system
Authors: Kobayashi Kiyohiro , Imamura Tsuguyasu , Takahashi Masashi , Kubota Fumiko , Kanaoka Taiho , Hamamoto Yoshihiko , Tomita Shingo
Published: July 2007

To obtain a required document from the uncertain string information inputted by the user in a document retrieval system or an electronic filing system, the string most similar to the inputted string must be searched.

This paper assumes the most general case, where no constraint is imposed on the input error and discusses the efficient method of search for the string in the file which is the most similar to the inputted string. The tree structure is considered to be data structure. The string in the file corresponds to the leaf of the tree. Other vertices of the tree correspond to a string constructed from the set of strings below those vertices as a representative element.

The classification of the set of strings is made based on the similarity between strings. A simulation is executed using 100 to 1000 English words as the strings in the file. The search probability of the string most similar to the input string, as well as the search efficiency based on the number of similarity calculations, are examined to evaluate the usefulness of the proposed method.
Contour extraction by local parallel and stochastic algorithm which has energy learning faculty
Authors: Hongo Sadayuki , Kawato Mitsuo , Inui Toshio , Miyake Sei
Published: July 2007

When a combined Markov random field (MRF) image model is applied to the contour extraction problem, the values of parameters specifying the model cannot be known. However, the parameter values can be learned from image examples containing a contour line. This paper first describes details of the learning algorithm. States of line process representing contour line obeys a probability distribution function determined by three aspects: input image, energy function and energy parameters called potential.

In the learning algorithm presented here, a value of local potential which specifies an MRF image model is learned using the maximum likelihood method from a contour line image given as a teacher. By applying the proposed learning algorithm to real images, energy parameters are obtained that enable contour extraction that is superior in connectivity and has little noise. Moreover, as a consideration of the generalization faculty of the energy learning algorithm, energy learning for images and extracted contours of images (which are not good for learning) are performed using learned parameters. It was verified that contour lines extracted nonlearning images that are of the same quality as that of contour lines of learning images.
Self‐organizing architecture for learning novel patterns
Authors: Yamauchi Kouichirou , Jimbo Takashi , Umeno Masayoshi
Published: July 2007

Although the neuron model is very useful for many applications, it has a serious problem of learning. For example, a neuron model for pattern recognition works well after learning, but it must be retrained on all sample patterns if a new category of patterns is added. On the other hand, humans can add the new category immediately, without relearning all the old patterns. To solve this problem, we propose a new self‐organizing architecture for learning novel patterns. This model can learn novel patterns as soon as they are recognized to be new, just like humans do.
Conditions of efficient updates on network structures
Authors: Konomi Shin'Ichi , Furukawa Tetsuya , Kambayashi Yahiko
Published: July 2007

Redundant network structures allow efficient retrievals. Procedures to design network structures that allow efficient retrievals [9] add redundancies into network structures. However, as redundancies increase, costs of updates increase. When network structures are redundant, costs of updates include costs of updating original data, checking consistencies, and updating derived data.

This paper presents the super‐key condition to reduce the costs of checking consistencies in redundant network structures.

First, constraints required to keep redundant network structures consistent are shown and then a sequence of processes to delete or insert a record in redundant network structures maintaining the constraints is given. Relationships between functional dependencies and updates are discussed to derive the super‐key condition. The condition classifies network structures regarding costs of the processes to delete or insert a record. Finally, a procedure to design network structures that satisfy the super‐key condition is given. The procedure may increase redundancies of network structures to reduce costs of updates.
Recognition of three‐ vowel sequences on the basis of perceptual phoneme boundary lines defined by a flexible model
Authors: Ohtomo Teruhiko , Kaneko Masato , Ohuchi Takao , Hara Ken‐Ichi
Published: July 2007

The authors are attempting to clarify the emphasizing mechanism of phoneme perception in co‐articulation. Psychoacoustic experiments were made on the symmetrical and asymmetrical three‐vowel sequences, and the effect of the preceding or succeeding vowels on the central vowel is examined.

Based on the examined effect, a model is proposed wherein the perceptual phoneme boundary lines of the central vowel are set, considering the three‐vowel sequence as a unit. Using this model, the perceptual phoneme boundary line of the central vowel of the three‐vowel sequence can be defined by adjusting the 50 percent phoneme boundary line in the perceptual phoneme distribution of the steady vowel on F1‐F2 logarithmic plane, according to the positions of the formant frequencies of the preceding and succeeding vowels.

A model is presented here which defines the phoneme boundary lines of the central vowel in the three‐vowel sequence with co‐articulation, by adjusting the 50 percent perceptual phoneme boundary lines of the steady vowel. It is then applied to the real spoken vowels, and its effectiveness is evaluated. Then an automatic recognition system for the three‐vowel sequence is proposed, which is based on the trajectory of the three‐vowel formant frequency and the perceptual phoneme boundary lines set by the flexible model. A recognition experiment is conducted for the three‐vowel sequences using the system, and the usefulness of the system is demonstrated.
Evaluation of range‐checking addressing modes and the architecture of FLATS2
Authors: Ichikawa Shuichi , Sato Mitsuhisa , Goto Eiichi
Published: July 2007

FLATS2 is a cyclic pipeline computer, i.e., a kind of resource‐shared MIMD computer. This paper presents the instruction set design and its realization. It is shown that efficient processings can be realized for the processings such as array processing. The result of evaluation for FLATS2 is shown and discussed. The instruction set of FLATS2 is an extension of the existing scalar instruction set. The addressing mode of FLATS2 includes the range‐checking function, as well as the function to branch according to the result of check. When the access address is within the specified range, the operation is actually executed on the memory operand and the operation branches to the specified address. If the address is outside the range, the operation does not branch but proceeds to the next instruction. If all of those operations are executed by one instruction, the array processing in the numerical calculation and symbolic processing can be made efficient.

In the iterative processing by a loop, for example, the time for the loop control can be combined and concealed by superposing the loop control on the memory access and execution of operation. As a result, data are supplied continuously to the arithmetic operator and a high numerical operation performance is realized. Furthermore, it is permitted in FLATS2 to execute more than one operation by an instruction using the composite instruction, which further improves the operation performance.
Four‐variable AND‐EXOR minimum expressions and their properties
Authors: Koda Norio , Sasao Tsutomu
Published: July 2007

An AND‐EXOR expression (exclusive‐or sum‐of‐products expression: ESOP) is obtained by EXORing arbitrary product terms. First, some properties are shown of minimum ESOPs which are useful for the minimization of ESOPs. Second, a catalog of minimum ESOPs for the representative functions of 4‐variable NP‐equivalence classes is presented. Minimality is defined as first minimizing the number of the product terms and then the number of the literals in the ESOP. Minimum ESOPs are obtained by an exhaustive method. The average number of products to realize the 4‐variable functions by AND‐OR sum‐of‐products expressions is 4.13 and 3.66 by ESOPs.

Minimum ESOPs with four variables or less are obtained easily by the table look‐up of the catalog. The catalog is useful for the minimization and the complexity analysis of ESOPs with five or more variables.
Reviews
Authors: Hennessey Jeannemarie , Freeman Karen C. , Hamilton Phyllis A. , Heacock Maria G.
Published: July 2007

Drug Information Handbook for Perioperative Nursing, AORN and Lexi‐Comp, Inc, 2006; 2,002 pages, $39.95 softcover, or $79.95 softcover with PDA download

The Art of Connecting: How to Overcome Differences, Build Rapport, and Communicate Effectively with Anyone, Claire Raines and Lara Ewing, 2006, 230 pages, $24.95 hardcover

Building on the Promise of Diversity: How We Can Move to the Next Level in Our Workplaces, Our Communities, and Our Society, R. Roosevelt Thomas, Jr., 2006, 256 pages, $27.95 hardcover

One Hundred Orthopedic Conditions Every Doctor Should Understand, Second edition, Roy A. Meals and Scott A. Mitchell, 2006, 400 pages, $65 softcover
New parametrization method for dissipative particle dynamics
Authors: Travis Karl P. , Bankhead Mark , Good Kevin , Owens Scott L.
Published: July 2007

We introduce an improved method of parametrizing the Groot-Warren version of dissipative particle dynamics (DPD) by exploiting a correspondence between DPD and Scatchard-Hildebrand regular solution theory. The new parametrization scheme widens the realm of applicability of DPD by first removing the restriction of equal repulsive interactions between like beads, and second, by relating all conservative interactions between beads directly to cohesive energy densities. We establish the correspondence by deriving an expression for the Helmoltz free energy of mixing, obtaining a heat of mixing which is exactly the same form as that for a regular mixture (quadratic in the volume fraction) and an entropy of mixing which reduces to the ideal entropy of mixing for equal molar volumes. We equate the conservative interaction parameters in the DPD force law to the cohesive energy densities of the pure fluids, providing an alternative method of calculating the self-interaction parameters as well as a route to the cross interaction parameter. We validate the new parametrization by modeling the binary system SnI4∕SiCl4, which displays liquid-liquid coexistence below an upper critical solution temperature around 140°C. A series of DPD simulations were conducted at a set of temperatures ranging from 0°C to above the experimental upper critical solution temperature using conservative parameters based on extrapolated experimental data. These simulations can be regarded as being equivalent to a quench from a high temperature to a lower one at constant volume. Our simulations recover the expected phase behavior ranging from solid-liquid coexistence to liquid-liquid coexistence and eventually leading to a homogeneous single phase system. The results yield a binodal curve in close agreement with the one predicted using regular solution theory, but, significantly, in closer agreement with actual solubility measurements.
Effect of substrate-induced strain on transport and magnetic properties of epitaxial La0.66Sr0.33MnO3 thin films
Authors: Dey P. , Nath T. K. , Taraphder A.
Published: July 2007

Electrical transport and magnetic properties of epitaxial 500Å La0.67Sr0.33MnO3 (LSMO) thin films, grown on different substrates having different lattice strains, are found to exhibit strong correlation with Jahn-Teller (JT) strain. The authors’ study reveals that a sufficiently large JT strain gives rise to distinct insulating state in LSMO films even below the respective para-ferromagnetic Curie temperature, which is a contradiction with the established phase diagram of Sr doped manganites. The authors have presented a microscopic model for the analysis of their data instead of the usual expansion around the undistorted state. The model incorporates two relevant eg orbitals and the effect of both JT and bulk strains on the transition temperature via double exchange.
New method for calculating bound states: The A1 states of Li3 on the spin-aligned Li3(1A′4) potential energy surface
Authors: Li Xuan , Brue Daniel A. , Parker Gregory A.
Published: July 2007

In this paper, we present a calculation for the bound states of A1 symmetry on the spin-aligned Li3(1A′4) potential energy surface. We apply a mixture of discrete variable representation and distributed approximating functional methods to discretize the Hamiltonian. We also introduce a new method that significantly reduces the computational effort needed to determine the lowest eigenvalues and eigenvectors (bound state energies and wave functions of the full Hamiltonian). In our study, we have found the lowest 150 energy bound states converged to less than 0.005% error, and most of the excited energy bound states converged to less than 2.0% error. Furthermore, we have estimated the total number of the A1 bound states of Li3 on the spin-aligned Li3(1A′4) potential surface to be 601.
Culture and Theater as Foundation for National Identity Formation in the Russian Far East: Where Europe Meets Asia
Authors: Ossipova Erika V.
Published: July 2007

For several centuries the overall trend in the world development has been along the way paved by Western civilization. Hence, the predominant flow has been based on borrowed Western cultural features. The issue of cultural interaction among nations with different culture types became fairly topical in contemporary society. Humankind now faces the legacy of moral decline of the past century and is trying to find a way out of its ideological dead end through other cultures and civilizations. In addition, the globalization processes that developed towards the end of the last century have also embraced the nations' cultural ties, turning the cross-cultural communication into an integral part of humankind's existence. The unique role of Russia in Northeastern Asia calls for an answer to the following question: Is there any cultural interaction between the Russian Far East, on the one hand, and the East Asian nations, on the other? And if so, what are its manifestations and how big are they?
CONTINUING MEDICAL EDUCATION
Authors: Marshall J.R.
Published: July 2007

Some of the problems facing the concept of continuing medical education are discussed. It is argued that an educational program is essential if any continuing medical education is to be successful. Some basic issues in the development of print programs are mentioned. Discussion then takes place on practical ways of developing valid programs, and the continuing education program of the Royal Australian College of General Practitioners (check program) is used as an illustration.

Brief mention is made of special issues involving the provision of self‐assessment materials. While still restricted by cost and accessibility, the future concept of computerized video programs is examined. The potential for using continuing medical education in the areas of peer review and recertification is discussed.

As the Paper attempts to deal with continuing medical education for the medical profession, the vital issue of patient education is not addressed here.
STRATEGIES FOR CONTINUING MEDICAL EDUCATION IN SUBSTANCE ABUSE
Authors: Ewan Christine
Published: July 2007

Developing methods to motivate practitioners to undertake continuing education is a general problem.

Successful continuing education programs should be based on principles of adult learning — they should provide a means for doctors to recognize and assess their own learning needs, emphasize practical and behavioural aspects of the topics, provide a range of options for learning and provide continuing support to sustain behavioural change.
EDUCATIONAL STRATEGIES IN DRUG EDUCATION: A FOCUS FOR MEDICAL PRACTITIONERS IN THE PROBLEMS ASSOCIATED WITH ALCOHOL AND DRUG USE
Authors: Irwin R.P.
Published: July 2007

The medical practitioner, as an adult learner, has a part to play in drug education, which extends beyond the confines of medical practice. General practice is changing to meet the pressure for health promotion, which is implicit in the philosophy of the National Drug Education Program. A comprehensive approach is required from the adult learner in this context.

Drug education is an important part of education and an integral part of health education. The scenario for health education seeks the development of personal health behaviour which will affect the lifestyle of the community.

Learning objectives and educational approaches are to be set at various levels. General practitioners, as self‐directed learners, have a wider range of educational strategies available to them to support educational interventions which assist with the problems associated with alcohol and drug use.
INITIATION INTO POST‐GRADUATE EDUCATION: A PERSONAL IN‐SERVICE APPRAISAL
Authors: Whyte Malcolm
Published: July 2007

For most of us working in this field, appropriate education has had to be gained almost entirely through learning on‐the‐job. It is rather like parachuting ill‐prepared and ill‐equipped into an unfamiliar, neglected, confusing territory to tackle tasks which are complex, poorly understood and looked upon with disdain and despair by many people.

With this picture in mind, I have reviewed my own experiences since taking the leap five years ago, to crystallize out of them what seems to have been of most value and to be pertinent to a discussion on education in this field: recognizing that learning on‐the‐job, as a form of in‐service training, is desirable, necessary and inevitable, but when, how and the extent to which it is relied upon in a program of training, are critical questions for planners. I deal first with the bewildering array of items which confronts the initiate, all clamouring for immediate new knowledge, understanding, skills and action. These have to be sorted out into manageable categories, given an order of priority, and tackled as efficiently as possible by selective reading, consulting, visiting, recording, doing and, most importantly, thinking. Finally, I expose several ways of looking at aspects of this territory which I regard as helpful, even essential, for getting the complexities into perspective and having a framework for continuing education.
AN APPRAISAL OF THE LEDERMANN THEORY
Authors: de Burgh S.P.H.
Published: July 2007

The Ledermann approach to alcohol prevention has revived public health thinking on the subject by emphasizing the importance of total consumption in populations. This importance has been overstated, however, for the proposal that there is a fixed relationship between mean consumption and the prevalence of heavy drinking cannot be supported. There is a general relationship between mean consumption and heavy drinking, and between heavy drinking and alcohol problems, so it seems prudent to support measures such as price manipulation which restrain overall consumption. However, any such measures have to be evaluated according to their effects and not according to their theoretical background. Nor should they be emphasized at the expense of measures which attempt to prevent alcohol problems rather than reduce total consumption. The Ledermann theory has no further contribution to make to alcohol prevention and continuing debate over its validity has little point.
RESPONDING TO ALCOHOL AND DRUG PROBLEMS
Authors: WODAK A. D.
Published: July 2007

Despondency about the efficacy of both diagnosis and treatment for alcohol‐related problems is common. Several major causes of morbidity and mortality in our community are characterised by under‐diagnosis in the community, under‐diagnosis on presentation, lack of highly effective treatment or poor delivery of treatment to those most in need. Similar problems are encountered in the delivery of treatment to individuals with alcohol‐related problems in the community. Most alcohol‐related problems in the community are associated with only moderately elevated alcohol consumption, although the small number of individuals with exceptionally high intake have a higher relative risk of developing problems. The number of individuals exposed to a low risk of problems will be disproportionately influenced by changes in mean alcohol consumption. Approaches to prevention follow socio‐cultural, public health, or consumption models. Compelling evidence closely links indices reflecting harm to changes in alcohol consumption. The challenge of prevention of alcohol‐related problems is to devise measures which are acceptable to the entire population, yet also deal with problems associated with a small minority.
USING COMMUNITY RESOURCES
Authors: WIDMER BLAIR
Published: July 2007

In the outer Eastern Suburbs of Melbourne there are significant community projects. The Maroondah Social Health Centre looks at the social and emotional needs of the community, helping to reduce the loneliness and lack of self‐esteem which can lead to alcoholism and addictive behaviour. Maroondah Alcohol Recovery Project with its two half‐way houses for dry alcoholic men and women, besides helping the long term rehabilitation of its residents, is helping the community to understand the problems of alcoholism and addictive behaviour.
HEROIN DEPENDENCE: INPATIENT DETOXIFICATION WITH CLONIDINE
Authors: STANHOPE JOHN M. , CURRY KENNETH H. , NAYER RAVI
Published: July 2007

The traditional regime for detoxification of heroin dependence at this Clinic has been based on sedation with chlormethiazole or chlordiazepoxide, supplemented with chlorpromazine. A new regime based on clonidine has been compared with this and found superior in that fewer patients on clonidine were discharged for misbehaviour and fewer patients on clonidine required supplementary medication. Clonidine was as effective as the sedative regime in relieving most withdrawal symptoms, with the additional advantage that clients who were less sedated were more responsive to supportive counselling.
Thermoregulatory Responses in Alcoholism
Authors: Robinson B. J. , Johnson R. H. , Lambie D. G. , Whiteside E. A.
Published: July 2007

Abstract: The thermoregulatory responses to acute heat stress were examined in twelve alcoholics and in eight control subjects. The alcoholic subjects had higher temperatures after heat exposure (P<0.05). This group also had reduced weight loss after heat exposure (P<0.05) and in five alcoholic subjects, all of whom had evidence of peripheral neuropathy, there was impaired distal sweating; there was no evidence of compensatory sweating.
Alcoholics: Their Substance Use and Psychiatric Features
Authors: Blankfield Adele
Published: July 2007

Abstract: Fifty consecutive clients admitted for treatment of alcohol dependence were questioned about their past use of prescribed or illicit drugs, taken separately or together with alcohol. Abuse of other drugs and overdose behaviour were found to be significantly more common in patients with personality disorders of the antisocial, impulsive type. These behaviours are probably related to personality rather than being specific to alcohol dependent persons. Behavioural cues which might constitute drug acquisitive behaviour are postulated.
The Outcome of Occupational Referrals
Authors: Parmeter Yvonne , Walsh Raoul
Published: July 2007

Abstract: A follow‐up study was undertaken of all clients referred to the Hunter Drug Advisory Service from their place of employment during the period 1978‐82. Data are presented describing the age, sex, principal drug problem(s) and the period of follow‐up of the clients. In addition the amount and type of treatment received by each client is briefly discussed. At follow‐up 12 of the 24 clients (50%) were judged to have been successfully rehabilitated in terms of their work performance. Successful clients were on average 14 years younger than those judged unsuccessful. The degree of treatment received including involvement in Alcoholics Anonymous did not appear to influence the quality of outcome.
Stereotyping by the Clinician: An Impediment to Progress
Authors: Larkins K.
Published: July 2007

Abstract: The study of addictions has produced useful constructs and models that have assisted in the understanding of the condition, but they have also led to the development of set and immutable beliefs, with the result that the essence of the condition is lost. A plea is made for more flexibility in treatment options also.
The Detection and Management of Patients with Excessive Alcohol Consumption in General Practice
Authors: Haines A. P. , Wallace P. G.
Published: July 2007

Abstract: Several studies have suggested that only a minority of excessive drinkers in the population are known to their general practitioners. We have compared several methods for the detection of excessive alcohol consumption in patients in primary care. In addition we are evaluating the impact of general practitioner intervention on these patients.

A self administered questionnaire, the Health Survey Questionnaire (HSQ) was mailed to 3,997 patients registered with two general practices in North West London. Replies were received from 75% of the patients. Of the respondents, 11% males, and 5% females were identified as excessive drinkers (using the limits of 42 units per week or greater for males, and 21 units per week or greater for females). In the practice where a disease register was kept, use of the HSQ resulted in more than four‐fold increase in the number of patients known to be excessive drinkers. Around 45% of the excessive drinkers expressed concern about their drinking. The HSQ compared favourably with a standard drinking interview, breath alcohol measurement and laboratory tests of excessive consumption in the detection of excessive alcohol consumption. This flexible and low cost instrument could be used to increase the detection of excessive drinkers in primary care.

We are currently undertaking a pilot randomised trial of the effects of GP intervention in patients with excessive alcohol consumption involving follow up of 60 such patients over one year. A multi centre trial including around 1,000 patients from 10 group practices is planned for 1985.
Controlled Drinking — an Approach to Management
Authors: Robertson Ian H.
Published: July 2007

Abstract: The aim of this paper is to give an account of controlled drinking ‐ its origins, its clinical and experimental basis, its role in treatment, education and public health policy. There follows a discussion of the practicalities of implementing controlled drinking treatment regimes.

The origins of the disease model of alcohol problems in the AA movement of the 30's and 40's which had close links with the Yale Center of Alcohol Studies, are covered briefly. The explosive response in the USA to the publication of D. L. Davies' paper and to the release of the Rand Report are discussed in the context of the recent history of the disease model movement. The most recent controversy, that surrounding the Sobells' studies, is briefly discussed.

A number of experimental drinking studies which throw light on such mechanisms as loss of control and craving are reviewed and the arguments for an alternative theoretical framework for alcohol use, grounded in social learning theory, are presented. The work of Mello, Mendelson, Bigelow, Hodgson, Rankin and several others are figured in this overview. The first controlled drinking studies in Australia and the USA are described in the context of this behavioural research, and subsequent clinical research on controlled drinking, including some recent unpublished Scottish work, is outlined.

The advantages of including controlled drinking as a therapeutic and health education option are discussed. In particular, the possibilities for recruiting less severely dependent problem drinkers, for breaking down theoretical and practical boundaries between health education and treatment services and for improving treatment outcome results are considered.

Finally, some of the practicalities of carrying out controlled drinking treatement and advice are reviewed. A study of the effects of a controlled drinking self‐help manual is briefly described. Some recommendations about future directions for policy and research are then made.
Co‐operation — Can it be Done and How?
Authors: Hawks D. V.
Published: July 2007

Abstract: The case for co‐operation is presented along with that for confrontation. Recent encouraging developments in the detection and treatment of drug related problems need to take place in an environment calculated to reduce the incidence of those problems. A proposal to liberalise South Australia's licensing laws is instanced as a case for confrontation.
Crises and Motivation for Treatment in Alcoholics
Authors: Blankfield Adele
Published: July 2007

Abstract: A minority of alcohol dependent persons ever enters specialized treatment units and there is little information on why they are admitted. This study of 50 consecutive clients revealed that admission occurred in the presence of a recent psychosocial crisis in an otherwise protracted disorder. Motivation for treatment was difficult to assess. The decision to admit for inpatient rather than outpatient treatment tended to be influenced by the distressed state of the client or the degree of disturbance created in relation to the crisis. The complex issues of crisis, motivation and treatment compliance are reviewed.
Adolescent Tobacco Dependency
Authors: Bittoun R.
Published: July 2007

Abstract: The role of nicotine dependence in the establishment of a heavy smoking habit in young people has been little investigated. In this study of high school students, aged 16–18 years, 41% had scores on the Fagerstrom Nicotine Dependency Questionnaire which indicated a high level of nicotine dependence, comparable with that of adult smokers attending a smoking cessation clinic. The implications of this finding are briefly discussed.
Background to the Conference
Authors: Saunders John B.
Published: July 2007

Abstract: This introductory paper summarises the background to the Medical Education Conference on Alcohol and Drugs, describes its aims and outlines the format that was adopted to facilitate discussion of the issues and the devising of recommendations for improving medical education in this field.
Core Teaching Issues and Potential Difficulties
Authors: Mathews J.D.
Published: July 2007

Abstract: Theories of alcoholism are considered, as is the variation in individual response to alcohol, and the reasons for this. The association between alcohol use and conditions such as hypertension and neuropsychological impairment is outlined and the causal status of the alcohol is discussed. Flexible intervention strategies are called for.
Early Intervention for Alcohol and Drug Problems: Core Issues for Medical Education
Authors: Skinner Harvey A.
Published: July 2007

Abstract: There is increasing evidence that lifestyle problems, such as excessive drinking, cigarette smoking and drug abuse, can be successfully treated by brief intervention. The primary care physician is in a good position to identify these problems among patients, and to intervene with brief counselling at an early stage when prognosis is more favourable. This article provides a blueprint of core teaching issues for medical education on early intervention. Four specific questions are addressed: 1. who is the target population? 2. what are the key indicators? 3. how should physicians intervene? and 4. why is early intervention important? Practical strategies are discussed for early detection and brief counselling that can be readily implemented in busy clinical settings.
Aims and Behavioural Objectives of an Education Programme
Authors: Cowley James
Published: July 2007

Abstract: This paper argues that clear objectives are crucial to drug education. Unless considerable effort is spent on planning the objectives of national and local drug education generally and medical drug education specifically, we may end up with just an interesting range of projects rather than a major improvement in the situation. The paper discusses one potentially fruitful approach.
Core Content Areas for Teaching on Alcohol and Other Drugs in the Undergraduate Curriculum
Authors: O'Hagan John J.
Published: July 2007

Abstract: A draft of an idealized core curriculum on alcohol and drug studies for the undergraduate medical course is presented. Five major core content areas are described in order of priority. For each of these areas, the educational objectives in the form of knowledge, skills, and attitudes are outlined. For each objective, specific teaching approaches, evaluation methods, and appropriate timing in the curriculum are suggested. Priorities and problems in implementation are discussed.
Drug and Alcohol Education in the Medical Profession
Authors: Krivanek Jara A.
Published: July 2007

Abstract: This paper defines some of the issues that underlie the reluctance of many doctors to identify and treat patients with alcohol and drug problems. Ways of overcoming the negative feelings doctors have towards this field are suggested. Some general principles for developing medical education and training in drug and alcohol problems are outlined, and some “core” topics in diagnosis and treatment are proposed. Finally the organisation and power structure of medical institutions are discussed and the various levels at which developments in alcohol and drug education can be promoted are identified.
The National Campaign Against Drug Abuse
Authors: Drew L.R.H.
Published: July 2007

Abstract: In his presentation Dr Drew outlined the aims and the strategies contemplated for the forthcoming national campaign against drug abuse. They would be debated at the Special Premiers' Conference in April 1985. He sought advice from participants about the most effective way of advancing medical skills in the drug and alcohol field, both through existing training programmes and by means of “emergency” training.
Buphrenorphine: Detoxification After Maintenance Treatment
Authors: Quigley Allan J. , Seow Simon S.W. , Ilett K.F. , Dusci L. , Swensen G. , Harrison‐Stewart A. , Rappeport L.
Published: July 2007

Abstract: Buprenorphine, a partial opiate agonist, has shown promise as a new drug for the maintenance, treatment and detoxification of heroin addictions. In this double blind study 15 outpatient heroin addicts were stabilised on sublingual buprenorphine (4mg/day) and then the effects of a 30 day gradual detoxification were assessed. For the first 2 weeks of the study, while taking 4mg of buprenorphine subjects reported symptoms of opiate intoxication and withdrawal, 2–4 and 8–9 hours respectively after each day's dose. During this time 12 of the 15 subjects had one or more opiate positive urine specimens and 48% of all urine specimens were opiate positive. As detoxification progressed subjects reported an earlier onset and a greater number of withdrawal symptoms. In addition they requested symptomatic treatment. The prescription of dextropropoxyphene napsylate (up to 800mg per day) and clonidine hydrochloride (up to 450mcg per day) controlled the subjects' withdrawal discomfort. Of the 6 subjects who completed the detoxification and the two‐week follow‐up period, 5 had one or more opiate positive urine specimens and 57% of all specimens were opiate positive. The study has shown that sublingual buprenorphine is acceptable to outpatient heroin addicts and that a gradual withdrawal of the drug can be undertaken successfully. However, the results suggest that doses greater than 4mg/day will be needed to suppress illicit opiate use.
Peer Review and the Editorial Process
Authors: Landauer Ali A.
Published: July 2007

Abstract: Peer reviewers are selected because they are experts in the area with which the manuscript deals. These referees evaluate the submission and give an opinion to the editor. In either accepting or rejecting a manuscript the editor and peer reviewers are guided by a number of principles. These include that ethical standards are maintained; that the experimental design is accurate; that the research is original, not too trivial and that the work of others is properly acknowledge; that the results are correctly interpreted; that style, presentation and the way references are cited and listed follows the convention of the journal; and that the stylistic qualities of the manuscript are improved, thus making the article intelligible to the non‐expert. The good referee will evaluate the manuscript promptly and will usually recommend one of the following alternatives: acceptance, acceptance with minor modifications, resubmission after major modifications, or rejection.
What is Controlled Drinking?
Authors: Ryder David
Published: July 2007

Abstract: Different terms have been utilized to define the drinking dispositions of problem drinkers which are neither total abstinence nor overtly harmful. The main terms that have been used are “normal drinking”, “controlled drinking”, “non‐problem drinking” and “attenuated drinking”. Each concept is considered and criticized and it is concluded that clinicians and researchers need to be very aware of the overlap that exists between the different definitions. It is concluded that the greatest value that has been achieved from the advent of controlled drinking treatmentand the ensuing debate is not that another treatment option has been developed, but that the perception of alcohol related problems has been changed to encompass the drinking of the population as a whole.
The National Media Campaign Revisited
Authors: Grichting Wolfgang L. , Barber James G.
Published: July 2007

Abstract: A representative sample of the North Queensland population was interviewed at the end of Phase I of the national media campaign of the National Campaign Against Drug Abuse (NCADA) to ascertain public perception of the campaign. While 93% had heard about the NCADA only 75% had received the booklet which was to be distributed to all households. Respondents were somewhat critical of the booklet and the various television and radio programs. Measured on a scale of 1 (extremely poor) to 6 (extremely good) most components of the media campaign scored just below 4. Thirty percent of respondents said they had gained some information from the booklet. In half this was about the physiological effects of drug abuse and in half about the National Drug Information telephone line. Of the 919 respondents, only 15 had attempted to ring the service and 9 received a satisfactory answer. Most respondents considered that current efforts to control drug abuse were inadequate.
Genetics of Alcoholism: an Overview
Authors: Deitrich Richard A.
Published: July 2007

Abstract: There is little doubt that human alcoholism carries a significant genetic risk factor. Studies in Scandinavia over many years and more recently elsewhere have clearly shown this relationship. However, we do not know what characteristics or determinants of alcoholism are inherited and this is the focus of current research. Animal genetic studies have contributed to the field and promise to be even more important in the future in defining the neurochemical basis of behavior observed in human alcoholics. The premise that understanding the enzymology and genetics of alcohol metabolism alone would solve the alcoholism problem has not materialized in spite of major advances in the understanding of the enzymes responsible for ethanol metabolism.
Behavioral and Biochemical Correlates of Alcohol Drinking Preference: Studies on the Selectively Bred P and NP Rats
Authors: Lumeng Lawrence , Murphy James M. , McBride William J. , Li Ting‐Kai
Published: July 2007

Abstract: The alcohol‐preferring P and alcohol‐nonpreferring NP lines of rates have been selectively bred and used to study the behavioral and biochemical correlates of alcohol‐seeking behavior. The P rats satisfy all the perceived criteria for an animal model of alcoholism. Specifically, free‐fed P rats voluntarily drink alcoholic solutions (10 to 30% v/v) to intoxication; they bar‐press to obtain alcohol and self‐administer ethanol intragastrically when food and water are available; and they acquire metabolic and neuronal tolerance and develop physical dependence when they drink alcohol chronically in a free‐choice situation. The spontaneous motor activity in the P rats, but not in the NP rats, is stimulated acutely by low doses of alcohol. With a single hypnotic dose of ethanol, acute tolerance develops faster and to a greater degree and persists many days longer in the P than in the NP rats. These differences in response to ethanol may explain the disparate alcohol drinking behaviors of the P and NP rats. Biochemically, the P rats exhibit decreased serotonin levels in several brain regions including the nucleus accumbens. Serotonin uptake inhibitors curtail the alcohol drinking of the P rats suggesting a role of serotonin in mediating alcohol preference.
Fetal Alcohol Syndrome and Brain Damage
Authors: West J.R. , Kelly S.J. , Goodlett C.R.
Published: July 2007

Abstract: Alcohol exposure in utero causes mental retardation in humans. This paper reviews animal studies of alcohol exposure during both pre‐natal and early post‐natal periods demonstrating that alcohol disrupts the structural development of the central nervous system. More specifically, the proliferation of neurons has been delayed. Migration patterns are altered in the cerebral cortex where neuronal precursors remain in the deep layers rather than continuing into the more superficial layers. Differentiation of dendritic arborization appears to be suppressed in pyramidal neurons in the cortex and hippocampus and aberrant synaptic connectivity can be observed. The distribution and shape of dendritic spines appear immature at some time periods, although these alterations may recover by adulthood. The changes in the development of the central nervous system are reflected in behavioural dysfunction.
Regional Vulnerability of the Developing Brain to Alcohol Exposure
Authors: West J.R. , Bonthius D.J. , Hamre K.M. , Pierce D.R.
Published: July 2007

Abstract: These experiments were designed to look at regional vulnerability of the brain as a function of the daily dose and pattern of alcohol administration. Rat pups were given alcohol, using an artificial rearing technique, during postnatal days 4–10, a time period of brain growth which corresponds to that which occurs in humans during the third trimester. Alcohol was administered in 2 different paradigms: either continuously (with feedings every 3 hours) or condensed (with alcohol in 4 of 12 daily feedings). Regional weights, areal measurements or cell counts were recorded. With the condensed paradigm, a daily dose of 4.5 g/kg significantly lowered total brain weight and cerebellar weight, but a higher dose (6.6 g/kg) was needed to decrease brainstem weight significantly. Areal measurements revealed that continuous exposure to 9.8 g/kg/day reduced the hippocampus 26% and the cerebellum 15%, while the dentate gyrus was not affected. Following condensed exposure (6.6 g/kg/day), the cerebellum was reduced 23%, while the hippocampus and dentate gyrus were not significantly affected. Cell count data produced similar results. There was regional vulnerability with different brain regions and different neuronal populations within a single region unequally affected as a function of both daily alcohol dose and pattern of administration.
Structural Assessment of the Experimental Alcohol‐Treated Brain
Authors: Phillips S.C.
Published: July 2007

Abstract: Quantitative assessment of the protein content and synaptic density of various brain regions in experimental animals have been two popular techniques for demonstrating the effects of treatment with ethanol. There do exist other methods of assessing loss of nervous tissue after ethanol treatment which are less time‐consuming than chromatography and electron microscopy. Superfusion provides an uncomplicated direct measuring technique of applying any toxin to central nervous tissue, and Nauta staining of light microscopy sections provides an indicator of brain regions most sensitive to the toxin. Past experiments by various researchers involving long periods of ethanol treatment to experimental animals can be better designed to provide further insight into the mechanisms by which the alcoholic condition leads to brain damage. This involves a different approach in such a way as to separate brain damage during withdrawal from that occurring during intoxication, and to separate brain damage due to interacting treatments (as in the case of thiamin deficiency and ethanol administration) from that due to the accumulative sum of such treatments. The advantages of such approaches will be described.
Cerebro‐spinal Fluid Studies in Alcoholics and Violent Offenders
Authors: Nutt David , Adinoff Bryon , Ravitz Bernard , George Ted , Risher‐Flowers Debra , Eckardt Michael , Bone George , Martin Peter , Linnoila Markku
Published: July 2007

Abstract: Firstly, the contribution that cerebro‐spinal fluid (CSF) studies have made to our understanding of the pathophysiology of alcohol withdrawal is addressed. Secondly, the developing literature, from our own studies and those of others, on abnormal CSF measurements in alcoholics and violent offenders is reviewed, with particular regard to impulsive murderers and arsonists. It is concluded that there is CSF evidence for increased norepinephrine function in alcohol withdrawal and an underlying serotonin hypofunction in impulsive disorders including some forms of alcoholism. Finally we report that patients with Korsakoff's syndrome may have central serotonin dysfunction since they show memory improvements during treatment with the serotonin uptake blocker fluvoxamine. Furthermore, these improvements correlate with the magnitude of change that fluvoxamine produces in CSF concentrations of the serotonin metabolite 5‐HIAA.