Effects of a Transdiagnostic Internet Intervention («velibra») for Anxiety Disorders in Primary Care: Results of a Randomized Controlled Trial

Internet-based cognitive behavioral self-help treatment (ICBT) for anxiety disorders has shown promising results in several trials, but there is yet a lack of studies of ICBT in „real world” primary care settings. In this randomized controlled trial we recruited participants through general practitioners. The aim of the study was to examine whether treatment-as-usual (TAU) in primary care settings plus ICBT is superior to TAU alone in reducing anxiety symptoms and other outcome measures among individuals meeting diagnostic criteria of a least one of three anxiety disorders (social anxiety disorder, panic disorder with or without agoraphobia, generalized anxiety disorder). 150 adults fulfilling diagnostic criteria for a least one of the anxiety disorders according to a diagnostic interview are randomly assigned to one of the two conditions: TAU plus ICBT versus TAU. Randomization is stratified by primary disorder, medication (yes/no) and concurrent psychotherapy. ICBT consists of a transdiagnostic and tailored Internet-based self-help program for several anxiety disorders which also includes cognitive bias modification for interpretation (CBM-I). Primary outcomes are symptoms of disorder-specific anxiety measures and diagnostic status after the intervention (9 weeks). Secondary outcomes include primary outcomes at 3-month follow-up and secondary measures such as general symptomatology, depression, quality of life, adherence to ICBT and satisfaction with ICBT. The study is currently being completed. Primary results along with results for specific subgroups (e.g. primary diagnosis, concurrent medication and/or psychotherapy) will be presented and discussed.

A sorrow shared is a sorrow halved? Internet-based group therapy versus individual therapy for social anxiety disorder: A randomized controlled trial

Purpose: Social anxiety disorder is one of the most researched conditions in the field of Internet-based self-help. Various studies have shown that cognitive-behavioral treatments can be efficacious to reduce social phobic symptoms. Most of the interventions tested include some form of support, whereas the efficacy of a web-based group format has yet to be investigated. The present study aims at investigating the possible added value of therapist-guided group support in an Internet-based guided self-help treatment for SAD. Methods: A total of 150 adults with a diagnosis of SAD are randomly assigned to either a wait-list control group or one of two active treatment conditions. Participants in the two active conditions use the same Internet-based self-help program, either with individual guidance by a therapist or with the support of a therapist-guided group of 6 individuals. In the group condition, participants communicate with each other via an integrated, protected discussion forum. The primary outcome variables are symptoms of SAD and diagnostic status immediately after the intervention (12 weeks) and at 6-month follow-up. Secondary endpoints are general symptomatology, depression, quality of life and adherence to treatment. Furthermore, process variables such as group processes and the working alliance are studied. Results: Results are currently being analyzed. Results at post-treatment will be presented and discussed. Potential moderating and mediating variables of treatment success will be addressed. Conclusion: The results of this study should indicate whether therapist-guided group support could enhance the efficacy of an internet based self-help treatment for SAD. This novel treatment format, if shown efficacious, could represent a cost-effective option and could be further modified to treat other conditions.

Adjustment Disorders Are Uniquely Suited for eHealth Interventions: Concept and Case Study

Background: Adjustment disorders (also known as mental distress in response to a stressor) are among the most frequently diagnosed mental disorders in psychiatry and clinical psychology worldwide. They are also commonly diagnosed in clients engaging in deliberate self-harm and in those consulting general practitioners. However, their reputation in research-oriented mental health remains weak since they are largely underresearched. This may change when the International Statistical Classification of Diseases-11 (ICD-11) by the World Health Organization is introduced, including a new conceptualization of adjustment disorders as a stress-response disorder with positively defined core symptoms. Objective: This paper provides an overview of evidence-based interventions for adjustment disorders. Methods: We reviewed the new ICD-11 concept of adjustment disorder and discuss the the rationale and case study of an unguided self-help protocol for burglary victims with adjustment disorder, and its possible implementation as an eHealth intervention. Results: Overall, the treatment with the self-help manual reduced symptoms of adjustment disorder, namely preoccupation and failure to adapt, as well as symptoms of depression, anxiety, and stress. Conclusions: E-mental health options are considered uniquely suited for offering early intervention after the experiences of stressful life events that potentially trigger adjustment disorders.

Resistencia adhesiva de dos agentes de fijación a base de resinas

Los agentes de fijación a base de resina autoacondicionantes - autoadhesivos (SE/SA) fueron desarrollados con el objetivo de simplificar la técnica de cementado a un solo paso, ahorrando tiempo y errores por parte del operador. El objetivo de este trabajo fue evaluar si dicha simplificación influye negativamente sobre los valores adhesivos tal como sucediera en los sistemas adhesivos a esmalte y dentina autoacondicionantes. Se confeccionaron 20 probetas de dentina en las cuales se cementaron probetas de resina compuesta: 10 muestras fueron cementadas con un cemento de grabado total (TE) y 10 con un cemento SE/SA y conservadas a 37 ºC y 100 % de humedad hasta su ensayo mecánico. Los resultados observados muestran una disminución en la resistencia adhesiva de los cementos SE/SA. Esto se explica por la menor traba micro mecánica generada por la presencia del barro dentinario y por el menor coeficiente de penetración de los monómeros modificados en estos cementos comparados con los cementos de resinas convencionales.

Análisis de bocinas en MatLab

El presente proyecto parte de un programa utilizado en las prácticas de laboratorio en la asignatura Antenas y Compatibilidad Electromagnética del sexto semestre llamado SABOR, que pretende ser actualizado para que en las nuevas versiones de los sistemas operativos ofrecidos por la compañía Windows pueda ser operativo. El objetivo principal será diseñar e implementar nuevas funcionalidades así como desarrollar mejoras y corregir errores del mismo. Para su mejor entendimiento se ha creado una herramienta en entorno MATLAB para analizar uno de los tipos más comunes de Apertura que se utilizan actualmente, las bocinas. Dicha herramienta es una interfaz gráfica que tiene como entradas las variables elementales de diseño de la apertura como por ejemplo: dimensiones de la propia bocina o los parámetros generales comunes a todas ellas. A su vez, el software nos genera algunos de los parámetros de salida fundamentales de las antenas: Directividad, Ancho de haz, Centro de fase y Spillover. Para el correcto desarrollo del software se ha realizado numerosas pruebas con el fin de depurar y corregir errores con respecto a la anterior versión del SABOR. Por otra parte se ha hecho también hincapié en la funcionalidad del programa para que sea más intuitivo y evitar complejidades. El tipo de antena que se pretende estudiar es la bocina que consiste en una guía de onda en la cual el área de la sección se va incrementando progresivamente hasta un extremo abierto, que se comporta como una apertura. Se utilizan extensamente en satélites comerciales para coberturas globales desde órbitas geoestacionarias, pero el uso más común es como elemento de radiación para reflectores de antenas. Los tipos de bocinas que se van a examinar en la herramienta son: Sectorial H, Sectorial E, Piramidal, Cónica, Cónica Corrugada y Piramidal Corrugada. El proyecto está desarrollado de manera que pueda servir de información teórico-práctico de todo el software SABOR. Por ello, el documento además de revisar la teoría de las bocinas analizadas, mostrará la información relacionada con la programación orientado a objetos en entorno MATLAB cuyo objetivo propio es adquirir una nueva forma de pensamiento acerca del proceso de descomposición de problemas y desarrollo de soluciones de programación. Finalmente se ha creado un manual de autoayuda para dar soporte al software y se han incluido los resultados de diversas pruebas realizadas para poder observar todos los detalles de su funcionamiento, así como las conclusiones y líneas futuras de acción. ABSTRACT This Project comes from a program used in the labs of the subject Antennas and Electromagnetic Compatibility in the sixth semester called SABOR, which aims to be updated in order to any type of computer running a Windows operating systems(Windows 7 and subsequent versions). The main objectives are design and improve existing functionalities and develop new features. In addition, we will correct mistakes in earlier versions. For a better understanding a new custom tool using MATLAB environment has been created to analyze one of the most common types of apertura antenna which is used for the moment, horns. This tool is a graphical interface that has elementary design variables as a inputs, for example: Dimensions of the own horn or common general parameters of all horns. At the same time, the software generate us some of the fundamental parameters of antennas output like Directivity, Beamwidth, Phase centre and Spillover. This software has been performed numerous tests for the proper functioning of the Software and we have been cared in order to debug and correct errors that were detected in earlier versions of SABOR. In addition, it has also been emphasized the program's functionality in order to be more intuitive and avoiding unnecessary barriers or complexities. The type of antenna that we are going to study is the horn which consists of a waveguides which the section area has been gradually increasing to an open-ended, that behaves as an aperture. It is widely used in comercial satellites for global coverage from geostationary orbits. However, the most common use is radiating element for antenna reflectors. The types of horns which is going to be considered are: Rectangular H-plane sectorial, Rectangular E-plane sectorial, Rectangular Pyramidal, Circular, Corrugated Circular and Corrugated Pyramidal. The Project is developed so that it can be used as practical-theorical information around the SABOR software. Therefore, In addition to thoroughly reviewing the theory document of analyzed horns, it display information related to the object-oriented programming in MATLAB environment whose goal leads us to a new way of thinking about the process of decomposition of problems and solutions development programming. Finally, it has been created a self-help manual in order to support the software and has been included the results of different tests to observe all the details of their operations, as well as the conclusions and future action lines.

Contributions to the Resilience Management in the Internet of Things

El auge del "Internet de las Cosas" (IoT, "Internet of Things") y sus tecnologías asociadas han permitido su aplicación en diversos dominios de la aplicación, entre los que se encuentran la monitorización de ecosistemas forestales, la gestión de catástrofes y emergencias, la domótica, la automatización industrial, los servicios para ciudades inteligentes, la eficiencia energética de edificios, la detección de intrusos, la gestión de desastres y emergencias o la monitorización de señales corporales, entre muchas otras. La desventaja de una red IoT es que una vez desplegada, ésta queda desatendida, es decir queda sujeta, entre otras cosas, a condiciones climáticas cambiantes y expuestas a catástrofes naturales, fallos de software o hardware, o ataques maliciosos de terceros, por lo que se puede considerar que dichas redes son propensas a fallos. El principal requisito de los nodos constituyentes de una red IoT es que estos deben ser capaces de seguir funcionando a pesar de sufrir errores en el propio sistema. La capacidad de la red para recuperarse ante fallos internos y externos inesperados es lo que se conoce actualmente como "Resiliencia" de la red. Por tanto, a la hora de diseñar y desplegar aplicaciones o servicios para IoT, se espera que la red sea tolerante a fallos, que sea auto-configurable, auto-adaptable, auto-optimizable con respecto a nuevas condiciones que puedan aparecer durante su ejecución. Esto lleva al análisis de un problema fundamental en el estudio de las redes IoT, el problema de la "Conectividad". Se dice que una red está conectada si todo par de nodos en la red son capaces de encontrar al menos un camino de comunicación entre ambos. Sin embargo, la red puede desconectarse debido a varias razones, como que se agote la batería, que un nodo sea destruido, etc. Por tanto, se hace necesario gestionar la resiliencia de la red con el objeto de mantener la conectividad entre sus nodos, de tal manera que cada nodo IoT sea capaz de proveer servicios continuos, a otros nodos, a otras redes o, a otros servicios y aplicaciones. En este contexto, el objetivo principal de esta tesis doctoral se centra en el estudio del problema de conectividad IoT, más concretamente en el desarrollo de modelos para el análisis y gestión de la Resiliencia, llevado a la práctica a través de las redes WSN, con el fin de mejorar la capacidad la tolerancia a fallos de los nodos que componen la red. Este reto se aborda teniendo en cuenta dos enfoques distintos, por una parte, a diferencia de otro tipo de redes de dispositivos convencionales, los nodos en una red IoT son propensos a perder la conexión, debido a que se despliegan en entornos aislados, o en entornos con condiciones extremas; por otra parte, los nodos suelen ser recursos con bajas capacidades en términos de procesamiento, almacenamiento y batería, entre otros, por lo que requiere que el diseño de la gestión de su resiliencia sea ligero, distribuido y energéticamente eficiente. En este sentido, esta tesis desarrolla técnicas auto-adaptativas que permiten a una red IoT, desde la perspectiva del control de su topología, ser resiliente ante fallos en sus nodos. Para ello, se utilizan técnicas basadas en lógica difusa y técnicas de control proporcional, integral y derivativa (PID - "proportional-integral-derivative"), con el objeto de mejorar la conectividad de la red, teniendo en cuenta que el consumo de energía debe preservarse tanto como sea posible. De igual manera, se ha tenido en cuenta que el algoritmo de control debe ser distribuido debido a que, en general, los enfoques centralizados no suelen ser factibles a despliegues a gran escala. El presente trabajo de tesis implica varios retos que conciernen a la conectividad de red, entre los que se incluyen: la creación y el análisis de modelos matemáticos que describan la red, una propuesta de sistema de control auto-adaptativo en respuesta a fallos en los nodos, la optimización de los parámetros del sistema de control, la validación mediante una implementación siguiendo un enfoque de ingeniería del software y finalmente la evaluación en una aplicación real. Atendiendo a los retos anteriormente mencionados, el presente trabajo justifica, mediante una análisis matemático, la relación existente entre el "grado de un nodo" (definido como el número de nodos en la vecindad del nodo en cuestión) y la conectividad de la red, y prueba la eficacia de varios tipos de controladores que permiten ajustar la potencia de trasmisión de los nodos de red en respuesta a eventuales fallos, teniendo en cuenta el consumo de energía como parte de los objetivos de control. Así mismo, este trabajo realiza una evaluación y comparación con otros algoritmos representativos; en donde se demuestra que el enfoque desarrollado es más tolerante a fallos aleatorios en los nodos de la red, así como en su eficiencia energética. Adicionalmente, el uso de algoritmos bioinspirados ha permitido la optimización de los parámetros de control de redes dinámicas de gran tamaño. Con respecto a la implementación en un sistema real, se han integrado las propuestas de esta tesis en un modelo de programación OSGi ("Open Services Gateway Initiative") con el objeto de crear un middleware auto-adaptativo que mejore la gestión de la resiliencia, especialmente la reconfiguración en tiempo de ejecución de componentes software cuando se ha producido un fallo. Como conclusión, los resultados de esta tesis doctoral contribuyen a la investigación teórica y, a la aplicación práctica del control resiliente de la topología en redes distribuidas de gran tamaño. Los diseños y algoritmos presentados pueden ser vistos como una prueba novedosa de algunas técnicas para la próxima era de IoT. A continuación, se enuncian de forma resumida las principales contribuciones de esta tesis: (1) Se han analizado matemáticamente propiedades relacionadas con la conectividad de la red. Se estudia, por ejemplo, cómo varía la probabilidad de conexión de la red al modificar el alcance de comunicación de los nodos, así como cuál es el mínimo número de nodos que hay que añadir al sistema desconectado para su re-conexión. (2) Se han propuesto sistemas de control basados en lógica difusa para alcanzar el grado de los nodos deseado, manteniendo la conectividad completa de la red. Se han evaluado diferentes tipos de controladores basados en lógica difusa mediante simulaciones, y los resultados se han comparado con otros algoritmos representativos. (3) Se ha investigado más a fondo, dando un enfoque más simple y aplicable, el sistema de control de doble bucle, y sus parámetros de control se han optimizado empleando algoritmos heurísticos como el método de la entropía cruzada (CE, "Cross Entropy"), la optimización por enjambre de partículas (PSO, "Particle Swarm Optimization"), y la evolución diferencial (DE, "Differential Evolution"). (4) Se han evaluado mediante simulación, la mayoría de los diseños aquí presentados; además, parte de los trabajos se han implementado y validado en una aplicación real combinando técnicas de software auto-adaptativo, como por ejemplo las de una arquitectura orientada a servicios (SOA, "Service-Oriented Architecture"). ABSTRACT The advent of the Internet of Things (IoT) enables a tremendous number of applications, such as forest monitoring, disaster management, home automation, factory automation, smart city, etc. However, various kinds of unexpected disturbances may cause node failure in the IoT, for example battery depletion, software/hardware malfunction issues and malicious attacks. So, it can be considered that the IoT is prone to failure. The ability of the network to recover from unexpected internal and external failures is known as "resilience" of the network. Resilience usually serves as an important non-functional requirement when designing IoT, which can further be broken down into "self-*" properties, such as self-adaptive, self-healing, self-configuring, self-optimization, etc. One of the consequences that node failure brings to the IoT is that some nodes may be disconnected from others, such that they are not capable of providing continuous services for other nodes, networks, and applications. In this sense, the main objective of this dissertation focuses on the IoT connectivity problem. A network is regarded as connected if any pair of different nodes can communicate with each other either directly or via a limited number of intermediate nodes. More specifically, this thesis focuses on the development of models for analysis and management of resilience, implemented through the Wireless Sensor Networks (WSNs), which is a challenging task. On the one hand, unlike other conventional network devices, nodes in the IoT are more likely to be disconnected from each other due to their deployment in a hostile or isolated environment. On the other hand, nodes are resource-constrained in terms of limited processing capability, storage and battery capacity, which requires that the design of the resilience management for IoT has to be lightweight, distributed and energy-efficient. In this context, the thesis presents self-adaptive techniques for IoT, with the aim of making the IoT resilient against node failures from the network topology control point of view. The fuzzy-logic and proportional-integral-derivative (PID) control techniques are leveraged to improve the network connectivity of the IoT in response to node failures, meanwhile taking into consideration that energy consumption must be preserved as much as possible. The control algorithm itself is designed to be distributed, because the centralized approaches are usually not feasible in large scale IoT deployments. The thesis involves various aspects concerning network connectivity, including: creation and analysis of mathematical models describing the network, proposing self-adaptive control systems in response to node failures, control system parameter optimization, implementation using the software engineering approach, and evaluation in a real application. This thesis also justifies the relations between the "node degree" (the number of neighbor(s) of a node) and network connectivity through mathematic analysis, and proves the effectiveness of various types of controllers that can adjust power transmission of the IoT nodes in response to node failures. The controllers also take into consideration the energy consumption as part of the control goals. The evaluation is performed and comparison is made with other representative algorithms. The simulation results show that the proposals in this thesis can tolerate more random node failures and save more energy when compared with those representative algorithms. Additionally, the simulations demonstrate that the use of the bio-inspired algorithms allows optimizing the parameters of the controller. With respect to the implementation in a real system, the programming model called OSGi (Open Service Gateway Initiative) is integrated with the proposals in order to create a self-adaptive middleware, especially reconfiguring the software components at runtime when failures occur. The outcomes of this thesis contribute to theoretic research and practical applications of resilient topology control for large and distributed networks. The presented controller designs and optimization algorithms can be viewed as novel trials of the control and optimization techniques for the coming era of the IoT. The contributions of this thesis can be summarized as follows: (1) Mathematically, the fault-tolerant probability of a large-scale stochastic network is analyzed. It is studied how the probability of network connectivity depends on the communication range of the nodes, and what is the minimum number of neighbors to be added for network re-connection. (2) A fuzzy-logic control system is proposed, which obtains the desired node degree and in turn maintains the network connectivity when it is subject to node failures. There are different types of fuzzy-logic controllers evaluated by simulations, and the results demonstrate the improvement of fault-tolerant capability as compared to some other representative algorithms. (3) A simpler but more applicable approach, the two-loop control system is further investigated, and its control parameters are optimized by using some heuristic algorithms such as Cross Entropy (CE), Particle Swarm Optimization (PSO), and Differential Evolution (DE). (4) Most of the designs are evaluated by means of simulations, but part of the proposals are implemented and tested in a real-world application by combining the self-adaptive software technique and the control algorithms which are presented in this thesis.

O Teste de Apercepção Temática (TAT) em adultos: dados normativos para o sistema morvaliano

No contexto da pesquisa e utilização prática das técnicas de autoexpressão, o Teste de Apercepção Temática (TAT) apresenta reconhecidas vantagens. Apesar de linhas de pesquisa bastante desenvolvidas internacionalmente, não existem estudos atuais sobre as propriedades deste instrumento no Brasil, levantando a necessidade de conhecer seus alcances e limites nesse contexto cultural. Desse modo, o desenvolvimento de normas que descrevam o desempenho típico de uma população não clínica se mostra um importante passo inicial rumo à retomada da pesquisa com o TAT e sua adoção por profissionais. Tendo em vista que a validação das técnicas de autoexpressão se refere aos sistemas de classificação e não aos instrumentos em si, o presente estudo adotou, dentre a miríade de sistemas de categorização das histórias do TAT descritos na literatura, o sistema proposto por Monique Morval, que foi desenvolvido para estudantes e profissionais com pouca experiência com o TAT, utilizando pressupostos da Personologia de Henry Murray, Psicologia Cognitiva e Psicologia do Ego, possibilitando leituras objetivas e qualitativas do material. Considerando o potencial de utilização desse sistema por parte dos psicólogos brasileiros - visto sua semelhança com o atual sistema aprovado para uso pelo Sistema de Avaliação dos Testes Psicológicos (SATEPSI) do Conselho Federal de Psicologia - foram feitos aprimoramentos no assim chamado sistema morvaliano, possibilitando sua adoção no estudo normativo proposto pelo presente projeto. Tais aprimoramentos consistiram na revisão e adição de categorias e subcategorias, a partir de trabalhos brasileiros e internacionais sobre o instrumento. Desta forma, o presente estudo teve por objetivo desenvolver normas para o TAT (Sistema Morvaliano) em adultos, a partir de uma amostra não clínica, aleatória e estratificada por critérios de idade, sexo, escolaridade e nível socioeconômico (NSE) da cidade de Ribeirão Preto (SP). Os participantes foram 100 adultos (25 a 44 anos de idade), selecionados através de visita a domicílios sorteados em bairros de diferentes NSE. Foram realizadas entrevistas de avaliação psicológica individuais, utilizando um roteiro de entrevista semiestruturada, o Teste de Inteligência Geral Não-Verbal (TIG-NV) e 20 cartões do TAT, pré-selecionados de acordo com as recomendações do manual original do instrumento. As histórias do TAT foram categorizadas no sistema morvaliano revisado e seus dados passaram por análises estatísticas e sínteses qualitativas em busca de diferenças de desempenho relacionadas ao sexo, escolaridade e NSE. Os resultados mostram poucas diferenças entre os grupos que justifiquem a elaboração de normas específicas; apesar disso, foi identificada uma tendência (ainda que pequena) de o nível de escolaridade e o NSE favorecerem um melhor desempenho nas variáveis relativas à organização formal das histórias. São discutidas as implicações dos dados obtidos em termos do perfil normativo de desempenho nas variáveis do sistema morvaliano, suas evidências preliminares de validade e futuras direções para estudos sobre o TAT nesse sistema.

The Use of Humor in Therapy : Research-Based Training Recommendations

Despite its essential and universal nature, humor has historically received limited attention from the behavioral sciences, particularly as compared to other affective experiences like anger and sadness. Some authors (e.g., Bell & Malhi, 2009; Provine, 2000a; Roeckelein, 2002) suggest that this is because researchers have traditionally failed to "take humor seriously" and, according to O'Connell (cited in Roeckelein, 2002), have too often pursued its study in a piecemeal manner lacking scientific rigor, resulting in "no comprehensive network of facts about the development and purposes of humor in human existence" (p. 1). Roeckelein (2002) found not a single mention of humor, laughter, wit, comedy, or theories relating to these topics in introductory psychology textbooks published between 1930 and 1996.While research interest in the area has grown, especially over the last decade, it remains an elusive and nebulous topic, more likely to be examined in specialty psychology texts (e.g., social psychology and child development) than general ones (Martin, 2007; Roeckelein, 2002). Organizations (e.g., The International Society for Humor Studies; The Association for the Advancement of Therapeutic Humor), journals (e.g., Humor: International Journal of Humor Research) and internet phenomena such as "The Humor Project" (www.humorproiect.com) have made great strides in integrating information about humor from discreet fields such as the arts and humanities, biological and social sciences, education, and business management. Still, the therapeutic potential of humor remains a relatively young subject of serious scientific inquiry (Marci, Moran, & Orr, 2004; Sala, Krupat, & Roter, 2002). While humor does make appearances in self-help books and publications addressing clinical applications, these sources are much ...

Migration in the Central Mediterranean. Jean Monnet Occasional Papers 02/2013

In the last decade irregular immigration has emerged as a “security” challenge (in the language of International Relations military “threat”) in the Mediterranean region particularly in the central, sub-region1. The designation of this issue as a “security challenge” or “threat” is itself controversial and will be discussed further down. This paper focuses on the situation in the central Mediterranean involving mainly four countries namely Italy, Libya, Malta and Tunisia all of which have long standing historic links and bilateral relations and participate in the so called “5+5” Dialogue in the Western Mediterranean. Two of these Central Mediterranean countries (Italy, Malta) are EU member states and Tunisia has a long standing relationship with the EU [Association Agreement, Barcelona Process (EMP), Neighbourhood Policy (ENP), Union for the Mediterranean (UfM)] while Libya so far has no formal relations at all with the EU. This paper analyses some of the aspects of migration in the central Mediterranean focusing on the link between the domestic and international politics of the issue in Italy and Malta and contrasting the different approaches taken. For example, although Italy and Malta both resort to self-help and both try to involve the EU in helping them tackle the problem, they do this in a markedly different way: Italy uses the EU as a supplement to its independent and bilateral efforts while Malta looks to the EU as the major solution to the problem. Lacking the power and influence to deal with the issue, Malta tends to see the problem as primarily a multilateral issue or one that can only be tackled in concert with stronger powers in the region preferably within an EU context. On the other hand, Italy has been keen in involving the EU but decided to go it alone when this option turned out to be a dead end. In this paper I also try to show the extent (or limitations) to which multilateral initiatives such as the “5+5” and Euro operation really play a decisive role in incentivizing or facilitating inter-state cooperation or joint solutions. This paper also refers to the EU acquis, the notion of solidarity (norms) and the extent to which it is implemented as well as a number of connected issues. The subjects of this paper, the Mediterranean Boat People, have been referred to by various names in the literature, all of which may be more or less deficient in actually defining them all. They have been referred to as “illegal” or “irregular” immigrants, “refugees” in search of international protection, “migrants at sea” and “boat people”. The use of “boat people” dispenses with the need of having to define the various categories of migrants involved and is thus preferred in this paper.

Efficacy of an Internet-based, individually tailored smoking cessation program: A randomized trial

Introduction: Self-help computer-based programs are easily accessible and cost-effective interventions with a great recruitment potential. However, each program is different and results of meta-analyses may not apply to each new program; therefore, evaluations of new programs are warranted. The aim of this study was to assess the marginal efficacy of a computer-based, individually tailored program (the Coach) over and above the use of a comprehensive Internet smoking cessation website. Methods: A two-group randomized controlled trial was conducted. The control group only accessed the website, whereas the intervention group received the Coach in addition. Follow-up was conducted by e-mail after three and six months (self-administrated questionnaires). Of 1120 participants, 579 (51.7%) responded after three months and 436 (38.9%) after six months. The primary outcome was self-reported smoking abstinence over four weeks. Results: Counting dropouts as smokers, there were no statistically significant differences between intervention and control groups in smoking cessation rates after three months (20.2% vs. 17.5%, p¼0.25, odds ratio (OR)¼1.20) and six months (17% vs. 15.5%, p¼0.52, OR¼1.12). Excluding dropouts from the analysis, there were statistically significant differences after three months (42% vs. 31.6%, p¼0.01, OR¼1.57), but not after six months (46.1% vs. 37.8%, p¼0.081, OR¼1.41). The program also significantly increased motivation to quit after three months and self-efficacy after three and six months. Discussion: An individually tailored program delivered via the Internet and by e-mail in addition to a smoking cessation website did not significantly increase smoking cessation rates, but it increased motivation to quit and self-efficacy.

Annual seminar report.

Mode of access: Internet.

La Palabra alhambre de MASH.

Mode of access: Internet.

Assistive technology : a selective bibliography.

Shipping list no.: 92-0304-P.

Access to multimedia technology by people with sensory disabilities /

"March 13, 1998."

A basic manual for developing Vietnam veteran employment services by community-based organizations /

Mode of access: Internet.