Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397

Introducing the CTA concept

The Cherenkov Telescope Array (CTA) is a new observatory for very high-energy (VHE) gamma rays. CTA has ambitions science goals, for which it is necessary to achieve full-sky coverage, to improve the sensitivity by about an order of magnitude, to span about four decades of energy, from a few tens of GeV to above 100 TeV with enhanced angular and energy resolutions over existing VHE gamma-ray observatories. An international collaboration has formed with more than 1000 members from 27 countries in Europe, Asia, Africa and North and South America. In 2010 the CTA Consortium completed a Design Study and started a three-year Preparatory Phase which leads to production readiness of CTA in 2014. In this paper we introduce the science goals and the concept of CTA, and provide an overview of the project.

Technology acquisition through licensing. Implications for firm strategy

Nowadays licensing practices have increased in importance and relevance driving the widespread diffusion of markets for technologies. Firms are shifting from a tactical to a strategic attitude towards licensing, addressing both business and corporate level objectives. The Open Innovation Paradigm has been embraced. Firms rely more and more on collaboration and external sourcing of knowledge. This new model of innovation requires firms to leverage on external technologies to unlock the potential of firms’ internal innovative efforts. In this context, firms’ competitive advantage depends both on their ability to recognize available opportunities inside and outside their boundaries and on their readiness to exploit them in order to fuel their innovation process dynamically. Licensing is one of the ways available to firm to ripe the advantages associated to an open attitude in technology strategy. From the licensee’s point view this implies challenging the so-called not-invented-here syndrome, affecting the more traditional firms that emphasize the myth of internal research and development supremacy. This also entails understanding the so-called cognitive constraints affecting the perfect functioning of markets for technologies that are associated to the costs for the assimilation, integration and exploitation of external knowledge by recipient firms. My thesis aimed at shedding light on new interesting issues associated to in-licensing activities that have been neglected by the literature on licensing and markets for technologies. The reason for this gap is associated to the “perspective bias” affecting the works within this stream of research. With very few notable exceptions, they have been generally concerned with the investigation of the so-called licensing dilemma of the licensor – whether to license out or to internally exploit the in-house developed technologies, while neglecting the licensee’s perspective. In my opinion, this has left rooms for improving the understanding of the determinants and conditions affecting licensing-in practices. From the licensee’s viewpoint, the licensing strategy deals with the search, integration, assimilation, exploitation of external technologies. As such it lies at the very hearth of firm’s technology strategy. Improving our understanding of this strategy is thus required to assess the full implications of in-licensing decisions as they shape firms’ innovation patterns and technological capabilities evolution. It also allow for understanding the so-called cognitive constraints associated to the not-invented-here syndrome. In recognition of that, the aim of my work is to contribute to the theoretical and empirical literature explaining the determinants of the licensee’s behavior, by providing a comprehensive theoretical framework as well as ad-hoc conceptual tools to understand and overcome frictions and to ease the achievement of satisfactory technology transfer agreements in the marketplace. Aiming at this, I investigate licensing-in in three different fashions developed in three research papers. In the first work, I investigate the links between licensing and the patterns of firms’ technological search diversification according to the framework of references of the Search literature, Resource-based Theory and the theory of general purpose technologies. In the second paper - that continues where the first one left off – I analyze the new concept of learning-bylicensing, in terms of development of new knowledge inside the licensee firms (e.g. new patents) some years after the acquisition of the license, according to the Dynamic Capabilities perspective. Finally, in the third study, Ideal with the determinants of the remuneration structure of patent licenses (form and amount), and in particular on the role of the upfront fee from the licensee’s perspective. Aiming at this, I combine the insights of two theoretical approaches: agency and real options theory.

The Time-Of-Flight detector of ALICE at LHC: construction, test and commissioning with cosmic rays

The Time-Of-Flight (TOF) detector of ALICE is designed to identify charged particles produced in Pb--Pb collisions at the LHC to address the physics of strongly-interacting matter and the Quark-Gluon Plasma (QGP). The detector is based on the Multigap Resistive Plate Chamber (MRPC) technology which guarantees the excellent performance required for a large time-of-flight array. The construction and installation of the apparatus in the experimental site have been completed and the detector is presently fully operative. All the steps which led to the construction of the TOF detector were strictly followed by a set of quality assurance procedures to enable high and uniform performance and eventually the detector has been commissioned with cosmic rays. This work aims at giving a detailed overview of the ALICE TOF detector, also focusing on the tests performed during the construction phase. The first data-taking experience and the first results obtained with cosmic rays during the commissioning phase are presented as well and allow to confirm the readiness state of the TOF detector for LHC collisions.

La carriera degli attori italiani di prosa dalla scena allo schermo (1909-1916)

Most actors of the Italian silent cinema in the early 1910s have a theatrical training. Some of them are already asserted or famous actors (like Cesare Dondini, Ermete Novelli, Ermete Zacconi, Giovanni Grasso) who are invited “to pose” for the cinema following their reputation, according to a strategy of an aesthetic and cultural legitimacy launched in 1909 by film d'art of the Pathé Consortium. I think it is the proverbial readiness and strength of the stage Italian actors that create a decisive contribution to the rapid development of the national cinema industry, despite its serious structural deficiencies, from the protoindustrialized phase (1909) to the golden age of divismo (starting in 1913), until the first signs of decadence (1919), and the so-called “fall” of the UCI production and distribution system. This is the main topic of the thesis: an investigation on the Italian stage actors engaged in the film industry (“from stage to screen” as the Italian title says, but in a “post-Vardac” approach) through many different sources: periodicals, memories, personal and business letters, and also contracts, found in several archive funds. A specific chapter is dedicated to the artistic career of Febo Mari (1881-1939), real name Alfredo Rodriguez, witch is a time-sample symptomatic of deep ties established between the growing film publishing and the Italian theatrical production system in the 1910s. The Mari debut in cinema and his ascent toward screen “divo” status coincides with the parable that leads from emergence to decadence of divismo in Italy.

The topological trigger system of the TOF detector for the ALICE experiment at the LHC

The ALICE experiment at the LHC has been designed to cope with the experimental conditions and observables of a Quark Gluon Plasma reaction. One of the main assets of the ALICE experiment with respect to the other LHC experiments is the particle identification. The large Time-Of-Flight (TOF) detector is the main particle identification detector of the ALICE experiment. The overall time resolution, better that 80 ps, allows the particle identification over a large momentum range (up to 2.5 GeV/c for pi/K and 4 GeV/c for K/p). The TOF makes use of the Multi-gap Resistive Plate Chamber (MRPC), a detector with high efficiency, fast response and intrinsic time resoltion better than 40 ps. The TOF detector embeds a highly-segmented trigger system that exploits the fast rise time and the relatively low noise of the MRPC strips, in order to identify several event topologies. This work aims to provide detailed description of the TOF trigger system. The results achieved in the 2009 cosmic-ray run at CERN are presented to show the performances and readiness of TOF trigger system. The proposed trigger configuration for the proton-proton and Pb-Pb beams are detailed as well with estimates of the efficiencies and purity samples.

ALMASat-1, ALMASat-EO and beyond: evolution of structural concepts and technologies towards multifunctional structures for microsatellites

Multifunctional Structures (MFS) represent one of the most promising disruptive technologies in the space industry. The possibility to merge spacecraft primary and secondary structures as well as attitude control, power management and onboard computing functions is expected to allow for mass, volume and integration effort savings. Additionally, this will bring the modular construction of spacecraft to a whole new level, by making the development and integration of spacecraft modules, or building blocks, leaner, reducing lead times from commissioning to launch from the current 3-6 years down to the order of 10 months, as foreseen by the latest Operationally Responsive Space (ORS) initiatives. Several basic functionalities have been integrated and tested in specimens of various natures over the last two decades. However, a more integrated, system-level approach was yet to be developed. The activity reported in this thesis was focused on the system-level approach to multifunctional structures for spacecraft, namely in the context of nano- and micro-satellites. This thesis documents the work undertaken in the context of the MFS program promoted by the European Space Agency under the Technology Readiness Program (TRP): a feasibility study, including specimens manufacturing and testing. The work sequence covered a state of the art review, with particular attention to traditional modular architectures implemented in ALMASat-1 and ALMASat-EO satellites, and requirements definition, followed by the development of a modular multi-purpose nano-spacecraft concept, and finally by the design, integration and testing of integrated MFS specimens. The approach for the integration of several critical functionalities into nano-spacecraft modules was validated and the overall performance of the system was verified through relevant functional and environmental testing at University of Bologna and University of Southampton laboratories.

Valorisation of organic waste: new developments from proton nuclear magnetic resonance characterization

The last half-century has seen a continuing population and consumption growth, increasing the competition for land, water and energy. The solution can be found in the new sustainability theories, such as the industrial symbiosis and the zero waste objective. Reducing, reusing and recycling are challenges that the whole world have to consider. This is especially important for organic waste, whose reusing gives interesting results in terms of energy release. Before reusing, organic waste needs a deeper characterization. The non-destructive and non-invasive features of both Nuclear Magnetic Resonance (NMR) relaxometry and imaging (MRI) make them optimal candidates to reach such characterization. In this research, NMR techniques demonstrated to be innovative technologies, but an important work on the hardware and software of the NMR LAGIRN laboratory was initially done, creating new experimental procedures to analyse organic waste samples. The first results came from soil-organic matter interactions. Remediated soils properties were described in function of the organic carbon content, proving the importance of limiting the addition of further organic matter to not inhibit soil processes as nutrients transport. Moreover NMR relaxation times and the signal amplitude of a compost sample, over time, showed that the organic matter degradation of compost is a complex process that involves a number of degradation kinetics, as a function of the mix of waste. Local degradation processes were studied with enhanced quantitative relaxation technique that combines NMR and MRI. The development of this research has finally led to the study of waste before it becomes waste. Since a lot of food is lost when it is still edible, new NMR experiments studied the efficiency of conservation and valorisation processes: apple dehydration, meat preservation and bio-oils production. All these results proved the readiness of NMR for quality controls on a huge kind of organic residues and waste.

Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.

Drug hypersensitivity: flare-up reactions, cross-reactivity and multiple drug hypersensitivity

In drug hypersensitivity, change of drug treatment and continuation with a new drug may result in reappearance of drug hypersensitivity symptoms. This is not uncommon in patients with chronic infections requiring continued and long-lasting antibiotic treatments. For the clinician, the question arises whether these symptoms are due to cross-reactivity, are due to a new sensitization or are a reflection of a multiple drug hypersensitivity syndrome. Based on the p-i concept (pharmacological interaction with immune receptors), we propose that the efficient stimulation of T cells by a drug is the sum of drug-T-cell receptor affinity and readiness of the T cell to react, and therefore not constant. It heavily depends on the state of underlying immune activation. Consequently, drug hypersensitivity diseases, which go along with massive immune stimulations and often high serum cytokine values, are themselves risk factors for further drug hypersensitivity. The immune stimulation during drug hypersensitivity may, similar to generalized virus infections, lower the threshold of T-cell reactivity to drugs and cause rapid appearance of drug hypersensitivity symptoms to the second drug. We call the second hypersensitivity reaction a "flare-up" reaction; this is clinically important, as in most cases the second drug may be tolerated again, if the cofactors are missing. Moreover, the second treatment is often too short to cause a relevant sensitization.

Leukocyte populations and mRNA expression of inflammatory factors in quarter milk fractions at different somatic cell score levels in dairy cows

The effect of somatic cell count (SCC) and milk fraction on milk composition, distribution of cell populations, and mRNA expression of various inflammatory parameters was studied. Therefore, quarter milk samples were defined as cisternal (C), first 400 g of alveolar (A1), and remaining alveolar milk (A2) during the course of milking. Quarters were assigned to 4 groups according to their total SCC: 1) <12 x 10(3)/mL, 2) 12 to 100 x 10(3)/mL, 3) 100 to 350 x 10(3)/mL, and 4) >350 x 10(3)/mL. Milk constituents of interest were SCC, fat, protein, lactose sodium, and chloride ions as well as electrical conductivity. Cell populations were classified into lymphocytes, macrophages, and neutrophils (PMN). The mRNA expression of the inflammatory factors tumor necrosis factor-alpha, interleukin-1beta, cyclooxygenase-2, lactoferrin, and lysozyme was measured via real-time, quantitative reverse transcription PCR. Somatic cell count decreased from highest levels in C to lowest levels in A1 and increased thereafter to A2 in all groups. Fat content increased from C to A2 and with increasing SCC level. Lactose decreased with increasing SCC level but remained unchanged during milking. Concentrations of sodium and chloride, and electrical conductivity increased with increasing SCC but were higher in C than in A1 and A2. Protein was not affected by milk fraction or SCC level. The distribution of leukocytes was dramatically influenced by milk fraction and SCC. Lymphocytes were the dominating cell population in group 1, but the proportion of lymphocytes was low in groups 2, 3, and 4. Macrophage proportion was highest in group 2 and decreased in groups 3 and 4, whereas that of PMN increased from group 2 to 4. The content of macrophages decreased during milking in all SCC groups whereas that of PMN increased. The proportion of lymphocytes was not affected by milk fraction. The mRNA expression of all inflammatory factors showed an increase with increasing SCC but minor changes occurred during milking. In conclusion, milk fraction and SCC level have a crucial influence on the distribution of leukocyte populations and several milk constituents. The surprisingly high content of lymphocytes and concomitantly low mRNA expression of inflammatory factors in quarters with SCC <12 x 10(3)/mL indicates a different and possibly reduced readiness of the immune system to respond to invading pathogens.

"From Dartboards to Dashboards: The Imperative of using Data to Improve Student Achievement"

Aimee Guidera, Director of the National Data Quality Campaign, delivered the second annual Lee Gurel '48 Lecture in Education, "From Dartboards to Dashboards: The Imperative of Using Data to Improve Student Outcomes." Aimee Rogstad Guidera is the Founding Executive Director of the Data Quality Campaign. She manages a growing partnership among national organizations collaborating to improve the quality, accessibility and use of education data to improve student achievement. Working with 10 Founding Partners, Aimee launched the DQC in 2005 with the goal of every state having a robust longitudinal data system in place by 2009. The Campaign is now in the midst of its second phase focusing on State Actions to ensure effective data use. Aimee joined the National Center for Educational Accountability as Director of the Washington, DC office in 2003. During her eight previous years in various roles at the National Alliance of Business, Aimee supported the corporate community's efforts to increase achievement at all levels of learning. As NAB Vice President of Programs, she managed the Business Coalition Network, comprised of over 1,000 business led coalitions focused on improving education in communities across the country. Prior to joining the Alliance, Aimee focused on school readiness, academic standards, education goals and accountability systems while in the Center for Best Practices at the National Governors Association. She taught for the Japanese Ministry of Education in five Hiroshima high schools where she interviewed educators and studied the Japanese education system immediately after receiving her AB from Princeton University’s Woodrow Wilson School of Public & International Affairs. Aimee also holds a Masters Degree in Public Policy from Harvard’s John F. Kennedy School of Government.

The Mediterranean climate: An overview of the main characteristics and issues

The Mediterranean Region has many morphologic, geographical, historical, and societal characteristics, which make its climate scientifically interesting. The concept of Mediterranean climate is characterized by mild wet winters and warm to hot, dry summers and occur on the west side of continents between about 30° and 40° latitude. However, the presence of a relatively large mass of water is unique to the actual Mediterranean region. The Mediterranean Sea is a marginal and semi-enclosed sea; it is located on the western side of a large continental area and is surrounded by Europe to the North, Africa to the South, and Asia to the East. The chapter discusses that the climate of the Mediterranean region is to a large extent forced by planetary scale patterns. The time and space behavior of the regional features associated with such large-scale forcing is complex. Orography and land–sea distribution play an important role establishing the climate at basin scale and its teleconnections with global patterns. Different levels of services of readiness to emergencies, technological, and economic resources are likely to result in very different adaptation capabilities to environmental changes and new problems. The different economic situations and demographic trends are likely to produce contrasts and conflicts in a condition of limited available resources and environmental stress.

Asymmetric sexual conflict over parental care in a biparental cichlid

Theoretical models predict that parents should adjust the amount of care both to their own and their partner's body condition. In most biparental species, parental duties are switched repeatedly allowing for repeated mutual adjustment of the amount of care. In the mouthbrooding cichlid Eretmodus cyanostictus, terms are switched only once with females taking the first share. The timing of the shift of the clutch between mates strongly determines both partners' brooding period and thereby their parental investment. Females signal their readiness to transfer the young several days before the male finally takes them, suggesting sexual conflict over the timing of the shift. In a lab experiment, we reduced the body condition of either the female or the male of a pair to test whether energy reserves affect the timing of the shift and whether female signalling behaviour depends on energetic state. Males with a lowered condition took the young later and incubated for a shorter period, which prolonged the incubation time of their female partners. When female condition was lowered, female and male incubation durations remained unchanged, although females signalled their readiness to shift more intensely. Our results suggest that males adjust their parental investment to own energy reserves but are unresponsive to their mate's condition. Females appear to carry the entire costs for the male's adjustment of care. We propose that intrinsic asymmetries in the scope for mutual adjustment of parental investment and the costs of negotiation crucially influence solutions of the conflict between sexes over care.

[Bisexuality and AIDS. Implications for heterosexual HIV infections in women]

One of the possible pathways into heterosexual population is the transfer of HIV-virus from bisexual men to their female partners. Therefore sexual behaviour of HIV-positive and -negative bisexual men (n = 31) before and after Aids-disease was analysed. Prior to the Aids-epidemic promiscuous behavior towards male partners (about one female partner per year versus 10 male partners per year). Relatively common contacts to woman occurred within steady relationships. After contact with HIV-test and personal counselling sexual practice became significantly different. The number of female and male contacts was markedly reduced, especially female chance acquaintances were avoided; safer sex was preferred and readiness to inform female partners about bisexuality was increased. This study suggests that reduction of risk for HIV-infection of female partners by homosexual men can be achieved by means of a HIV-test and personal counselling, a possibility that should be considered in preventive concepts.