text:
children and
those who serve
MinistrySafe provides a complete Child Safety System
designed to reduce the risk of child sexual abuse.
Protecting children and those who serve them
MinistrySafe provides a Complete Child Safety System
designed to reduce the risk of child sexual abuse.
What is MinistrySafe?
MinistrySafe was founded by legal professionals and sexual abuse experts, Gregory Love and Kimberlee Norris. Through their litigation practice representing victims of child sexual abuse, they recognized a vital need to equip churches and ministry programs to better protect children from sexual abuse. The risk is real, and it's preventable. Prevention starts with awareness.
Why Choose MinistrySafe?
With over 60 years combined experience in sexual abuse litigation, consultation and crisis management, Love & Norris understand the risk of sexual abuse and how it unfolds in ministry programs. They recognized patterns in predatory behavior, known as the abuser's grooming process, which is predictable and therefore preventable. MinistrySafe's complete Child Safety System provides comprehensive sexual abuse prevention.
MinistrySafe Offers Solutions For Your Program Needs
Every program providing services to children or youth wants to provide a safe, inviting environment where learning and enrichment can occur. When an effective Safety System is put in place, staff members and volunteers can focus on their core purpose, knowing precautions have been taken to prevent abuse and protect children in their care.
Our extensive experience providing training and resources to child-serving organizations shapes our industry-specific Safety System elements.
All ministries abhor child sexual abuse. Most claim to have 'zero-tolerance' for abuse, but there's a difference between opposition to abuse in concept and having preventative, proactive initiatives in place to protect children.
MinistrySafe equips the church with state-of-the-art resources unique to church ministry programs.
Sadly, there's no shortage of media reports about teachers and other school staff members getting arrested for sexually abusing one or more children. These disturbing reports alarm parents, students and all who are concerned about school safety. MinistrySafe provides schools with state-of-the-art tools and trainings, enabling schools to stay abreast of evolving state reporting, training and screening requirements.
Youth Sports
Young athletes are taught to trust the coach, an adult in a position of authority. The right coach can have an incredibly positive impact on a child's life—teaching and modeling sportsmanship, competition and teamwork. The wrong coach can cause serious damage.
Unfortunately, a growing number of sexual predators are gaining access to children through youth sports.
Foster Care/Adoption
Foster care and adoption programs provide services to a particularly vulnerable group of children who we cannot allow to slip through the cracks. Children receiving services through foster or adoption programs are at higher risk for sexual abuse, and many have already experienced the devastating impact of abuse or neglect.
MinistrySafe provides unique resources for foster care and adoption programs.
Child Services
Parents rely upon children's programming to educate their children and enrich their lives. Regardless of the program chosen, parents want to know that their child will be safe with caregivers.
The reality is, the risk of sexual abuse is ensnaring children in rising numbers, and many adults entrusted with protecting children simply don't have the facts about sexual abuse or sexual abusers. MinistrySafe provides unique resources for children's programs.
Insurance Professionals
The sexual abuse experts and attorneys at MinistrySafe have been training risk managers and insurance professionals for decades.
Agent/Underwriter Training provides comprehensive, four-hour training broken into three online Segments:
Segment 1: Understanding Sexual Abuse Risk
Segment 2: Identifying an Effective Safety System
Segment 3: Evaluating a Client's Preparedness for Sexual Abuse Risk
Services We Provide
We offer comprehensive resources and training to protect children from sexual abuse in your ministry program.
The Complete Child Safety System
Our 5-Part Safety System is a comprehensive framework for sexual abuse prevention.
Live and Online Trainings
Bring high quality, high impact training to your team, wherever you are.
Background Checks
We take the mystery out of background checks and help you maximize results.
MinistrySafe Institute
Seminary-level training equipping ministry leaders and risk managers.
Tailored Policies & Procedures
Let us help you create and implement effective policies and procedures.
Legal Services
Members have access to legal consultation from attorneys who are sexual abuse experts.
Risk Management Training
Comprehensive online training for insurance professionals and risk managers.
An Effective Child Safety System
Requires All Five Parts
An Effective Child Safety System Requires All Five Parts
What people are saying about us
MinistrySafe works with clients in a wide variety of child-serving industries utilizing tools and resources designed to better protect children.
In our broken world, children are threatened on all sides. MinistrySafe helps reduce the risk from those threats by thoroughly training organizations to recognize threats as well as those seeking to use our organizations to prey on children. We readily recommend the trainings offered by MinistrySafe and their processes for implementing best practices to keep the safety of students at the center of our actions.
Chris Steinmann
Superintendent & CEO, Cleveland Lutheran HS Association
Protecting children and youth is something that Church Mutual takes very seriously. MinistrySafe is the most passionate, most advanced and most qualified authority on preventing child sexual abuse, which makes them the best choice to be our partner in preventing this risk.
Guy Russ
Assistant VP - Risk Control, Church Mutual Insurance
MinistrySafe provides the most sophisticated and comprehensive sexual abuse prevention training available in the field today, offering comprehensive risk management programs which incorporate current research on child sexual abuse prevention practices.
Wayne D. Duehn, Ph.D., ACSW, LMSW-AP
Professor of Social Work
The services provided by MinistrySafe/Abuse Prevention Systems have helped Lena Pope Home further develop our risk management programs to protect children from abuse. They have also educated our staff as to the importance of our diligence as well as legal requirements related to their behavior with children and their responsibility to observe others with children.
Ted Blevins
Executive Director, Lena Pope Home
It is evident that we, as caregivers to children, need every available tool to assure the safest possible environment for children in ministry programs. MinistrySafe has supplied us with effective tools, provided training to our staff members, and cast the vision that each overseer has a responsibility to screen candidates who might seek to obtain a position in our church programs.
Ken Jackson
Children's Pastor, Gateway Church
Our all-staff webcast was easy to set up and easy for attendees to view. We are grateful for the passion, care, experience and attention MinistrySafe provides to help protect children in our ministry. We rely on MinistrySafe as an integral training element to protect children and students involved in Perimeter ministries.
Cheryl Flanagan
HR Specialist, Perimeter Church
I highly recommend MinistrySafe to churches as a resource for ensuring that staff members and volunteers are effectively screened and trained to keep our children safe.


text:
Although its implementation is likely to vary across states due to the recent Supreme Court decision, passage of the Affordable Care Act (ACA) is expected to dramatically impact the delivery of substance use disorder (SUD) treatment through changes to treatment financing and greater integration of mainstream health care and SUD treatment. The evolving system of buprenorphine treatment for opioid use disorders (OUDs) is a prime example of integration. While this system has grown substantially in the past decade, research is limited regarding how physicians are implementing this lifesaving treatment and whether they are delivering HIVrelated services. It is unknown how the ACA will impact the delivery of buprenorphine treatment. The proposed study seeks 1 year of R21 support to establish study feasibility and 4 years of R33 support to conduct a longitudinal study of buprenorphine implementation that integrates multi-level data on state-level variations in ACA implementation with longitudinal surveys of buprenorphine-prescribing physicians. The primary aim of the R21 phase is to determine the feasibility of conducting a longitudinal study that integrates physician-level and state-level data collection, through research procedures linked to 4 milestones encompassing the construction of the physician sample, survey development through qualitative and cognitive interviews, and generation of a protocol for longitudinal collection of state-level data on ACA implementation. The three specific aims of the proposed R33 study are: (1) To estimate cross-sectional and longitudinal models of buprenorphine utilization as well as the implementation of high-quality clinical practice behaviors (CPBs) and HIV-related services in buprenorphine treatment in the context of states implementation of the ACA; (2) To examine the relative importance of patient payment source (e.g., Medicaid, private insurance, or out-of-pocket) and other patient characteristics on physician decision-making during buprenorphine treatment; and (3) To model the state-level associations between the implementation of the ACA and two state-level outcomes: utilization of buprenorphine within Medicaid and the number of physicians holding the X-license for prescribing buprenorphine.
These aims will be accomplished through ongoing collection of policy and administrative data at the state-level with 4 annual surveys of a nationally representative sample of 1,200 physicians who hold the X-license to prescribe buprenorphine. This longitudinal survey design will support fielding four unique conjoint analyses, each addressing a key domain of physician decision-making, while also collecting data on CPBs over time. Data analysis will include cross-sectional multivariate models of decision-making and multi-level longitudinal analyses of CPB adoption and implementation to test theory-driven hypotheses. By measuring the quality, availability, and utilization of buprenorphine treatment in the US, this research may identify treatment gaps for which interventions may be developed to improve treatment quality for OUDs while contributing to scientific knowledge regarding the impact of the ACA on US treatment services.
This research will provide significant information about the implementation of buprenorphine for the treatment of opioid dependence by physicians in the context of the Affordable Care Act, including clinical decisionmaking and treatment quality. Measuring the quality of buprenorphine treatment may identify important targets for future interventions to improve the quality of care received by opioid-dependent patients while providing vital information regarding how health care reform is impacting this sector of the US treatment system.
|Lin, Lewei Allison; Lofwall, Michelle R; Walsh, Sharon L et al. (2018) Perceptions and practices addressing diversion among US buprenorphine prescribers. Drug Alcohol Depend 186:147-153
|Knudsen, Hannah K; Lofwall, Michelle R; Walsh, Sharon L et al. (2018) Physicians' Decision-making When Implementing Buprenorphine With New Patients: Conjoint Analyses of Data From a Cohort of Current Prescribers. J Addict Med 12:31-39
|Knudsen, Hannah K; Studts, Jamie L (2018) Physicians as Mediators of Health Policy: Acceptance of Medicaid in the Context of Buprenorphine Treatment. J Behav Health Serv Res :
|Knudsen, Hannah K; Studts, Jamie L (2017) Perceived Impacts of the Affordable Care Act: Perspectives of Buprenorphine Prescribers. J Psychoactive Drugs 49:111-121
|Knudsen, Hannah K; Havens, Jennifer R; Lofwall, Michelle R et al. (2017) Buprenorphine physician supply: Relationship with state-level prescription opioid mortality. Drug Alcohol Depend 173 Suppl 1:S55-S64
|Knudsen, Hannah K; Cook, Jennifer; Lofwall, Michelle R et al. (2017) A mixed methods study of HIV-related services in buprenorphine treatment. Subst Abuse Treat Prev Policy 12:37
|Knudsen, Hannah K; Lofwall, Michelle R; Havens, Jennifer R et al. (2015) States' implementation of the Affordable Care Act and the supply of physicians waivered to prescribe buprenorphine for opioid dependence. Drug Alcohol Depend 157:36-43
|Knudsen, Hannah K (2015) The Supply of Physicians Waivered to Prescribe Buprenorphine for Opioid Use Disorders in the United States: A State-Level Analysis. J Stud Alcohol Drugs 76:644-54

subset: commoncrawl


text:
A bunch of fringe first-class players has inflicted the first psychological blow of the summer against India as the tourist's attack struggled against the Cricket Australia XI in their tour match at the SCG.
Australian coach Justin Langer and his charges could have been watching on in delight as the CA XI forced the Indian to toil for 151 overs on Saturday.
The CA XI were eventually dismissed for 544 with a 186-run first-innings lead after a century by South Australian wicketkeeper Harry Nielsen.
Former Australian quick Mitchell Johnson took to Twitter to declare Nielsen, who has seven first-class games to his credit, a future Test player as he upstaged a full-strength Indian attack.
Worryingly for the tourists, the CA XI tail wagged on day four, with the Australians' last four batsmen contributing 203.
While it was on a flat wicket, India's inability to close out the innings was alarming.
"Anybody can score runs. We play the wicket," Indian opener Murali Vijay said.
"We tried our best to get them all out and our intensity was not up to the mark. We were trying a few things. That's bound to happen in a practice game."
Nielsen said his side had delivered a psychological blow and the tourists had expected them to declare early on day four.
"I think they were getting a bit grumpy, which was pleasing us with an eye towards the first Test," Nielsen said.
"I think we did beautifully batting for 160 overs or whatever. I bet they certainly didn't plan on that but they should have bowled us out."
No.9 Dan Fallins made an impressive 43, while Luke Robbins (38 not out) and Jackson Coleman (36) put on 57 for the final wicket.
India fielded what's expected to be their Test attack but they all struggled, with Mohammed Shami (3-97), Umesh Yadav (1-113), Ishant Sharma (1-73) and Ravichandran Ashwin (2-122) all expensive.
After play began 30 minutes early, the lunch break was delayed by half an hour to give India a chance to claim CA XI's final wicket. However, they couldn't land a breakthrough.
The game's first-class status was revoked after India asked to use 14 players.
And after lunch the Indians brought on a further two players in Jasprit Bumrah and Kuldeep Yadav. In all, India used 10 bowlers.
It took Virat Kohli to dismiss Nielsen, who skied a half-tracker from the star Indian batsman.


text:
Richarlison, Abdoulaye Doucoure and Marco Silva; three key figures during Watford's promising first three months of the Premier League season.
They are also, perhaps unsurprisingly, the three men being linked with other clubs and moves away from Vicarage Road.
As frustrating as that may be for the club and fans to see - especially when a certain Merseyside-based club do not take no for an answer - it is also a compliment.
Tottenham, Chelsea and Arsenal are not linked with players, certainly not players in this country anyway, unless they have excelled at their current teams.
Richarlison is an obvious one and he was on the radar of other English clubs prior to moving to Watford from Fluminense for £11.5m in early August.
His goals, performances and general attitude have only increased his value, as well as the interest in him.
Clubs are likely to come after him, whether that is in January or next summer remains to be seen.
He is a young Brazilian who excites crowd and has taken to English football like a duck to water.
The hype does not match that of Gabriel Jesus, understandably, but it will continue to grow over the coming weeks.
Doucoure, to Watford fans at least, is also obviously going to be a target for other clubs.
He has been one of the best performing midfield players in the Premier League throughout 2017, not just since Silva took over in July.
The gangly Frenchman has dominated players with much bigger reputations and transfer fees already this season.
When Watford play games live on BT or Sky Sports, Doucoure is usually the player other clubs' fans are talking about; he's the one they would love at their club.
Silva, well, enough has been written about him in the past couple of weeks and the future that he has in the game.
He knows that some of his charges at Watford are ambitious young footballers too, just as he is with his managerial career, and that they will be aiming for the very top in their careers.
He also knows that Doucoure and Richarlison must not change anything, though, in terms of their approach to training and games if, eventually, they do want to secure a move to a bigger club.
"I'm sure Richarlison and Doucoure will stay in a good way [despite the speculation], and nothing's changed in our behaviour," Silva said.
"It [speculation] is normal, it can happen. The players are doing well, the team has performed well.
"The players know that to achieve what they want in their careers, they have to give 100% here everyday.
"They have goals as well, but they need to work for Watford everyday first."
Silva also reiterated the need for Watford's entire first-team squad to keep their feet on the ground, something that is perhaps easier now given their run of defeats prior to the international break.
He says there is still 'a lot' that Watford need to change if they want to fulfil their early season promise.
"Everybody has asked me since the first day I came [if our target has now changed] and I don't like, even if we perform well, to change things in 11 or 12 games," he added.
"We keep our feet on the ground and we need to improve a lot, a lot, a lot.
"To achieve these things we need to improve a lot and change things."
Silva was not keen to expand on what it is that they need to improve: "They are things I talk about with Gino [Pozzo], not with you," he said, but he did accept that it is an exciting time for everyone involved in the club.
"This is our job; for our owner, Gino, me as a coach and for our players too, to do all we can, do our work and keep them [the fans] happy," he explained.
"They love the club and if they feel we are doing our best then they're happy and enjoy it."


text:
- Research
- Open access
- Published:
Impact of a board-game approach on current smokers: a randomized controlled trial
Substance Abuse Treatment, Prevention, and Policy volume 8, Article number: 3 (2013)
8268 Accesses
27 Citations
11 Altmetric
The main objective of our study was to assess the impact of a board game on smoking status and smoking-related variables in current smokers. To accomplish this objective, we conducted a randomized controlled trial comparing the game group with a psychoeducation group and a waiting-list control group.
The following measures were performed at participant inclusion, as well as after a 2-week and a 3-month follow-up period: "Attitudes Towards Smoking Scale" (ATS-18), "Smoking Self-Efficacy Questionnaire" (SEQ-12), "Attitudes Towards Nicotine Replacement Therapy" scale (ANRT-12), number of cigarettes smoked per day, stages of change, quit attempts, and smoking status. Furthermore, participants were assessed for concurrent psychiatric disorders and for the severity of nicotine dependence with the Fagerström Test for Nicotine Dependence (FTND).
A time × group effect was observed for subscales of the ANRT-12, ATS-18 and SEQ-12, as well as for the number of cigarettes smoked per day. At three months follow-up, compared to the participants allocated to the waiting list group, those on Pick-Klop group were less likely to remain smoker.
Outcomes at 3 months were not predicted by gender, age, FTND, stage of change, or psychiatric disorders at inclusion.
The board game seems to be a good option for smokers. The game led to improvements in variables known to predict quitting in smokers. Furthermore, it increased smoking-cessation rates at 3-months follow-up. The game is also an interesting alternative for smokers in the precontemplation stage.
Although most smokers are informed about the disease and death risks associated with smoking, this awareness is not always sufficient to induce behavioral change [1]. Furthermore, despite the efficacy of nicotine replacement therapy (NRT; [2], bupropion [3], varenicline, and behavioral approaches [4], these treatments are used by only a minority of smokers [5, 6], and the number of sustained smoking cessation attempts remains insufficient. This is probably at least partly linked to attitudes towards smoking and smoking cessation [7]; to smokers' lack of knowledge about, or negative attitudes towards, treatments [8]; and to lack of self-efficacy (confidence in one's own ability to refrain from smoking in a relapse situation); [9]. For example, a positive attitude towards NRT and an increase in self-efficacy may lower the consumption of cigarettes and increase quitting in smokers [8, 10, 11]. More specifically, positive attitudes towards NRT are associated with more frequent use of NRT [8]. Thus, the development of new instruments able to have an impact on these dimensions, and which are acceptable by a wide range of smokers, including those who do not want to quit, is of particular interest.
A board game may be a good approach for modifying attitudes and cognitions. Board games probably excite curiosity, as well as emotional and intellectual investment in a secure place ("the game"). They do so in a decentered way that does not induce feelings of guilt, because participants do not have to talk about their individual problems. Board games may also facilitate communication between players. Furthermore, games can be effortlessly disseminated. Games have already been used in another health-related domain with promising results [12].
The board game "Pick-Klop" has been created with this in mind. Its objectives are to (1) inform smokers about smoking and smoking cessation in a way that does not make them feel guilty; (2) increase smokers' confidence in their ability to stop smoking (self-efficacy); (3) modify attitudes (i.e., perceived advantages and drawbacks) towards smoking and towards tobacco dependence treatments; and (4) help or lead smokers during smoking reduction and smoking abstinence processes.
A first assessment of this game was carried out in 51 patients hospitalized in a psychiatric clinic [13] and concluded to the acceptability of the game and to a favorable impact on intentions to stop smoking. This first study and a second non-controlled study (in press) in a general population of smokers led to improvements in the design and characteristics of the game after a qualitative analysis of the smokers' comments.
The current study aimed to assess, with a randomized controlled design, the impact of two sessions of this game on a sample of current smokers who did or who did not ask for smoking cessation (precontemplation, contemplation, or preparation stages).
Study design
We conducted a prospective open-label randomized controlled trial with follow-up after 3 months. Eligible smokers were randomly allocated to one of three treatments: two sessions of 1.5 hours each of the Pick-Klop game, two sessions of 1.5 hours each of psychoeducation, or a waiting list. Pick-Klop and psychoeducation sessions were given in a group format once a week for 2 weeks. The randomization ratio was 2:1:1 to obtain more participants in the Pick-Klop experimental condition. A permuted block randomization procedure was done by a research assistant. There was no blinding assessment. The measures were, however, based on self-report questionnaires.
Information related to the study was given in written and oral form by the psychologists working as research assistants. After inclusion criteria were checked, participants gave their written informed consent to the research assistants. The study was approved by ethics commissions in Lausanne, Geneva, and Valais, Switzerland.
To be included in the study, participants had to be adults (18–65 years) who were current daily smokers (smoking daily during the last month) and had to give written informed consent. Exclusion criteria were limited to mental retardation and several acute psychiatric disorders that may compromise participation in the Pick-Klop group (acute psychotic episode, manic episode, and moderate or severe depressive episode).
Smokers were recruited between 2007 and 2010 by advertising in local newspapers, and among employees and students at schools and universities.
After preliminary e-mail or phone contact, potential participants received information about the study. A total of 248 current smokers (60% of those who sent an e-mail or asked by phone for further information in response to the advertising) were then assessed for study inclusion. Only two of them were not included because of exclusion criteria and six refused study participation. As a result, 240 smokers were eligible and participated in the study, 65% of whom were women.
All participants who fulfilled the inclusion criteria and signed the consent form were randomized as follows: 120 participants in the Pick-Klop group, 60 in the psychoeducation group, and 60 in the waiting-list group (Figure 1).
Sample size estimation and randomization procedures
This study derives from a more complex study that was designed for six groups of participants (three groups of adults aged between 18 and 65: Pick-Klop, psychoeducation, and waiting list; and three groups of teenagers under 18: Pick-Klop, psychoeducation, and waiting list) and four repeated measures (one baseline and three follow-up measures). From the outcome of the psychoactive benefits of smoking, a domain of Attitudes Towards Smoking Scale (ATS-18), it was hypothesized that a clinically meaningful difference of 0.7 between the Pick-Klop and the psychoeducation group means after treatment could be detected with 80% power. Hence, after inputting the other values in the formula by Diggle, Liang, and Zeger (Analysis of Longitudinal Data, 1994), namely, type I error rate: α = 0.05, measurement variation: σ2 = 9.0, number of repeated observations per person: n = 4, and correlation among the repeated observations: p = 0.3, the estimated sample size for this design was about 100 persons per group. In order to obtain a balanced design for adult participants, the number of persons in the Pick-Klop group was brought to twice as many as the number of persons in the two control groups put together. Hence, given this 2:1:1 ratio, the final sample size for the Pick-Klop group was 200 participants. Because of recruitment difficulties, however, the randomization procedures generated by http://www.randomization.com stopped prematurely at 30 permuted blocks of 8, thus leaving a sample of 240 adult participants for the analysis. The number of repeated measures also had to be revised downward to three.
The Pick-Klop board game
The Pick-Klop game (an informal expression for "pick a cigarette") includes more than 300 cards with questions, each with three response options. The questions cover the following: (1) smoking and tobacco history, (2) tobacco components and their biological effects, (3) reinforcement mechanisms involved in smoking addiction, (4) cognitive and behavioral mechanisms involved in the maintenance of smoking, (5) smoking cigarettes as a coping strategy, (6) costs of tobacco addiction and the benefits of quitting smoking, (7) stages of change, (8) cognitive and behavioral mechanisms involved in behavioral change, and (9) medications and treatments that help during smoking cessation.
Participants play in groups of two to six. The game board (Figure 2) introduces different characters in different stages of change. Players move their pawns by throwing dice. According to the score obtained, players draw a card in one of the following categories: question, surprise, or temptation. If they answer the question cards correctly, players may gain points. Surprise cards add amusement, allowing players to obtain a gift or secret cards that allow them to help or block another player during play at the moment of their choice. The number of temptation cards increases at the end of the game board. These cards illustrate lapse and relapse processes, as well as relapse prevention strategies. Different lapse/relapse situations are presented, each with two ways of facing the situation: smoking or adopting another behavior. To pass a temptation box, players have to pay points; if they do not have enough points (a metaphoric illustration of inadequate preparation for how to behave in relapse situations), players move to one of three different levels of relapse boxes. In each of these boxes, participants receive bonus points and pursue the game and may win a play. The winner is the first participant to reach the last game box. Participants may choose between shorter or longer ways to attain the end point. Shortcuts may help a player to win quickly, but they involve a possibly higher risk of relapse (fewer questions and then possibly fewer points to pass the temptation boxes). A full game play usually takes between 15 and 45 minutes.
During each game session, the cards are selected randomly. Therefore, in each group, the cards used vary widely. The high number of cards in each category allows participants to explore the main aspects of smoking and smoking-cessation processes during each session and to consider a variety of situations and answers when playing repetitively.
Psychoeducation group
Trained psychologists gave two standardized group sessions (1.5 hours each) of psychoeducation (with a slide show) about smoking and smoking cessation. They presented information on smoking, smoking costs (health risks), dependence criteria, motivational stages of change, and available treatments for smoking cessation and discussed these topics with participants.
Waiting-list group
Participants on the waiting list, as well those allocated to the other groups, received a Pick-Klop game board after the third month's assessment.
At inclusion, participants were assessed for socio-demographic characteristics and psychiatric disorders by using the Mini International Neuropsychiatric Interview (MINI; [14]. Psychiatric disorders were assessed to establish exclusion criteria and also in consideration of the frequency of psychiatric disorders among smokers. Population-based studies have repeatedly found that daily smoking is more common among individuals with psychiatric disorders, including mood disorders, than among individuals with no psychiatric diagnosis [15–17]. Furthermore, smokers with psychiatric disorders appear to be less likely to quit smoking than those without such disorders [18]. In consideration of the inclusion and exclusion criteria, we expected the present study on current smokers from the community to include a substantial proportion of persons with psychiatric disorders.
Participants were also assessed for past smoking cessation attempts, smoking environment (living with smokers), nicotine dependence using the Fagerström Test for Nicotine Dependence (FTND; [19, 20], and other smoking-related attitudes and behaviors. Several measures related to smoking behavior were repeated at follow-up after 2 weeks (after treatment sessions) and after 3 months. These measures included the following: stage of change [21], (ATS-18) [1], Smoking Self Efficacy Questionnaire (SEQ-12); [22], Attitudes Towards Nicotine Replacement Therapy scale (ANRT-12); [23], smoking status, occurrence of new smoking cessation attempts, methods used to stop smoking, and number of cigarettes smoked per day.
At the end of the second Pick-Klop session, participants also answered questions on satisfaction with the game, using an adaptation of Attkisson's Client Satisfaction Questionnaire (8-item version, CSQ-8); [24].
The stage of change was assessed with a "yes" or "no" question related to the participant's intention to quit smoking (i.e., precontemplation: no intention to quit smoking in the next 6 months; contemplation: seriously considering quitting smoking in the next 6 months; preparation: have decided to quit smoking in the next 30 days; and action: stopped smoking).
Smoking status was assessed by self-report. Included participants were daily smokers (smoking daily during the last month) and were considered non-smokers after at least 1 month without smoking for the assessment made at month 3 (T2). Participants were considered non-smokers at T1 (Week 2) if they stopped smoking at least one day before the assessment (initiation of smoking-cessation).
SEQ-12 is a two-dimensional scale that measures confidence in aptitude to refrain from smoking when facing external stimuli (six items: e.g., being with smokers) and internal stimuli (six items: e.g., feeling anxious; [22]. Smokers were asked to indicate whether they were sure that they would refrain from smoking in each situation. Response options were coded on a Likert scale from not at all sure (score: 1 point) to absolutely sure (score: 5 points).
The three subscales of the ATS-18 measure perceptions of adverse effects of smoking (10 items), psychoactive benefits of smoking (four items), and pleasure of smoking (four items). Answers were given on a 5-point Likert scale from totally disagree (score: 1) to fully agree (score: 5).
ANRT-12 is composed of two subscales that measure the perception of the advantages (eight items) and drawbacks (four items) of NRT, respectively [23]. Participants answered the questions on a 5-point Likert scale ranging from strongly disagree (score: 1) to fully agree (score: 5). A sixth response option is "I don't know." A further subscale of the ANRT-12 is related to the sum of "I don't know" answers. The total score for each subscale is obtained by adding the scores obtained for each item. A higher score on a subscale means higher involvement in the subscale.
ATS-18, SEQ-12, and ANRT-12 have good psychometric properties [1, 22, 23]: test-retest correlation coefficients range between 0.75 and 0.95, and internal consistency coefficients (Cronbach's alpha) range between 0.75 and 0.95 for all scales.
Primary and secondary outcomes
The primary outcomes were the following ones:
ANRT-12 score assessed at baseline, and then 2 weeks and 3 months later
ATS-18 score assessed at baseline, and then 2 weeks and 3 months later
SEQ-12 score assessed at baseline, and then 2 weeks and 3 months later
The secondary outcomes were the following ones:
Smoking status assessed at week 2 and month 3
Number of cigarettes smoked per day assessed at baseline, and then 2 weeks and 3 months later
Number of quit attempts assessed at baseline, and then 2 weeks and 3 months later
Stage of change assessed at baseline, and then 2 weeks and 3 months later
Satisfaction of the Pick-Klop user assessed at week 2.
In the text, baseline, 2-week, and 3-month measures will be referred to henceforth as T0, T1, and T2 measures, respectively.
Statistical analysis
Preexisting differences between the three study groups in participants' characteristics at baseline, as well as potential attribution bias between completers and non-completers, were checked.
In this regard, for quantitative measures, one-way analysis of variance (ANOVA) or Student t-tests were used as appropriate, whereas for categorical measures, we used the Pearson's chi-square or Fisher's exact tests. The impact of the game was studied through changes over time occurring in the outcome measures between the three study groups as follows.
For quantitative outcomes (ANRT-12, ATS-18, SEQ-12, number of cigarettes smoked, number of quit attempts), we used repeated measures ANCOVAs (analysis of covariance), with treatment group (Pick-Klop vs. psychoeducation vs. waiting list) as the factor of interest while controlling for age and gender which were found differently distributed across groups at baseline. Preliminary checks were conducted to ensure that the assumptions of normality, linearity, homogeneity of variances and homogeneity of regression slopes were satisfied. When either of these conditions was not met, appropriate transformations such as categorization of the covariate were done, notwithstanding some loss of information, and repeated measures ANOVAs conducted instead.
To assess the evolution of categorical outcomes (stage of change observed at T0, T1, and T2 and smoking status observed at T1 and T2), we used the generalized estimations equation (GEE) approach to handle these correlated data. This procedure fits a model for the dependent variable stage of change to the respective smoking status, using treatment group and time as factors. To allow for adequate group size, we dichotomized stages of change as follows: participants in the precontemplation stage were grouped in stage 1, while participants in the contemplation, preparation, and action stages were grouped in stage 2. Because the model specification assumes a binomial distribution of the outcomes, we chose a logit link function, which relates the probability of these outcomes to a linear combination of the predictors. As a goodness-of-fit criterion, we used The Quasi-likelihood under Independence Model Criterion (QIC) to select between two models: one with the main effects only and one with the main effects together with an interaction term. The model that obtains the smaller QIC is "better" according to this criterion.
In addition, to assess potential factors associated with smoking cessation (smoker vs. non-smoker) at T2, we used a multiple logistic regression model with age, gender, FTND scores, treatment group, stage of change and psychiatric disorders as independent variables. Likewise, selected end-point outcomes, namely ARNT-12, ATS-18 and SEQ-12 scores at T2 were also regressed on the same variables but in multiple linear regression models due to their quantitative nature.
Analyses were done on an intention-to-treat basis, whereby all randomized subjects were included. Quantitative missing data were imputed by the expectation-maximization algorithm, a statistical simulation technique that estimates the averages, the matrix of variance and covariance, and the matrix of correlations for the quantitative variables by using an iterative procedure. After convergence, the missing data were replaced by their obtained estimation and the completed data were then analyzed by the usual methods.
For categorical outcomes, adopting the worst-case scenario, we assumed that everyone who was missing in the intervention groups or in the control group had the worst outcomes. All the statistical tests were two-tailed and at a 5% significance level. Statistical analysis was performed with SPSS (version 18.0, IBM, Chicago, USA).
Baseline characteristics of subjects
The mean age of the participants was 31.5 (SD = 12.1) years, the mean baseline cigarette consumption was 15 cigarettes per day (SD = 7.9), and the mean age at onset of smoking was 16.2 years (SD = 2.7). The Fagerström Test for Nicotine Dependence (FTND) mean was 3.2 (SD = 2.1). Among participants, 28.11% had psychiatric disorders according to MINI, most frequently mood disorders. Furthermore, 22.7% of smokers reported cannabis use at least once a week, 77.5% reported regular alcohol consumption, and 6.2% had alcohol dependence according to MINI. At T0, 35% of smokers were in the precontemplation stage of change (had no intention to quit smoking in the next 6 months).
At T0, participants differed on the following variables: gender, age, age at start of smoking, number of cigarettes smoked per day, and stage of change (Table 1).
At T1, 53 participants (22.1%) discontinued the study. Their baseline characteristics were compared with those who continued the study (Table 2). There was a statistically significant difference between completers and non-completers regarding the stage of change (p = 0.006), the level of education (p = 0.01), and the psychoactive benefits of smoking (p = 0.008). By using logistic regression, we observed that, compared with those who continued, participants who dropped out of the study were more likely to be in the preparation stage of change than in the precontemplation stage, had a lower level of education and scored higher on the perception of the psychoactive benefits of smoking. There was no attribution bias since no statistical difference in the distribution of completers and non-completers in the three study groups was observed. At T2, 14 participants did not show up for unknown reasons. In the end, the rate (number) of non-completers was 21.7% (26), 36.7% (22), and 31.7% (19) in the Pick-Klop, psychoeducation, and waiting-list groups, respectively. The details of their distribution are shown in Figure 1.
Attitudes Towards Nicotine Replacement Therapy Scale (ANRT-12)
We conducted a repeated ANCOVA analysis for the perceived advantages of NRT. The multivariate results showed a statistically significant overall time effect (F (2, 234) = 4.3, p =0.01). We noted a sharp increase of scores between T0 and T1 (F (1,235) = 7.0, p = 0.009). There also was a treatment group × time interaction (F (4,470) = 8.3, p < 0.0005). Both intervention groups compared to the control group significantly increased their mean between T0 and T1 (F (2,235) = 16.7, p < 0.0005). This mean difference was still significant between T1 and T2 (F (2,235) = 3.3, p = 0.04). Finally, a main group effect was observed (F (2,235) = 6.0, p = 0.003). This translates higher overall means on the dependent variable for Pick-Klop and psychoeducation groups compared to the waiting list group. The covariate age was not linearly related to the dependent variable and therefore provided no statistically significant adjustment. No significant main effect of gender was found.
For the nicotine perceived drawback, the covariate age had to be transformed to a categorical variable due to the heterogeneity of the regression slopes. Based on the histogram, three levels of this variable were identified: 18–24, 25–30 and more than 30 years old. Hence, we conducted a repeated ANOVA. The multivariate results showed a statistically significant time x treatment group effect (F (4, 460) = 4.4, p =0.002). Between T0 and T1 the mean scores for Pick-Klop and waiting list groups increased (F (2, 230) = 7.9, p < 0.0005) while they decreased for psychoeducation. A statistically significant treatment group x age interaction was found (F (4, 230) = 6.3, p < 0.0005). The youngest in the Pick-Klop and waiting list groups had higher mean scores than their counterparts in psychoeducation. No main effect was observed for gender.
Regarding the "don't know" answer scores, a repeated ANCOVA analysis yielded significant overall time effect (F (2,234) = 9.0, p < 0.0005). The scores decreased between T0 and T1 (F (1, 235) =18.1, p < 0.0005) and between T1 and T2 respectively (F (1, 235) =5.6, p =0.02 ). There also was a treatment group × time interaction (F (4,470) = 3.2, p = 0.01). Between T0 and T1, psychoeducation groups decreased their scores more than Pick-Klop and the waiting list group (F (2,235) = 5.2, p = 0.006). But between T1 and T2, Pick-Klop decreased its scores more than psychoeducation and waiting list groups (F (2,235) = 4.7, p = 0.01). The covariate age was significantly associated with the dependent variable. Moreover a main effect was observed for gender, with higher scores for women than men.
Attitudes Towards Smoking Scale (ATS-18)
For scores related to the perception of the pleasure of smoking, following an ANCOVA analysis, a multivariate results showed an overall time effect (F (2, 234) = 8.0, p < 0.0005). A decrease of mean scores was observed between T0 and T1 and between T1 and T2 (F (1, 235) = 7.5, p = 0.007 and F (1, 235) = 4.4, p = 0.04 respectively). A time x group interaction (F (4, 470) = 4.3, p = 0.002) was also observed. Between T0 and T1, the mean scores for the two treatment groups decreased while they increased for the waiting list (F (2, 235) = 5.7, p = 0.004). The covariate age was significantly associated with the dependent variable. There was no main effect for gender.
The multivariate results only showed an overall time effect for scores related to the perception of psychoactive benefits of smoking (F (2, 234) = 6.6, p = 0.002). This decrease of scores was mainly observed between T0 and T1 (F (1, 235) = 11.9, p = 0.001). The covariate age was not linearly related to the dependent variable and therefore provided no statistically significant adjustment. On the contrary, there was a significant main effect for gender, with higher scores for women than men.
For adverse effects of smoking, to circumvent the heterogeneity problem of regression slopes, we used categories of age and gender as control variables in a repeated ANOVA. The multivariate results showed an overall time effect (F (2, 227) = 9.5, p < 0.0005). An increase of scores was observed, mainly between T0 and T1 (F (1, 228) = 14.5, p < 0.0005). A time x treatment group interaction was also observed at the limit of significance (F (4,456) = 2.4, p = 0.05) with an increase for Pick-Klop and waiting list between T0 and T1. An effect of group x age was observed. The eldest in Psychoeducation and waiting list groups had higher mean scores than the youngest in Pick-Klop. Finally, an effect of group and gender showed that women in Pick-Klop and waiting list had higher scores than men. The reverse was true for psychoeducation.
Smoking Self-Efficacy Questionnaire (SEQ-12)
Self-efficacy towards external stimuli was assessed through an ANOVA for repeated measures using age categories and gender as control variables. An overall time effect was observed (F (2, 233) = 6.0, p = 0.003). It was shown that this effect was accompanied by an increase of scores between T0 and T1 (F (1, 234) = 4.3, p =0.04) and between T1 and T2 (F (1, 234) = 6.0, p = 0.02). There was a main effect for age: older participants had higher mean scores than the youngest. No main effect for gender.
To assess self-efficacy towards internal stimuli, we used an ANCOVA for repeated measures. There was an overall time effect (F (2, 234) = 6.2, p = 0.002). It was shown that this effect occurred mainly between T1 and T2 (F (1, 235) = 10.4, p = 0.001). A treatment group × time interaction was observed as well (F (4, 470) = 3.5, p = 0.008). This effect occurred mainly between T1 and T2 (F (2, 235) = 4.2, p = 0.02). The scores were significantly higher for the Pick-Klop group compared with the psychoeducation and the waiting list groups between these times. The covariate age was not linearly related to the dependent variable and therefore provided no statistically significant adjustment. However, a significant main effect was observed for gender, with higher scores for men than women.
Number of cigarettes smoked per day
A repeated measures ANOVA using age categories and gender as control variables was conducted. The results showed an overall time effect (F (2 229) = 24.8, p < 0.0005). This effect reflects a significant decrease of cigarettes smoked mainly between T1 and T2 (F (1, 230) = 25.8, p < 0.0005). A time x treatment group effect was observed as well (F(4, 460) = 5.2, p < 0.0005). The Pick-Klop group significantly decreased the number of cigarette smoked per day compared to the psychoeducation and the waiting list groups mainly between T1 and T2 (F(2, 230) = 3.5, p = 0.03). Younger participants in psychoeducation smoked more cigarettes per day than their counterparts in Pick-Klop. There was no main effect of gender.
Number of quit attempts
A repeated measures ANOVA using age categories and gender as control variables was conducted. The multivariate results showed a significant time effect (F (2, 233) = 31.0, p < 0.0005). The mean number of quit attempts increased between T1 and T2 (F (1, 234) = 9.4, p = 0.002). There was a main effect for age: the youngest had a lower number of quit attempts than the eldest. No other effect was observed.
Stage of change
At T0, 35% of smokers were in the precontemplation stage (had no intention to quit smoking in the next 6 months), 51.3% in the contemplation stage (seriously considered quitting smoking in the next 6 months), and 13.8% in the preparation stage (had decided to quit in the next month). At T1, a new stage emerged: the action stage (participants who stopped smoking). Details for each study group are reported in Table 3.
The evolution of stage of change measures was assessed through the GEEs by which we fitted a model with time and group main effects only, as the inclusion of a time × group interaction term did not seem to give a better fit. The GEE results showed a time effect: compared with participants at T2, participants at T0 and T1 were more likely to be in stage 2 than in stage 1 (p < 0.005, OR = 2.04, and CI = [1.45; 2.87] and p = 0.004, OR = 1.49, and CI = [1.14; 1.95], respectively). There also was a group effect. With a significance of 0.02, the Pick-Klop and psychoeducation groups were more likely to be in stage 2 than in stage 1 compared with the waiting-list group (OR = 1.8 and CI = [1.1; 2.9].
Smoking status
Again, according to the QIC value, we chose the main effect model with time and group as factors. The GEE results showed both a time effect and a group effect. Compared with participants at T2, those at T1 were more likely to be smokers (p = 0.001, OR = 4.27, and CI = [1.87; 9.77]). Compared with the participants in the waiting-list group, those in the Pick-Klop group were less likely to be smokers (p = 0.04, OR = 0.32, and CI = [0.11; 0.96]). There was no significant difference between the psychoeducation and the waiting-list groups as the confidence interval includes the "1" value.
Prediction of smoking cessation and other cessation-related variables
In order to find possible independent variables that predict smoking cessation at T2, a logistic regression was carried out with the following variables: age, gender, FTND scores, psychiatric disorders (at least one psychiatric disorder or dependence on a substance other than nicotine), treatment group and stage of change at baseline. The results showed that 11% of the variance of the dependent variable was explained by this model. Only treatment group was found to predict smoking cessation at T2. Compared to the waiting list group, Pick-Klop group was less likely to be smoker at T2 (p = 0.03, OR = 0.18, and CI = [0.04; 0.86]).
Similarly, predictions of other smoking-related attitudes (ANRT-12, ATS-18, and SEQ-12 subscale scores at T2) by linear multiple regressions with age, gender, FTND scores, stage of change, treatment group and psychiatric disorders as independent variables were significant for treatment group only. For these regressions, the variance ranged from 1% to 14%. Introducing the subscale scores under analysis at T0 as supplementary predictors changed the variance from 7% to 44%. Hence, the scores at T0 were significant predictors of scores at T2.
Satisfaction of Pick-Klop users
During the sessions, participants laughed frequently in a pleasurable ambiance. They often added personal comments in relation to the cards. The game received a good score on the CSQ-8 by the participants, with a mean score of 23.2 (SD = 3.2) of 32. Only 13.8% of the participants gave a score below 20.
This study showed that Pick-Klop, a board game for smokers, is an acceptable, feasible, and potentially helpful intervention for smokers who wish to quit smoking or for those who do not. At inclusion, 35% of smokers were in the precontemplation stage (had no intention to quit smoking in the next 6 months). The game therefore seems also to be acceptable for smokers in the precontemplation stage.
Furthermore, the study assessed participants for psychiatric and substance abuse disorders, which are common comorbidities among smokers [15–17], showing the acceptability of the game and the study process among participants with comorbid psychiatric or substance use disorders.
The dropout rate was relatively low (22.1%), indicating a good acceptability of the study process and the study treatment procedures. Smokers who dropped out of the study were more likely to be in the preparation stage than in the precontemplation stage. One possible hypothesis is that for people who are in precontemplation, the tools and the game are acceptable, whereas a part of the smokers in preparation may ask for more intensive treatment tools. There is higher dropout among people who scored high on the psychoactive benefits of smoking, probably linked to more difficulty in engaging in a smoking-cessation process. Furthermore, people with a lower level of education dropped out more frequently, possibly due to difficulties regarding several aspects of the game questions or of psychoeducation. Overall, it appears, however, that the smokers reported good satisfaction related to the game.
A favorable time effect was observed for most of the variables under scrutiny. A number of important between group differences were observed.
Across time, between T1 and T2, scores on internal self-efficacy increased for smokers allocated to Pick-Klop more than for the participants allocated to psychoeducation or to the waiting list. The game includes an important number of cards linked to smoking facing internal stimuli. This may explain the more important impact on internal self efficacy than on external self-efficacy.
In addition, smokers in the Pick-Klop and the psychoeducation groups increased their knowledge related to NRT (decrease of "I don't know" answers). Psychoeductaion seems to have a more important effect between T0 and T1 whereas the effect of Pick-klop seems to be more important between T1 and T2. Furthermore the perceived advantages of NRT increased in pick–klop and psychoeducation groups more than it did among the participants allocated to the waiting-list group.
These observed changes were of high interest in consideration of previous studies showing that a positive attitude towards NRT and an increase in self-efficacy may enhance quitting in smokers, reduce the number of smoked cigarettes, and increase the use of NRT during smoking-cessation attempts [8, 10, 11].
During the study, a decrease of the scores related to the perception of the pleasure of smoking was observed. This decrease was more important for the participants allocated to Pick Klop and psychoeducation than to the waiting list between T0 and T1 and between T1 and T2.
The study did not find any treatment group effect on the perception of psychoactive benefits of smoking. The mean scores related to the perception of the adverse effects of smoking increased however between T0 and T1 for Pick Klop and waiting list group (at a trend level) more than for the other groups.
Lack of clear treatment group effects on these last two measures is possibly due to the sample size. Furthermore, participants have already a relatively good awareness related to the adverse effects of smoking among participants at inclusion. So it is probably more difficult to increase more this aspect. Psychoactive benefits of smoking were discussed during the Pick Klop game sessions as well as during psychoeducation as possible reinforcement mechanisms involved in smoking addiction and were acknowledged by this way. So the interventions may have an impact on the awareness of the links between these effects and the addictive aspects of the behavior rather than on the strict perception of the effects.
The decrease of the scores related to the perception of the pleasure of smoking may have an impact on further smoking cessation attempts by a modification of the perception of the advantages related to smoking.
Because of the relatively small sample size, stages of change were regrouped into stage 1 (precontemplation) and stage 2 (contemplation, preparation and action). It appears that smokers allocated to the Pick-Klop and psychoeducation groups were more likely to progress towards stage 2 than were participants in the waiting-list group.
Positive group effects on the behavioral measures were also found. For instance, a greater decrease in the number of cigarettes smoked per day was observed for the participants of the Pick-Klop group than for the other groups mainly between T1 and T2.
The observed finding is possibly of interest regarding the previously reported link between the reduction of the number of smoked cigarettes and the observation of further smoking cessation [25].
Furthermore, compared with participants at T1, those at T2 were more likely to be non-smokers. This effect is more important among participants in the Pick-Klop group than among participants in the waiting-list group. There was no significant difference between the psychoeducation and the waiting-list groups.
Thus, the participants allocated to the Pick-Klop group or to the psychoeducation group showed rapid improvement (since T1) in the main non-behavioral outcomes (attitudes towards NRT, self-efficacy, attitudes towards smoking). For some of these outcomes, Pick-Klop seems to have some advantages, particularly on internal self-efficacy and to a lesser extent on the perception of the adverse effects of smoking.
The effect of Pick-Klop on several of these non-behavioral measures appears more clearly between T1 and T2, particularly for internal self-efficacy and knowledge related to NRT. One can hypothesize that the game may enhance change by some connections automatically made by the participants when facing, at distance from the game sessions, situations similar to those encountered during the game sessions (i.e. similarities with situations encountered by the game characters…).
The behavioral effects (reduction of the number of cigarettes smoked per day and smoking cessation) appeared later at T2. One could thus hypothesize that the first non-behavioral modification will lead to later behavioral change. For example, it was previously found that an increase in self-efficacy is associated with further smoking cessation [22]. The participants in Pick-Klop showed greater changes towards smoking cessation than the waiting-list group did. The differences on smoking cessation was however not significant between psychoeducation and the waiting list. The small sample size may contribute to this finding. The game may offer some advantages for the enhancement of behavioral change, possibly by some identification with the game characters.
None of the demographic, psychological, or psychiatric variables studied in the present study were strongly associated with further smoking cessation. This finding is possibly due to the sample size, or to the contribution of other factors to the change process, such as environmental support [26]. Treatment group allocation was however found to predict smoking cessation at T2. Compared to the waiting list group, Pick-Klop group was less likely to be smoker at T2.
The Pick-Klop group performed better than the waiting-list group and as well as or better than the psychoeducation group for the main outcomes. Thus, psychoeducation and the Pick-Klop game may have some advantage on non behavioral (i.e. internal self-efficacy) and behavioral outcome (smoking cessation at T2). The game seems to be a good option, possibly eliciting behavioral change in a wide range of smokers, including smokers in precontemplation or smokers with psychiatric or substance use disorders, as previously suggested by preliminary studies [13].
Despite the randomized controlled design of the present study, some limitations have to be considered, including the open-label design, the absence of long-term follow-up, the absence of biochemical variation in smoking abstinence, and the relatively small sample size. In addition, the particular circumstances of the premature closure of the study because of recruitment difficulties led to an underpowered study. Indeed, with the formula given by Diggle et al., the study could achieve only 70% of power. As power remains a useful statistical measure that acts as a magnifying glass in the detection of an effect size, the research may have sometimes failed to point to a true between-groups difference due to lack of power. The modification of the study objectives (in terms of the number of included participants) was discussed with an independent referral extern to the study group (study founding contributor) and was considered as an acceptable option.
The difficulties related to the recruitment process were probably due to the characteristics of the study which was may be too much demanding in time for smokers who were not asking for help. The game in itself seems to be appreciated by the participants. One of the possible advantages of a game such as Pick-Klop is to offer smokers an alternative way to learn about information and treatment. Further studies may specify the factors associated with smokers' learning preferences. A further question is related to the impact of the game on smokers' later use of other proposed tools and aids for smoking cessation. It may also be helpful to study and develop other varieties of the game, as differences in game format, content, or purpose may change its clinical impact and attractiveness. A further study, in preparation, will assess an electronic version of the game, which may be more appealing in general, especially for younger smokers.
Etter JF, Humair JP, Bergman MM, Perneger TV: Development and validation of the Attitudes Towards Smoking Scale (ATS-18). Addiction. 2000, 95 (4): 613-625. 10.1046/j.1360-0443.2000.95461312.x.
Silagy C, Mant D, Fowler G, Lancaster T: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2000, CD000146-3
Hughes JR, Stead LF, Lancaster T: Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2003, CD000031-2
Stead LF, Lancaster T: Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2002, CD001007-3
Hughes JR: Motivating and helping smokers to stop smoking. J Gen Intern Med. 2003, 18 (12): 1053-1057. 10.1111/j.1525-1497.2003.20640.x.
Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE: Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003, 5 (1): 13-25.
Droomers M, Schrijvers CT, Mackenbach JP: Educational differences in the intention to stop smoking: explanations based on the Theory of Planned Behaviour. Eur J Public Health. 2004, 14 (2): 194-198. 10.1093/eurpub/14.2.194.
Hammond D, McDonald PW, Fong GT, Borland R: Do smokers know how to quit? Knowledge and perceived effectiveness of cessation assistance as predictors of cessation behaviour. Addiction. 2004, 99 (8): 1042-1048. 10.1111/j.1360-0443.2004.00754.x.
Prochaska JO, DiClemente CC, Norcross JC: In search of how people change. Applications to addictive behaviors. Am Psychol. 1992, 47 (9): 1102-1114.
Nicki RM, Remington RE, MacDonald GA: Self-efficacy, nicotine-fading/self-monitoring and cigarette-smoking behaviour. Behav Res Ther. 1984, 22 (5): 477-485. 10.1016/0005-7967(84)90051-2.
Dijkstra A, Wolde GT: Ongoing interpretations of accomplishments in smoking cessation: positive and negative self-efficacy interpretations. Addict Behav. 2005, 30 (2): 219-234. 10.1016/j.addbeh.2004.05.010.
Khazaal Y, Favrod J, Libbrecht J, Finot SC, Azoulay S, Benzakin L, Oury-Delamotte M, Follack C, Pomini V: A card game for the treatment of delusional ideas: a naturalistic pilot trial. BMC Psychiatry. 2006, 6: 48-10.1186/1471-244X-6-48.
Khazaal Y, Chatton A, Prezzemolo R, Hoch A, Cornuz J, Zullino D: A game for smokers: a preliminary naturalistic trial in a psychiatric hospital. Patient Educ Couns. 2008, 70 (2): 205-208. 10.1016/j.pec.2007.10.006.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC: The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998, 59 (Suppl 20): 22-33. quiz 34–57
Glassman AH, Helzer JE, Covey LS, Cottler LB, Stetner F, Tipp JE, Johnson J: Smoking, smoking cessation, and major depression. JAMA. 1990, 264 (12): 1546-1549. 10.1001/jama.1990.03450120058029.
Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH: Smoking and mental illness: a population-based prevalence study. JAMA. 2000, 284 (20): 2606-2610. 10.1001/jama.284.20.2606.
Sung HY, Prochaska JJ, Ong MK, Shi Y, Max W: Cigarette smoking and serious psychological distress: a population-based study of California adults. Nicotine Tob Res. 2011, 13 (12): 1183-1192. 10.1093/ntr/ntr148.
Pratt LA, Brody DJ: Depression and smoking in the U.S. household population aged 20 and over, 2005–2008. NCHS Data Brief. 2010, 1-8. 34
Pomerleau CS, Carton SM, Lutzke ML, Flessland KA, Pomerleau OF: Reliability of the Fagerstrom Tolerance Questionnaire and the Fagerstrom Test for Nicotine Dependence. Addict Behav. 1994, 19 (1): 33-39. 10.1016/0306-4603(94)90049-3.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO: The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991, 86 (9): 1119-1127. 10.1111/j.1360-0443.1991.tb01879.x.
Etter JF, Sutton S: Assessing 'stage of change' in current and former smokers. Addiction. 2002, 97 (9): 1171-1182. 10.1046/j.1360-0443.2002.00198.x.
Etter JF, Bergman MM, Humair JP, Perneger TV: Development and validation of a scale measuring self-efficacy of current and former smokers. Addiction. 2000, 95 (6): 901-913. 10.1046/j.1360-0443.2000.9569017.x.
Etter JF, Perneger TV: Attitudes toward nicotine replacement therapy in smokers and ex-smokers in the general public. Clin Pharmacol Ther. 2001, 69 (3): 175-183. 10.1067/mcp.2001.113722.
Attkisson CC, Zwick R: The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann. 1982, 5 (3): 233-237. 10.1016/0149-7189(82)90074-X.
Falba T, Jofre-Bonet M, Busch S, Duchovny N, Sindelar J: Reduction of quantity smoked predicts future cessation among older smokers. Addiction. 2004, 99 (1): 93-102. 10.1111/j.1360-0443.2004.00574.x.
Lawhon D, Humfleet GL, Hall SM, Munoz RF, Reus VI: Longitudinal analysis of abstinence-specific social support and smoking cessation. Health Psychol. 2009, 28 (4): 465-472.
We thank the Swiss Federal Office of Public Health (Smoking Prevention Section) and the Prevention Commission of the Swiss Vaud Canton (funding sources), the participants, Fabien Page for the illustrations, Thomas Verdu and Filippo Nugara for graphic design, Sebastien Pauchon for advice related to the rules of the game, and Sophie Cochand and Alioscia Hoch for their help during the earliest stages of the study. We also thank Rosaria Salvador and Giulia Ongaro for their help and Christine Fehr and Christine Famy for their technical assistance.
Funding source
The study was funded by grants from the Swiss Federal Office of Public Health and from the Canton of Vaud. The funding sources had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
Additional information
Competing interests
No competing interests. The first author is the author of the Pick-Klop game.
Authors' contributions
Y. Khazaal wrote the game. R. Prezzemolo, G. Monney, and A-S. Protti contributed to improvements in the game. Y. Khazaal and Daniele Zullino designed the study. A. Chatton undertook the statistical analysis. Y. Khazaal, D. Zullino, and A. Chatton contributed to the writing of the manuscript. J Cornuz, J-F Etter, R. Khan, F. Zebouni, and Y. Edel contributed to the editing and review of the final manuscript. The other authors carried out the research. R. Prezzemolo, J. Jacquet, O. Ruggeri, E. Burnens, G. Monney, and A-S Protti carried out the research and contributed to data collection. All authors contributed to and have approved the final manuscript.
Authors' original submitted files for images
Below are the links to the authors' original submitted files for images.
Rights and permissions
Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Khazaal, Y., Chatton, A., Prezzemolo, R. et al. Impact of a board-game approach on current smokers: a randomized controlled trial. Subst Abuse Treat Prev Policy 8, 3 (2013). https://doi.org/10.1186/1747-597X-8-3
DOI: https://doi.org/10.1186/1747-597X-8-3


text:
GOOD NEWS, we updated our platform, this may require you to reset your password. Simply click here to update your password.
Log in to start ROCKING your Network Marketing Business
Don't have an account? Join the Network Marketing University!
Looking for The Network Marketing Inner Circle? Click Here! | Need help Contact Us!


text:
We keep you updated with the latest news from Martin Hood and helpful information whenever there is a change to employment or tax laws.
February 9, 2017
In a recent tax meeting, the firm discussed Form 8867 – formerly called the "Paid Preparer's Earned Income Credit Checklist," it is now known as…
© 2023 Martin Hood. All Rights Reserved. | Privacy Policy |


text:
DESlock+ is a suite of encryption tools designed to protect against unintended events like the loss of a USB stick or laptop and to allow secure collaboration and data sharing within complex boundaries.
A single, common MSI install for DESlock+ has its feature set defined by the user licence type meaning that a licence upgrade will enable new features without the need to decrypt, backup or re-install.
For large scale deployments, our Enterprise Server management software allows remote deployment, management of users, licences and workstations and full control of encryption keys, security policy and features. Client PC's may be managed via the corporate network or across the internet using secure https: communication.


text:
Computer Makers Focus on Set-top Boxes to Merge TV, PC
As a result, many computer makers have backed off from including TV-reception capabilities in their new products. Among the big players this year, only Gateway will ship hardware with circuitry to support Windows 98 TV-tuner functions. Sean Kaldor, an International Data Corporation analyst, says most people don't need the extra complication. Furthermore, the cost is too high. Gateway's high-end PC/TV lists for over $3000 at a time when 40% of new computers sold are priced under $1000.
Even Microsoft, the owner of WebTV---the $300 set-top box that allows TV viewers to surf the Internet and send and receive e-mail---predicts that PCs with TV-tuner cards won't gain popularity until next year, if at all. However, the concept of a set-top box allows computer makers to hedge their bets.
Compaq has decided to follow Microsoft's lead by developing two new set-top boxes of its own. One of these boxes, which runs Windows 98, is now in production and should be market-ready by June. The other box, running Windows CE, is being readied for a November release to coincide with the debut of digital television.
Compaq's two previous excursions into the convergence market both failed. A TV-tuner card was offered as a system upgrade, but it went nowhere. A year ago, the company attempted a high-end PC/TV in collaboration with Thomson---the PC Theatre---which retailed at $5000. In January, it was deleted from Compaq's line after winning very few sales.
Is convergence a case of much ado about nothing? Do home-theater fans care as little about the Internet as computer folks seem to care about television? Is a bridge between the two really necessary? Or are convergence products a different category altogether for the vast bulk of the population who are neither computer-savvy nor really plugged into high-end home entertainment? The majority of the buying public are curious but reluctant to commit big bucks to potentially dead-end technology. Three hundred dollars might be as much as most are willing to gamble.


text:
After five days of exploring the 2019 International Home and Housewares Show, I can honestly tell you that I still love going to this show! With more than 60,000 attendees and 2,200 exhibitors, there is so much to see and learn about. The show is held at Chicago's McCormick Place Convention Center in three of its enormous halls.
What never ceases to amaze me is the creativity of products shown. Yes, all the major brands are there but so are small, soon-to-be-well-known (in my opinion) companies from all over the world. If you have ever wondered how a product comes to life, consider that someone had a need and made it happen.
Like Get It Right, a company owned and operated by a female entrepreneur who was frustrated with the way her spatulas broke while in use in her kitchen. So, she designed a line of silicone products that resolved her issue and so many of our complaints with kitchen tools. Last year, I was introduced to GIR's ladles. You never stop to think about all the ways you use this kitchen tool and what you might want it to do beyond its original purpose. But GIR founder, Samantha, and her team thankfully did! Try it yourself and you will see what I mean!
With all the eco initiatives, many brands have designed silicone re-usable straws instead of plastic. GIR even has a carrying case and cleaner for the straw to throw in your bag. They also have created stretch lids for round or rectangular containers. These are the perfect solution to not having to battle with plastic wrap. They are reusable and stretch to fit your bowls.
That last portion of any bottle that you simply can't reach, can now be used, thanks to Flip It's stand.
When it comes to top quality cutting boards, John Boos is what you want to keep your knives sharp. While they are also known for their wood kitchen islands, they are now making these stunning dining tables for home or restaurant use.
Technology is everywhere! A new pop up shop called b8ta is a showroom of tech gadgets. Such innovative ideas.
Oxo has some very useful products to share as you would expect. In the canister, there is a scoop that is attached to the lid of the container. Smart! An asparagus peeler to get rid of the woody ends rather than snapping the stalk. Children's bowls that adhere to their tray so no flying plates.
Had specialty coffee from IMUSA. Finished with brown sugar and steamed milk. Delicious!
Excitement surrounded KitchenAid as it celebrated it's 100 year anniversary. New products, classic favorites and current models all on display. Technology plays a part in their kitchen tools.
Impress your guests with Hasselback potatoes using this slicer from LeKUE. So easy to make and everyone loves them. Make your own bagels and add Everything Spices to the top.
Silicone is everywhere at the show with so many brands making what was once plastic into a more eco friendly option.
This super innovative brand of gadgets from Dreamfarm comes up with new ideas each time I see them. The purpose and design is well made and the colors are very fun!
Last year, I shared how SMEG collaborated with Dolce and Gabbana to design these kitchen appliances. Here are some new pieces to enjoy. Quite the art work for the kitchen!
The most well loved American made brand of cast iron cookware, Lodge, has created new pieces. Check out their Chef Collection for the noteworthy details. They also have many accessories to make using and carrying for this cookware easy.
Walking through French cookware manufacturer, Le Creuset, you notice that the new colors are softer shades. Le Creuset's spring 2019 color palette is called "The New Calm" and includes four tranquil shades: Meringue, Sea Salt, Fig, and Coastal Blue. Each one of the new colors is fresh and neutral.
A few more pieces from Le Creuset:
- A rice cooker was brought back due to demand
4) Metallic cups
Bialetti, known for their stovetop espresso machines brings us stackable non-stick cookware and their popular pasta pot in stainless steel. Note that stainless is coming this Fall.
I first saw these adorable faces from Tassen Fiftyeight several years ago at the National Restaurant Show before it was formally in the U.S. I am thrilled to see their growth. Fun, filled with personality and purpose. Each design is a conversation piece whether bowls, cups and saucers or pitchers.
A vase that caught my eye for it's beauty and usefulness is by a brand called Sagaform. This vase is pretty on it's own. But, it can also accommodate tall floral arrangements by lifting the gold decorative piece so your flowers won't droop. Such a great idea for a gift!
This list could go on and on as I found so many intriguing items. I will leave you with the following photo. After approximately 15,000 steps a day (times 5 days!), I'd like to thank Trumedic for saving my feet. This foot massage ended the show on a relaxing note.
See you next year, International Home and Housewares Show!


text:
Malpica, S., Herman, L. M., Wetzstein, G., Bylinskii, Z., Masia, B., Eagleman, D. Sun, Q. (2020). Has half the time passed? Investigating time perception at long time scales in Virtual Reality. Journal of Vision.
Time perception is fluid and can change in response to different visual inputs. Previous literature shows that time perception at short intervals is affected by low-level aspects of visual stimuli, including luminance contrast and temporal frequency. At long intervals, high-level aspects like emotions elicited by visual input affect time perception, but are confounded with semantics. In this project, we investigate the effects of changes in low-level aspects of visual input on time perception at long intervals. We conduct experiments in traditional displays (TD) and virtual reality (VR), and find that luminance contrast, temporal frequency of presentation, and field of view (FoV; tested in VR only) have significant effects on time perception.
First, we find that contrast and frequency have significant effects on time judgements of 30s trials with static images in TD. Second, we replicate these results in VR, and also find a significant effect of FoV. Third, the effects of contrast and frequency hold up when using 30s trials of video clips in TD. Fourth, we extend our experiments to longer blocks of up to 3 minutes while varying stimuli frequency, and find consistent results. Our results show that higher frequency, higher contrast, and larger FoV (bigger visual magnitude changes) shorten perceived time. These results provide a means of modifying visual stimuli to change their perceived duration. These findings have far-reaching implications for virtual technology used in a variety of settings, ranging from healthcare to productivity.
Malpica, S., Herman, L. M., Wetzstein, G., Bylinskii, Z., Masia, B., Eagleman, D. Sun, Q. (2020). Has half the time passed? Investigating time perception at long time scales in Virtual Reality. Journal of Vision.
Malpica, S., Masia, B., Herman, L. M., Wetzstein, G., Eagleman, D., Gutierrez, D., Bylinskii, Z., Sun, Q. (2022). Altering interval time perception: the inverted effect of asemantic visual features. PLOS One.


text:
InfoPath: Pre-populate the People Picker
In business forms, a common requirement is to pre-populate a people picker control, such as to default to the name of the currently logged in user, which would then allow them to pick someone else if needed. For example, a secretary could fill out a travel request for her boss, and in the "Traveler" people picker, she could pick his name instead of her own.
This solution can be done with any version of SharePoint 2010 or SharePoint Online with Office 365.
If you have Foundation, use my method in this other post in order to get the current user information, instead of the user profile service data connection: https://wonderlaura.com/2012/04/11/user-information-within-infopath-forms/
If you are on SharePoint 2013 or Office 365, there is an extra step: Upgrading InfoPath and the User Profile Service Data Connection by Lori Gowin. You do this after step 5 below…
7/8/2015 Update: I'm doing a whole SharePoint Power Hour on this topic, so tune in live, or watch it later here:
Here's a little bit of background on how the people picker is structured:
It is structured as a repeating table, and the "group" can be renamed. No other fields can be renamed
• DisplayName = Laura Rogers
This is the first name and last name of the user, which is going to be equivalent to the value of the PreferredName field in the user profile service.
• AccountId = contosolaura
This is domainusername
• AccountType = User
This is User or Group.
Here are the steps to prepopulate the people picker:
- On the Data tab, click Data Connections. Click Add..
- Choose Receive data and click Next. Choose SOAP web service, and click Next.
- Type the URL of your site, and after the site, type /_vti_bin/userprofileservice.asmx
Click Next.
- Choose GetUserProfileByName. Click Next. Click Next. Click Next. Click Finish.
- All we've done so far is create a connection to the user profile service web service, so that we can get some additional information about the logged in user. Since we only want the people picker to get pre-populated when it's a new form, we're going to create a form load rule that does this.
If you haven't already placed a people picker control on your InfoPath 2010 form, go ahead and do that.
- On the Data tab, click Form Load.
- In the form load rule pane on the right, click New and choose Action.
- We only want this to happen if there's no name in the people picker yet, so we'll create a condition first. Under the word "Condition", click the blue word None – …
- Creating the condition: In the first drop-down box (myFields), click Select a Field or Group. Navigate down to your people picker control group and expand it. Select the AccountId and click OK.
- On the condition's second drop-down, choose Is Blank. Click OK.
- Back in the form load rule pane, click Add and choose Set a Field's Value.
- For the Field box, select the DisplayName field inside your people picker form (that DisplayName field you see in the screenshot at step 9). Click OK.
- Click the fx (function) button next to the Value box. Click Insert Field or Group… In the Fields drop-down box, choose GetUserProfileByName.
- Drill all the way in the DataFields until you get to Value.
- Click the Filter Data button. Click the Add button.
- In the first drop-down box that says Value, choose Select a field or group. Select the Name field. Click OK.
- Leave the middle drop-down to say Is equal to. In the third drop-down box, choose Type text. Type the word PreferredName
It will automatically put the quotes around it for you, you don't need to type those. (this is case sensitive, so you have to type it exactly right) Click OK.
- On the Filter Data screen, click OK. On the select a field or group screen, click OK. On the insert formula screen, click OK.
- This is what your Rule Detail screen will look like. Click OK.
- Back over in the form load rule pane on the right, click the Add button again, and choose Set a field's value.
- For the Field, drill down to your form's people picker, and select the AccountId field, as seen in step 9. Click OK.
- Repeat steps 13-16.
- Leave the middle drop-down to say Is equal to. In the third drop-down box, choose Type text. Type the word AccountName
Click OK.
- This is what your Rule Detail screen will look like. Click OK.
- In the Rule pane on the right, click the Add button yet again. Choose set a field's value.
- For the Field, pick the AccountType field within your people picker. You can see what this field looks like back in step 9. Click OK.
- In the Value box, just type the word User
- This is what your Rule Details screen will look like. Click OK.
- Done. Publish your form and try it out. When you fill out a new form, your own name will be populated in the people picker.
If you need to do this solution in SharePoint 2007, follow Lori Gowin's 2 part blog series that starts here.


text:
|Toronto Wallunit Contractor
New home builds, design/build, additions, garages and entire home renovations including custom kitchens, bathrooms, built-in wall-units, cabinetry, basements, wood carpentry, flooring, framing, drywall, painting, interior wall removal, general contracting, project mgmt, design and other renovation services. We cover Toronto, Mississauga, Oakville, Burlington, Hamilton, Ancaster, Milton, Georgetown, Brampton, Caledon, Vaughan, and Richmond Hill
Sunday, September 29, 2019
Toronto Built-in Wallunit
This built-in wallunit was for one of our client's bedroom. You can see the custom design with cabinet doors on both sides of the TV and pull-out drawers for clothing below.


text:
Shame blocks the power center within our energetic bodies that allows for self belief and confidence. When this energy center is stopped or slowed, our feelings of empowerment are dulled and quieted. We stop flowing in the moment and question our ability to be ourselves. It is important to remember, we are never given a situation that we are not ready to handle; this doesn't happen. Every time we find ourselves in a circumstance; it is because we are uniquely suited to be there. When we doubt our ability to be realized within that situation, we lose our capacity to extract the wisdom and enlightenment that sits as our gift within that moment.
Many factors go into the concept of Shame. As children, we first feel shame when we let people we love down; when we don't meet their expectations of us. Shame accompanies us into our teen years where we learn to make many mistakes and missteps as we are guided towards who we are. The process of self discovery doesn't stop after adolescence, but so formative are those "struggling" years where we suffer embarrassment that they provide the groundwork for how we grow.
Our outside influences are another factor when we are discussing shame. Sometimes overbearing, over controlling, dominate influences in our lives can lay the groundwork for perpetual feelings of shame and ingratitude towards ourself. We suffer so silently, knowing in our own hearts, that we are simply not good enough, that we cannot do things well enough- so why even try? This self defeating form of shame blocks us from even making any steps forward; trapping us in an unending cycle of negative behaviors which inevitably turn into pain and anger.
Being careful to remember that shame is impermanent is the first step to healing this power center within your body. When we are able to observe the shame, without feeding it energy, it becomes just another fleeting concept; we don't own it- we simply release it. When shame is brought into the light of the present, it gets guided into its proper place and is rebalanced within the solar plexus chakra.
The Solar Plexus chakra is the energy center that governs our personal power. Mindfulness and living within the present moment energize this chakra, cleaning and clearing it. Within breathe lies the seed of life; awareness of our breath frees us from the hold shame may have on our self esteem and confidence. When we realize that within the breath is all the happiness, joy and freedom we desire; and we can revisit this breath every moment we choose to be aware, we remember that we are exactly where we should be, doing exactly what the moment requires us to do… this is what balances shame.
Practice the art of mindfulness and when you feel shame slowing your energy down, causing you to doubt yourself, lean into your process and into your breath. Incline towards peace and unconditional love and allow the feeling to pass and release.


text:
Windows 2003 Installation Blunder
I've spent the last 3 days trying to get an installation of Windows Server 2003 Enterprise edition onto a Virtual PC machine. I couldn't understand why it took so long until I realized I had accidentally selected the ISO image for the checked debug version. Arggggg!!! How stupid is that!?
Thankfully, the normal release version is installing much faster.


text:
Visit my website at
Shelly Rosen
March 1, 2009
Amazing Session!
I had a blast this evening with the "M" Family at Carlsbad beach. This is one fun-loving family! Thanks guys!
Email This
Share to Twitter
Share to Facebook
Share to Pinterest
1 comment:
Anonymous said...
Totally fun family shot! The sunset shot with the couple is my favorite. Amazing!
March 3, 2009 at 8:25 PM
Post a Comment
Newer Post
Older Post
Subscribe to:
Post Comments (Atom)


text:
Android 12 to bring App Pairs for more practical multitasking
While Android 11 already allows multitasking via split-screen, Google is now reportedly planning various changes for Android 12 that are supposed to improve the handling of multiple apps that are visible at the same time.
With so-called "App Pairs", Google allegedly wants to revise the split-screen multitasking that is already available today. 9to5Google reports that it has seen related information describing the changes expected for Android 12. Among other things, the new system is said to make it easier to select which two apps are running at the same time. Also switching between regular apps and these app pairings is expected to be simplified.
Split-screen multitasking should become easier
In Android 11, multiple apps can already be used simultaneously. Due to increasingly larger displays or even foldable smartphones, such as the Galaxy Z Fold 2 or the Surface Duo, this feature is already quite helpful. Unfortunately, Google's implementation has been rather cumbersome so far, which is why manufacturers like Samsung or Microsoft developed their own variants of this function. Now, however, Google is also working on a "complete revamp" of the split-screen system.
Specifically, it should be possible in the future to select the desired two apps for an app pairing directly from the most recently used apps. This pairing can then be used as one unit. This pairing is said to make it easier to switch back and forth between it and another single app.
The mockup seen above from 9to5Google, shows the currently known version included in Android 11 on the left. While one app is "pinned" to the top, you can select another app for the split-screen at the bottom. The draft of Android 12 seen on the right, on the other hand, shows how you can switch between app pairings and individual full-screen apps.
Multitasking in Android 12: More improvements possible
As 9to5Google further writes, Google wants to slightly expand the small separator bar between the two simultaneously visible apps. It no longer only controls the size of the apps by moving them, but also be able to swap the position of the two apps via a double-tap.
Such app pairings are included in some smartphone makers' Android customizations, as mentioned earlier. Samsung's version of "App Pairs", for example, offers the option to create your own shortcuts for such pairings. Tapping these then directly opens the two previously defined apps. Microsoft calls this feature "App Group". Whether the app pairs will work the same way on Android 12 is still unclear.
When will we be allowed to try out the app pairings in Android 12?
There is no official information on the start of a beta test of Android 12 so far. However, last year the Android 11 beta launched in mid-February, so we may only be a few weeks away from a first look at the new features. It will be a long time before Android 12 is finally available, though, so further tweaks to multitasking are conceivable – or the plans for app pairs shown here may be scrapped altogether.
Source: 9to5Google


text:
|Willipedia is now back online as of 5/5/2019
|It has been several years since Willipedia closed. Please help get it updated!
|Go to the Willipedia 2.0 Project to learn more.
no edit summary
Rude Cider is [[Dancing Folk]]'s own house band. Members play fiddles, guitars, flutes and whistles, [[piano]], banjoes, feet, and pretty much anything else acoustic. Repertoire consists of jigs, reels, waltzes, and a bit of miscellany, from Irish, Canadian, Bluegrass, and sundry other traditions.
Rude Cider rehearses about once a week and plays many of Dancing Folk's monthly dances. It welcomes students (and community members) of many levels of ability.
It currently lacks a pianist and would be particularly thrilled to find one.
If you play an instrument and are interested in folk music or dance tunes, please email
<email>firstname.lastname@example.com</email> or <email>firstname.lastname@example.com</email> and we'll keep you informed about when we rehearse.


text:
New BMX track opens in Sarasota County
Image 1 of 2
SARASOTA (FOX 13) - Sarasota County officials held a ribbon-cutting ceremony for a new BMX track Saturday morning.
The track is located at the county's Youth Athletic Complex on North Tuttle Avenue.
The complex and track underwent a $2.4 million renovation project, which included upgraded lighting and drainage, and new landscaping.
Residents enjoyed BMX demonstrations and refreshments at Saturday's grand opening event.
The athletic complex is considered one of Sarasota County's most valued sports facilities.


text:
Debt limit talks pick up pace and tax credit bonanza
CQ Budget podcast, Episode 118
With new warnings that the U.S. could run out of money to meet its obligations, Congress and the Trump administration are racing to raise the debt limit before lawmakers head home for August, says CQ Roll Call's appropriations reporter Jennifer Shutt. And tax reporter Doug Sword explains how oil refiners could get up to a $10 billion windfall with an expired tax credit unless Congress intervenes.
Show notes:
- Road ahead: Pressure rising for debt limit deal
- Debt limit may be reached before end of August recess, Mnuchin says
- Pelosi: Debt deal vote possible before August recess
- Oil refiners racing Congress to protect butane loophole


text:
|K19: The Widowmaker
starring Harrison Ford and Liam Neeson
3 stars
by Stephen Notley
K-19: The Widowmaker is a competent, satisfactory submarine movie. Not too terrible, not too great, it's the kind of movie they invented 3 stars for.
The biggest change from the typical submarine movie, K-19's big innovation, is that is doesn't feature any scenes where everybody gets terribly quiet while a sonar pings overhead. In fact, there's no combat at all -- no torpedoes launched, no depth charges avoided, no "Dive! Dive!" to avoid a pursuer (though there is a "Dive! Dive!" scene).
Nope, K-19's problems as a submarine are all internal. You might call it "The Unluckiest Submarine Ever." First, the big Soviet masters are so horny to try a submarine-launched missile test, they insist on sending K-19 out in a state of total disrepair (kinda like the Enterprise in Star Trek V). As if that wasn't bad enough, they demote crew-beloved captain Liam Neeson to executive officer and make stuffy Harrison Ford the new captain. And of course, Harrison Ford is the kind of perfectionist jerk who forces the crew to do drill after drill after drill.
We all know what happens when a tired, distracted crew are forced to do too many drills; eventually, somebody's gonna get his hand crushed. This is one unlucky boat. And if there's one thing you don't want to have on a really unlucky boat, it's a nuclear reactor.
It might seem rather counter-intuitive, Americans making a submarine movie that casts Soviets as the heroes. They make up for it by making the whole movie a big fat metaphor for collapsing communism, complete with stupid orders from the top, good men on down trying to do their duty, rickety everything, and nuclear disaster.
On the plus side, K-19 does a pretty good job of showing that, when it comes down to it, your average Russian little guy is capable of some pretty astounding acts of courage and deprivation.
K-19 is directed by Kathryn Bigelow, who dated James Cameron a decade ago and once made a pretty cool hardass vampire movie called Near Dark. Since then she's been failing to live up to Near Dark's promise with movies like Point Break, Blue Steel and Strange Days. Still, she's always had a good hand with the craft of her films, and she knows how to tell her story so it's tense, particularly some frankly grim reactor repair scenes.
Submarine movies always gotta have officers butting heads, and Neeson and Ford turn out to be pretty convincing butters. Luckily Harrison Ford comes off a lot better in the film than he does in the trailer, with his sad-pig version of a Russian accent. The bad accent doesn't do too much damage in the movie, thankfully, because Ford's Captain Vostrikov is the kind of guy who gives orders and then glares to get them followed, and Ford still glares like he used to (though it's hard to imagine what they think he's gonna be able to do in Indy 4). Neeson isn't trying too hard in the accent department either, but he sticks up for his men like he should, and between him and Ford, duty gets a big ol' workout.
As I say, a functional, workmanlike movie, one you could go to with
your parents. Nothing too fancy, but some changes in the submarine formula
and a story you can reasonably care about. Three stars, I'd say.