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Background Amphetamine-type stimulants (ATS) are globally widely used. Scientific literature generally defines four phases of substance use (initiation, continuation, increase and decrease); however, there is limited understanding of what influences these different phases of ATS use. The ATTUNE study investigated which factors shape individual phases of use, or ATS use patterns. In this article, we report on these phases into and out of ATS use, and propose a set of recommendations for prevention, harm reduction and treatment of the different phases of ATS use. Methods Qualitative, semi-structured interviews (n = 237) were conducted in five different European countries with participants who had used ATS, varying from a few times in a lifetime to daily. Results Amphetamine and MDMA were the most commonly used ATS. Yet, types of ATS used differed between the countries. We found that people who use ATS have various motives for and dynamic patterns of ATS use with alternating phases of increase, continuation, decrease and sometimes dependence. Cessation was pursued in different ways and for diverse reasons, such as mental health problems and maturing out. Availability seemed not an issue, regardless of the type of ATS, phase or country. Conclusions These findings demonstrate that tailor-made interventions are needed for the diverse types of people who use ATS and different phases or patterns of ATS use, to reduce possible harms of use. We recommended a set of interventions for the different ATS phases. These include drug checking services, peer-led information, self-management of ATS use, mental health support to help people cope with stressful life events and prevent uncontrolled use, and follow-up support after treatment.

In den letzen beiden Kapiteln wurde die Einfuhrung der Algebra, sowohl in einem historischen Kontext durch die Analyse von Eulers Lehrbuch „Vollstandige Anleitung zur Algebra”, als auch im heutigen Schulunterricht durch die Analyse von zwei Schulbuchreihen, betrachtet. Jede Betrachtung fur sich gibt Aufschluss uber das Verstandnis der behandelten Begriffe und die den Buchern zugrunde liegende Auffassung von Algebra. Ein Vergleich zwischen den Analysen gibt einen Einblick in eine mogliche Entwicklung der Lehre und kann gleichzeitig Grunde fur die Vorgehensweise und die Behandlung der Thematik in dem heutigen Mathematikunterricht liefern.

Wie im vorherigen Kapitel aufgezeigt, liegen die wesentlichen Schwierigkeiten der Schulerinnen und Schuler im Zusammenhang mit Algebra im Umgang mit Variablen und dem Verstandnis der Begrifflichkeiten. Die Schulerinnen und Schuler sind nicht in der Lage, spontan mit Unbekannten zu operieren, und auch nicht eine umgangssprachliche Situation in eine formale Sprache zu ubersetzen und richtig zu interpretieren. Die angesprochenen Probleme der Schulerinnen und Schuler beim Erlernen der Algebra sind verbunden mit dem Verstandnis des Konzepts der Variablen und dem Umgang mit symbolischen Ausdrucken.

IntroductionBy Jeffrey V Lazarus.In the last few years, as viral hepatitis has become amore prominent issue on national and internationalhealth agendas, talk of“learning from HIV” has becomequite common. It is understandable for researchers, pol-icy-makers and activists to make this link, given the nota-ble commonalities between HIV, hepatitis B and hepatitisC. All are life-threatening blood-borne viruses that affecthundreds of millions of people worldwide. All can remainasymptomatic for many years, making it difficult to pro-mote awareness of their danger. Ignorance about all ofthe major forms of viral hepatitis, particularly B and C,understandably reminds many people who are workingto confront this issue of the early years of the AIDS epi-demic, when a combination of misinformation andunwillingness to candidly address stigmatised behavioursand social inequalities led to a widespread failure to for-mulate a cohesive public health response.Other parallels might be elucidated, and there is cer-tainly good reason to think of the global HIV, hepatitisB and hepatitis C epidemics as having similar trajectoriesin some regards. Nonetheless, the differences betweenHIV and viral hepatitis– in terms of how these varieddiseases manifest both biologically and socially– shouldmake us wary of oversimplifying the connection.As discussions about hepatitis policies and strategiesgain momentum at the national and global level, it isbecoming increasingly important to articulate the“lessons learned” from the HIV field. Pertinent issuesinclude disease preventionmeasures, testing and earlydiagnosis, the scale-up of treatment, and barriers to ser-vice uptake and retention in care. Key social and politicalfactors associated with viral hepatitis call to mind otherpossible lessons relating to the value of civil societyengagement, leadership and governance issues, resourcemobilization including innovative financing, the causesand consequences of stigma, and the role of socialscience in addressing health threats.This is clearly a rich and important realm of inquiry–and it is time to move beyond the general calls to learnfrom HIV and begin to systematically formulate specificlessons. As a preliminary step, the following roundtablepresents the insights of a range of experts who were invitedto reflect on how experiences from the global response toHIV might inform the global response to viral hepatitis.Kicking off the discussion is Jens Lundgren, a renownedHIV researcher, head of the new WHO CollaboratingCentre on HIV and Viral Hepatitis and co-founder of theHIV in Europe Initiative. His perspective is much broaderthan that of a medical doctor gazing at his own disease. Inthe next two pieces, Jordi Casabona of the EpidemiologicalCenter for HIV/AIDS/STI of Catalonia and Lucas Wies-sing of the European Monitoring Centre for Drugs andDrug Addiction (and colleagues) consider surveillance andmonitoring issues. Sounding a cautionary note about the“discourse of hope and expectation” associated with hepa-titis C treatment, Magdalena Harris, a qualitativeresearcher at the London School of Hygiene and TropicalMedicine, critically reflects on treatment as prevention.