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The time-course of several of the adaptive responses to regular endurance training are known. For example, Vo2max typically increases 15 25% during the rst 2 3 months of endurance training with a further (smaller) improvement occurring over the next 6 24 months (Saltin et al. 1977). There are more robust changes in some of the muscle enzymes involved in the citric acid cycle and respiratory chain; most of these enzymes have rather short turnover times, with half-lives in the order of 1 3 weeks (Henrikksson & Reitman 1977). Less precise is the information on the time-course of changes for muscle ber conversion and capillary density. Transition of ber types may be quite labile in a similar manner to many of the oxidative enzymes (Saltin et al. 1977), whereas capillarization probably occurs at a slower rate. After 1 year or longer of endurance training, the metabolic capacity of muscle is enhanced to a far greater extent than the circulatory capacity of the body to utilize oxygen. The training-induced shift in patterns of muscle substrate utilization (i.e., the glycogen-sparing effect) is more pronounced with prolonged training history. Indeed, during the time of peak endurance performance, muscle metabolic adaptations have likely reached their maximal attainable level (Saltin et al. 1977).

Although it is important to implement systematic procedures for alcohol assessment, the extent to which an individual client is assessed and the manner in which the assessment takes place will depend on the unique characteristics of the client and the particular community or clinical setting The process of assessment can be considered in stages, each of which may or may not lead to the next stage The rst stage in alcohol assessment begins with identi cation (screening or case nding), where the basic question is whether an alcohol problem is present and whether further assessment is necessary (Connors, 1995) The objective is to detect individuals with alcohol problems and to set the stage for further assessment and intervention, as warranted.

The exponential distribution has many useful properties with analytic tractability, but is not always a good approximation to the observed distribution. Experiments have shown deviations. For example, the coefficient of variation of the service time of a processoris often greater than one, and for a peripheral device it is usually lessthan one. This observed behavior leads directly to the need to consider the following other distributions:

changing, while for the other health condition (cancer) the lack of change is linked to issues beyond the person s control If you believe that drug abuse is a disease, then anger is not a rational response toward someone who is not changing drug use If you believe that a drug problem is a reflection of poor skills and reinforcement history (a behavioral disorder), then anger is not congruent with the understanding that the person is doing the best he or she can with the skills he or she currently has If you are feeling anger about lack of progress, then you may wish to examine your assumptions about the client and about the cause of his or her problem A major reason that professionals get burned out surrounds circumstances in which clients do not seem to get better as quickly as hoped (or maybe not at all).

Second, if SF # 8, then the probability mass TF(O) assigned to the fast transient states SF is spread probabilistically across the macro states A4 according to rule implied by the probabilistic switch PFM given in Eq. (5.57):

Increasingly, evidence indicates that identifying individuals with early-stage, less severe alcohol abuse and providing brief intervention (advice or counselling) is effective in reducing alcohol consumption and related problems (Zweben & Fleming, 1999; Heather, 1996; Bien et al, 1993) Identi cation is mostly performed in primary health care settings where individuals generally present for health concerns that are not related to alcohol abuse A number of wellstudied screening instruments, such as the CAGE and AUDIT, can aid in the identi cation of alcohol problems among ambulatory populations (Allen et al, 1995) Clinicians should select a screening measure based on test acceptability to clients and providers, whether there are adequate resources (ie time, nancial, personnel) and whether it is logistically possible to incorporate reliable screening procedures into routine clinical practice Screening should have responsive procedures for feedback to clients and appropriate referrals for further evaluation.