Barriers to Smoking Cessation in Patients Enrolled in Suboxone Treatment Programs

Cigarette smoking is the leading cause of preventable death and disease in the United States, accounting for more than 480,000 deaths every year. The prevalence of tobacco use among substance abuse treatment program enrollees is substantially higher than that of the general population, with recent estimates ranging between 75-97%. The aim of this project was to identify specific barriers to smoking cessation in patients enrolled in suboxone treatment programs in Franklin County, VT. The most commonly cited barriers among survey responders were related to fear of the effects of tobacco withdrawl, while the most important barrier was related to fear of increased desire to use drugs following smoking cessation.https://scholarworks.uvm.edu/fmclerk/1493/thumbnail.jp

The absence of an auditory-visual attentional blink is not due to echoic memory.

Als binnen een halve seconde twee visuele items in een serieel aangeboden stroom moeten worden geselecteerd, is de prestatie voor het tweede item vaak relatief slecht (er treedt een “attentional blink” op); wanneer het eerste echter item auditief wordt aangeboden, verdwijnt de blink meestal. We hebben aangetoond dat dit laatste niet wordt veroorzaakt doordat proefpersonen hun echoïsch geheugen gebruiken om de verwerking van het auditieve item uit te stellen tot na het einde van de visuele stroom

Focus on environmental risks and migration: causes and consequences

Environmental change poses risks to societies, including disrupting social and economic systems such as migration. At the same time, migration is an effective adaptation to environmental and other risks. We review novel science on interactions between migration, environmental risks and climate change. We highlight emergent findings, including how dominant flows of rural to urban migration mean that populations are exposed to new risks within destination areas and the requirement for urban sustainability. We highlight the issue of lack of mobility as a major issue limiting the effectiveness of migration as an adaptation strategy and leading to potentially trapped populations. The paper presents scenarios of future migration that show both displacement and trapped populations over the incoming decades. Papers in the special issue bring new insights from demography, human geography, political science and environmental science to this emerging field

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Methodology of calculation of construction and hydrodynamic parameters of a foam layer apparatus for mass-transfer processes

Промислова реалізація методу стабілізації газорідинного шару дозволяє значно розширити галузь застосування пінних апаратів і відкриває нові можливості інтенсифікації технологічних процесів з одночасним створенням маловідходних технологій. У статті встановлені основні параметри, що впливають на гідродинаміку пінних апаратів, розглянуті основні конструкції та режими роботи пінних апаратів. Виявлено зв'язок гідродинамічних параметрів. Розглянуто гідродинамічні закономірності пінного шару. Вказані фактори, що впливають на процес масообміну, як в газовій, так і в рідкій фазах. Проведений аналіз ряду досліджень показав, що перспективним напрямком інтенсифікації процесу масообміну є розробка апаратів з трифазним псевдозрідженим шаром зрошуваної насадки складних форм із сітчастих матеріалів. Отже, необхідне проведення спеціальних досліджень гідродинамічних режимів роботи апарату з сітчастою насадкою і визначенням параметрів, що впливають на швидкість переходу насадки з одного режиму в інший.Industrial implementation of the stabilization method of the gas-liquid layer can significantly expand the field of use of foaming apparatus and opens up new opportunities for intensifying technological processes with the simultaneous creation of low-waste technologies. The article establishes the basic parameters influencing the hydrodynamics of foam apparatus, considers the basic constructions and operating modes of foam apparatus. The connection of hydrodynamic parameters is revealed. The hydrodynamic laws of the foam layer are considered. The indicated factors affecting the process of mass transfer, both in the gas and in the liquid phases. The conducted analysis of a number of studies showed that the perspective direction of intensification of the mass transfer process is the development of apparatuses with a three-phase fluidized bed of an irrigated nozzle of complex forms with mesh materials

Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Migration, environmental change, and the ‘challenges of governance’

This paper provides a framework for the theme issue by exploring links between environmental change and human migration. We review evidence that demonstrates that millions of people have moved or are likely to move towards and not away from environmental risk and hazard by moving from rural areas to rapidly growing urban areas. Moreover, some people may choose not to move or be unable to move. Environmental change may further erode household resources in such a way that migration becomes less and not more likely, even in the context of quite significant environmental change posing serious threats to the sustainability of livelihoods. This creates the possibility that populations will be trapped in areas that expose them to serious risk. We argue that the links between environmental change, migration, and governance are of significant importance, and directly influence the modes and efficacy of migration governance at different levels