The Disease Model of Alcoholism: A Kuhnian Paradigm

Despite the fact that the disease model of alcoholism has lost its status as paradigm in international circles, the alcoholism research and treatment community in the United States maintains steadfast allegiance to the tenets of the disease model. The disease model and the related treatment goal of abstinence continue to overwhelmingly dominate the treatment of alcoholism in the U.S. Critics have suggested that financial and political motives have served to maintain the dominance of the disease model, despite findings that violate its basic tenets. This paper presents an alternative explanation of the reluctance of the alcoholism treatment community to relinquish the disease model by utilizing Kuhn\u27s (1996) model of scientific progress in an historical analysis of the disease model. To support this position, evidence of the emergence of the disease model as a paradigm, alcoholism research as normal science, and the appearance of anomaly followed by crisis in the alcoholism research and treatment community are presented

Design, development and demonstration of a warm gas distribution system Quarterly report, period ending 31 Mar. 1968

Component tests and system assembly for hydrazine fuel gas distribution system of torque generator for spacecraft attitude contro

Habitual Physical Activity in Mitochondrial Disease

Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype.Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI. = −0.49; 95% CI −0.33, −0.63, P<0.01). There were no systematic differences in physical activity between different genotypes mitochondrial disease.These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease

How useful are volunteers for visual biodiversity surveys? An evaluation of skill level and group size during a conservation expedition

The ability of volunteers to undertake different tasks and accurately collect data is critical for the success of many conservation projects. In this study, a simulated herpetofauna visual encounter survey was used to compare the detection and distance estimation accuracy of volunteers and more experienced observers. Experience had a positive effect on individual detection accuracy. However, lower detection performance of less experienced volunteers was not found in the group data, with larger groups being more successful overall, suggesting that working in groups facilitates detection accuracy of those with less experience. This study supports the idea that by optimizing survey protocols according to the available resources (time and volunteer numbers), the sampling efficiency of monitoring programs can be improved and that non-expert volunteers can provide valuable contributions to visual encounter-based biodiversity surveys. Recommendations are made for the improvement of survey methodology involving non-expert volunteers

How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy

BACKGROUND: Quality of working life includes elements such as autonomy, trust, ergonomics, participation, job complexity, and work-life balance. The overarching aim of this study was to investigate if and how quality of working life affects Compassion Fatigue, Burnout, and Compassion Satisfaction among mental health practitioners. METHODS: Staff working in three Italian Mental Health Departments completed the Professional Quality of Life Scale, measuring Compassion Fatigue, Burnout, and Compassion Satisfaction, and the Quality of Working Life Questionnaire. The latter was used to collect socio-demographics, occupational characteristics and 13 indicators of quality of working life. Multiple regressions controlling for other variables were undertaken to predict Compassion Fatigue, Burnout, and Compassion Satisfaction. RESULTS: Four hundred questionnaires were completed. In bivariate analyses, experiencing more ergonomic problems, perceiving risks for the future, a higher impact of work on life, and lower levels of trust and of perceived quality of meetings were associated with poorer outcomes. Multivariate analysis showed that (a) ergonomic problems and impact of work on life predicted higher levels of both Compassion Fatigue and Burnout; (b) impact of life on work was associated with Compassion Fatigue and lower levels of trust and perceiving more risks for the future with Burnout only; (c) perceived quality of meetings, need of training, and perceiving no risks for the future predicted higher levels of Compassion Satisfaction. CONCLUSIONS: In order to provide adequate mental health services, service providers need to give their employees adequate ergonomic conditions, giving special attention to time pressures. Building trustful relationships with management and within the teams is also crucial. Training and meetings are other important targets for potential improvement. Additionally, insecurity about the future should be addressed as it can affect both Burnout and Compassion Satisfaction. Finally, strategies to reduce possible work-life conflicts need to be considered

Risk, responsibilities and rights: reassessing the ‘economic causes of crime’ thesis in a recession

This paper explores competing accounts of an apparent inversion of the previously-prevailing relationship between young people's unemployment and the incidence of youth offending at a time of economic recession. It begins by highlighting the faltering association between unemployment and offending, and considers the paradoxical implications for risk-based methodologies in youth justice practice. The paper then assesses explanations for the changing relationship that suggest that youth justice policies have successfully broken the unemployment-offending link; and alternatively that delayed effects of recession have yet to materialise, by reference to the work of four Inter-governmental organisations and to youth protests beyond the UK. In place of ever more intensive risk analyses, the paper then focusses on the adverse effects of unemployment on social cohesion, and proposes a rights-based approach to youth justice that recognises the growing disjuncture between the rights afforded to young people and the responsibilities expected of them

Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials

Background Patients with chronic obstructive pulmonary disease (COPD) have few options for treatment. The efficacy and safety of the phosphodiesterase-4 inhibitor roflumilast have been investigated in studies of patients with moderate-to-severe COPD, but not in those concomitantly treated with longacting inhaled bronchodilators. The effect of roflumilast on lung function in patients with COPD that is moderate to severe who are already being treated with salmeterol or tiotropium was investigated. Methods In two double-blind, multicentre studies done in an outpatient setting, after a 4-week run-in, patients older than 40 years with moderate-to-severe COPD were randomly assigned to oral roflumilast 500 mu g or placebo once a day for 24 weeks, in addition to salmeterol (M2-127 study) or tiotropium (M2-128 study). The primary endpoint was change in prebronchodilator forced expiratory volume in 1s (FEV(1)). Analysis was by intention to treat. The studies are registered with ClinicalTrials.gov, number NCT00313209 for M2-127, and NCT00424268 for M2-128. Findings In the salmeterol plus roflumilast trial, 466 patients were assigned to and treated with roflumilast and 467 with placebo; in the tiotropium plus roflumilast trial, 371 patients were assigned to and treated with roflumilast and 372 with placebo. Compared with placebo, roflumilast consistently improved mean prebronchodilator FEV(1) by 49 mL (p<0.0001) in patients treated with salmeterol, and 80 mL (p<0.0001) in those treated with tiotropium. Similar improvement in postbronchodilator FEV(1) was noted in both groups. Furthermore, roflumilast had beneficial effects on other lung function measurements and on selected patient-reported outcomes in both groups. Nausea, diarrhoea, weight loss, and, to a lesser extent, headache were more frequent in patients in the roflumilast groups. These adverse events were associated with increased patient withdrawal. Interpretation Roflumilast improves lung function in patients with COPD treated with salmeterol or tiotropium, and could become an important treatment for these patients

Measurements of the ϒ(1S), ϒ(2S), and ϒ(3S) differential cross sections in pp collisions at s=7TeV

Differential cross sections as a function of transverse momentum pTpT are presented for the production of ϒ(nS)ϒ(nS) (n = 1, 2, 3) states decaying into a pair of muons. Data corresponding to an integrated luminosity of 4.9View the MathML sourcefb−1 in pp collisions at View the MathML sources=7TeV were collected with the CMS detector at the LHC. The analysis selects events with dimuon rapidity |y|<1.2|y|<1.2 and dimuon transverse momentum in the range View the MathML source10<pT<100GeV. The measurements show a transition from an exponential to a power-law behavior at View the MathML sourcepT≈20GeV for the three ϒ states. Above that transition, the ϒ(3S)ϒ(3S) spectrum is significantly harder than that of the ϒ(1S)ϒ(1S). The ratios of the ϒ(3S)ϒ(3S) and ϒ(2S)ϒ(2S) differential cross sections to the ϒ(1S)ϒ(1S) cross section show a rise as pTpT increases at low pTpT, then become flatter at higher pTpT