Efficacy of treatment with buprenorphine, compared to methadone, in remission of opioid use disorder

Introduction:. Over the last decade, there has been a significant rise in deaths due to drug overdoses involving opioids. Opioids are highly addictive due to the rewarding effects they produce in the brain and body. Methadone is broadly used as a substitution for illicit opioid use for individuals with opioid use disorder. Methadone is a synthetic opioid that works by binding to the same receptor as other opioids and reduces the symptoms associated with opiate withdrawal. Buprenorphine, on the other hand, mimics the euphoric effects of opiates. Buprenorphine is less likely to be abused due to the low ceiling of the drug\u27s euphoric effect. There are different benefits and risks associated with each drug. Therefore, this review analyzes the efficacy of treatment with buprenorphine, compared to methadone, in remission of opioid use disorder. Methods: A literature search was completed through PubMed and Academic Search Ultimate in November 2019. A total of seven articles consisting of randomized control trials, secondary analyses of randomized control trials, and qualitative analyses were selected based on their publication date, intervention technique, outcome measurements, and sample population. The study design and results of these articles were then analyzed and compared. Results: This literature review revealed inconclusive evidence. As of now, evidence shows that methadone has an increased retention time in treatment, however, there is no evidence that either buprenorphine or methadone is more effective in overall reduction of opioid use. Discussion: Four of the seven studies found methadone to be significantly more effective in increasing treatment retention times. Four of the seven studies also found that between the two treatment options, there was no significant reduction in opioid use in general. These results indicate that since neither drug is more effective in the reduction of opioid usage, there may be other social determinants influencing time retained in treatment. Conclusion: Buprenorphine and methadone have both been prescribed as treatment of opioid withdrawal, but little evidence has been conducted to evaluate which drug is more beneficial. Research, as of today, has shown methadone increases time maintained in treatment, but not an overall significant decrease in opioid reduction. Future research is necessary to determine what other factors are influencing the differences in treatment retention

As relações de confiança como estratégia das relações públicas

O conceito de Relações Públicas (RP) foi evoluindo ao longo do tempo, num processo bem explicado por Grunig e Hunt (2003), quando avançam com quatro modelos teóricos: agente de imprensa/publicity; modelo de informação pública; modelo assimétrico bidirecional; e modelo simétrico bidirecional. E parece ser através do modelo comunicacional simétrico que as RP conseguem promover relações de confiança entre a organização e seus públicos interno e externo, um aspeto tão importante para o sucesso empresarial. Portanto, o que se pretende com este estudo é refletir sobre a contribuição das RP e da Comunicação para o processo de geração de confiança e de construção de um melhor ambiente de trabalho nas organizações Nessa perspectiva humanista e social, entende-se que praticar uma boa política de RP é desenvolver uma política de comunicação que seja capaz de estabelecer e manter relações de confiança

The Role of Inflammation In Post-Operative Cognitive Dysfunction

Post-operative cognitive dysfunction (POCD) is a common complication occurring mainly to elderly patients after surgery. The highest incidence of POCD is observed in orthopaedic and cardiac procedures. The background of this thesis is based on the evidence that hippocampal interleukin 1 beta (IL-1β) plays a major role in inflammation and memory performance. Localised IL-1β dysregulation in the hippocampus can be triggered by elevated systemic cytokines resulting from peripheral infective challenge; the underlying immune-to-CNS communication triggers glial activation, sickness behaviour and memory impairment. The aim of this work was to investigate a possible causative relationship between anaesthesia, aseptic surgical trauma, systemic and hippocampal inflammation and memory function in mice. The first part of the work was dedicated to the development of an appropriate model of orthopaedic surgery, which allowed me to show that surgery under anaesthesia, but not anaesthesia alone, causes inflammatory-mediated, hippocampal-dependent, cognitive dysfunction. Post-operative elevated plasma cytokines, assessed by ELISA, and clone expansion of inflammatory cells, such as monocytes (evidenced by flow cytometry techniques), were associated with memory impairment, increased IL-1β expression and reactive microgliosis (evidenced by immunohistochemistry), but not astrogliosis (assessed with western blotting), in the hippocampus. Results from behavioural tests such as fear conditioning showed that blocking inflammation with minocycline prevents these post-surgical changes. Likewise, antagonism of IL-1β receptors mitigated hippocampal-dependent memory dysfunction. Experiments to rule out a possible infection were also performed, and excluded that the results could depend upon contamination of the wounds in the animal model. Also, age and gender were explored as possible risk factors. These findings support the existence of a surgery-induced IL-1β-mediated inflammatory mechanism that is followed by reactive microgliosis in the hippocampus and underlies memory impairment. This mechanism appears to be dependent on gender and can be attenuated by some anaesthetics, but it is worse in older age

Sharp Estimates for Geman\u2013Yor Processes and applications to Arithmetic Average Asian options

We prove the existence of the fundamental solution of the degenerate second order partial differential equation related to Geman\u2013Yor stochastic processes, that arise in models for option pricing theory in finance. We then prove pointwise lower and upper bounds for such fundamental solution. Lower bounds are obtained by using repeatedly an invariant Harnack inequality and by solving an associated optimal control problem with quadratic cost. Upper bounds are obtained by the fact that the cost satisfies a specific Hamilton\u2013Jacobi\u2013Bellman equation.Nous d\ue9montrons l\u2019existence de la solution fondamentale pour une equation diff\ue9rentielle d\ue9g\ue9n\ue9r\ue9e d\u2019ordre deux associ\ue9e au processus stochastique de Geman\u2013Yor. Ce dernier est utilis\ue9 dans des mod\ue8les issus de la th\ue9orie du \u201cpricing\u201d des options financi\ue8res. Nous obtenons ensuite des bornes ponctuelles inf\ue9rieures et sup\ue9rieures pour cette solution fondamentale. Les bornes inf\ue9rieures sont obtenues en utilisant de facon r\ue9p\ue9t\ue9e une in\ue9galit\ue9 de Harnack invariante et en r\ue9solvant un probl\ue8me de commande optimale avec co\ufbt quadratique. Les bornes sup\ue9rieures sont quant \ue0 elles d\ue9riv\ue9es en utilisant le fait que le co\ufbt satisfait une \ue9quation de Hamilton\u2013Jacobi\u2013Bellman

Hygro-thermo-chemo-mechanical coupled discrete model for the self-healing in Ultra High Performance Concrete

Reliable durability predictions and design for advanced cement-based materials cannot disregard the modelling of their inherent self-healing capability. A discrete meso-scale model to simulate the recovery in water tightness, stiffness and strength induced by the (stimulated) autogenous healing of cracks for Ultra High Performance Concrete is presented. In this paper the model is implemented into the numerical framework of the Multiphysics-Lattice Discrete Particle Model (M-LDPM), resulting from the coupling of the Hygro-Thermo-Chemical (HTC) model and Lattice Discrete Particle Model (LDPM). Consistently with experimental evidence, the development of the self-repairing process is modelled as consisting of two independent stages: (a) the healing of matrix cracks, affecting both moisture permeability and fracture strength in the cracked state, and (b) the recovery in terms of fibre bridging action, relying on the adhesion between the healing products and the walls of the tunnel cracks which form during the fibre debonding process. This research activity is framed into the Horizon 2020 project ReSHEALience (GA 760824)

Numerical modelling via a coupled discrete approach of the autogenous healing for Fibre-Reinforced Cementitious Composites (FRCCs)

Aiming to predict long-term performance of advanced cement-based materials and design more durable structures, a reliable modelling of the autogenous healing of cementitious materials is crucial. A dis-crete model for the regain in terms of water tightness, stiffness and strength induced by the autogenous and/or “stimulate" autogenous healing was recently proposed for ordinary plain concrete. The modelling proposal stemmed from the coupling of two models, namely the Hygro-Thermo-Chemical (HTC) model, on one side,and the Lattice Discrete Particle Model (LDPM), on the other side, resulting in the Multiphysics-Lattice Discrete Particle Model (M-LDPM). Being this approach not customised only for ordinary concrete, but for the whole broad category of cementitious materials, in this paper, its application to Fibre-Reinforced Cementitious Composites is presented. To accurately simulate what has been experimentally observed so far, the mechanical model is updated to also include the self-healing of the tunnel cracks at the fibre-matrix interfaces. Therefore,the self-repairing process is modelled to develop on two independent stages: (a) matrix cracks healing, and(b) fibre bridging action restoring. This research activity is part of the modelling tasks framed into the project ReSHEALience, funded from the European Union’s Horizon 2020 Research and Innovation Programme

Prospectus, May 10, 1989

https://spark.parkland.edu/prospectus_1989/1011/thumbnail.jp

Prospectus, April 5, 1989

https://spark.parkland.edu/prospectus_1989/1006/thumbnail.jp

CONFIGURAÇÃO DO SISTEMA EDUCACIONAL BRASILEIRO: ANÁLISES E TENDÊNCIAS MERCADOLÓGICAS PARA AS PRÓXIMAS DÉCADAS.

O artigo permite a reflexão do Sistema Educacional Brasileiro, através da visão holística de sua configuração, acoplando cinco eixos de interesse: Educação Regular, Religiosa, Militar, Profissionalizante e Corporativa. Dessa configuração há um olhar às modalidades existentes de ensino e formação profissional, bem como das tendências emergentes do mercado de trabalho. A metodologia utilizada parte de bases qualitativas, por meio de levantamento documental bibliográfico histórico que permitiram atingir os propósitos da pesquisa. O período de levantamento e análise destas informações ocorreu no primeiro semestre de 2011. Os resultados permitiram visualizar novas tendências de mercado para a educação do Brasil e refletir sobre a nova Configuração do Sistema Educacional Brasileiro, contemplando os níveis e modalidades de formação educacional. A proposta em pauta ultrapassa os ordenamentos, contidos na Lei de Diretrizes e Bases da Educação (LDB/96), pois traz a superfície níveis de interesses emergentes da educação nacional e mundial para as primeiras décadas do século XXI. Conclui-se, ainda, que é urgente um olhar pró-ativo e institucionalizado para a educação corporativa no Brasil