Single high-dose buprenorphine for opioid craving during withdrawal.

BackgroundOpioid use disorder is one of the most prevalent addiction problems worldwide. Buprenorphine is used as a medication to treat this disorder, but in countries where buprenorphine is unavailable in combination with naloxone, diversion can be a problem if the medication is given outside a hospital setting.ObjectiveThe objective of this research is to evaluate the effect of a single, high dose of buprenorphine on craving in opioid-dependent patients over 5 days of abstinence from use of other opioids. The primary goal was to determine the safety and efficacy of buprenorphine during withdrawal in a hospital setting.MethodsNinety men who used opium, heroin, or prescribed opioids and met DSM-5 criteria for opioid use disorder (severe form) were randomized to three groups (n = 30 per group) to receive a single, sublingual dose of buprenorphine (32, 64, or 96 mg). The study was conducted in an inpatient psychiatric ward, with appropriate precautions and monitoring of respiratory and cardiovascular measures. Buprenorphine was administered when the patients were in moderate opiate withdrawal, as indicated by the presence of four to five symptoms. A structured clinical interview was conducted, and urine toxicology testing was performed at baseline. Self-reports of craving were obtained at baseline and on each of the 5 days after buprenorphine administration.FindingsCraving decreased from baseline in each of the three groups (p < 0.0001), with a significant interaction between group and time (p < 0.038), indicating that groups with higher doses of buprenorphine had greater reduction.ConclusionsA single, high dose of buprenorphine can reduce craving during opioid withdrawal; additional studies with follow-up are warranted to evaluate safety

Employment Choices of Persons with Disability (PWDs) in Metro Manila

This paper examined how PWDs in the Philippines make a living and determined the factors that influenced them to select a particular labor market status and/or a source of personal income. It also analyzed the different types of work these PWDs engage in and their association with levels of education. Using dataset from the pioneering survey on socioeconomic conditions of PWDs in selected cities in Metro Manila, Philippines conducted in 2008, econometric analyses were conducted. The paper then presented some insights that could help the government craft better policy strategies in the provision of livelihood to, as well as empowerment of, PWDs

Employment of Persons with Disabilities (PWDs) in the Philippines: The Case of Metro Manila and Rosario, Batangas

Persons with disability (PWDs) are among the vulnerable groups in the country that need utmost attention from the government. This is perhaps the reason why the institutional and legal environment has been made favorable to this particular group, especially in the area of employment. However, earlier reports note that the quality of employment of PWDs still needs improvement.This paper examines the employment profile of PWDs in the Philippines using the 2008 and 2010 disability surveys in selected cities of Metro Manila (urban) and Rosario, Batangas (rural), respectively. Key findings of this paper are as follows: (1) Proportion of employed among PWD respondents in the urban area is relatively higher than that in the rural area; (2) Roughly half of working PWDs are underemployed; (3) Employed PWDs in the urban area are dominated by the visually-impaired while the hearing-impaired has the highest proportion of employed in the rural area; (4) The leading occupation among PWDs in the urban area is masseur while farmer/farm worker/livestock and poultry raiser in the rural area, although many respondents in both areas are also engaged in entrepreneurial activities (e.g., managing a sari-sari store, e-load business, among others) and are working as helpers/utility workers or laborers; (5) The majority of employed respondents in both areas are considered as vulnerable workers - self-employed and unpaid family workers; (6) Some PWDs who are wage/salary workers are considered as informally employed as they are working as temporary workers without formal contract, seasonal workers, or hired on a daily basis; (7) Multiple Correspondence Analysis (MCA) suggests that being a member in a Disabled People's Organization and being at least high school graduate strongly correlate with being employed; and (8) MCA also revealed that PWDs who are at least college graduates are more closely related to being officers/managers/supervisors, professionals, and technicians/associate professionals while those who are at most elementary graduates tend to be laborers/unskilled and agricultural workers

The influence of 6 weeks of maximal eccentric plantarflexor training on muscle-tendon mechanics

Resistance training can influence muscle-tendon properties including strength, flexibility, stretch tolerance and muscle-tendon stiffness; however the specific influence of eccentric-only training is unknown. Therefore, the aims of the present study were to examine the effects of a 6-week maximal eccentric resistance training programme on isometric plantarflexor moment (MVC), dorsiflexion range of motion (ROM), stretch tolerance (peak passive moment), muscle and tendon stiffness and running economy. Thirteen recreationally active men (age = 20.0 ± 0.9 yr, mass = 75.9 ± 8.5 kg, height = 1.8 ± 0.1 m) volunteered for the study after giving written informed consent; ethical approval was granted from the University of Northampton. Training was performed twice weekly for six weeks and consisted of 5 sets of 12 repetitions of 3-s maximal eccentric contractions at 10°•s-1 from 20° plantarflexion to 10° dorsiflexion. Maximal isometric plantarflexor moment, dorsiflexion ROM, stretch tolerance, and muscle, tendon and muscle-tendon unit (MTU) stiffness were measured using isokinetic dynamometry, real-time ultrasound and 3D motion analyses before and after the training. Running economy (VO2) was determined at a running speed equating to 70%VO2max using online gas analysis. Repeated measures t-tests were used to determine significant differences between pre- and post-training data, significance accepted at p0.05). Analysis of ultrasound data revealed a significant decrease in muscle stiffness (20.6%; p0.05). While the training-induced increase in plantarflexor strength was expected, the substantial increases in ROM, stretch tolerance and tendon stiffness, and the reduction in passive muscle stiffness, were important and novel findings. Interestingly, when measured during passive stretch, MTU stiffness remained unchanged while tendon stiffness increased and muscle stiffness decreased. These disparate findings have clear implications for testing methodologies, and indicate that imaging techniques must be utilised in order to examine the effects of interventions on specific tissues. As the training clearly enhanced the capacity of the muscle to tolerate both tissue loading and deformation, which are commonly associated with muscle strain injury, these data have clear implications for both muscular performance and injury risk

The influence of acute variable resistance loading on subsequent free-weight maximal squat performance

Elastic bands attached to a loaded barbell during a squat exercise create a variable resistance (VR), thus changing the mechanical loading and stress placed through the musculoskeletal system. Preconditioning the neuromuscular system using near-maximal or maximal voluntary contractions (MVC) can induce a phenomenon known as post-activation potentiation (PAP) to enhance performance to ‘supramaximal’ levels. However, the potentiating effects of VR on subsequent free-weight resistance (FWR) squat performance have not been examined. Thus, the aim of the present study was to examine the influence of VR exercise using elastic bands on subsequent FWR squat performance. Sixteen recreationally active men (age = 26.0 ± 7.8 yr, height = 1.7 ± 0.2 m, mass 82.6 ± 12.7 kg) experienced in squatting (>3yr) volunteered for the study after giving written informed consent; ethical approval was granted from the University of Northampton. Subjects’ 1-RM were determined then on two subsequent days either a 3-RM FWR (control) or a 3-RM VR (experimental) squat exercise was performed at 85% 1-RM (35% of the load generated from band tension in the VR condition). Five minutes later, motion analysis recorded knee joint kinematics during a subsequent FWR 1-RM squat, with vastus medialis, vastus lateralis, rectus femoris and semitendinosus electromyograms (EMG) simultaneously recorded. Paired t-tests were used to determine significance, accepted at p0.05) or EMG amplitude (5.9%; p>0.05) occurred. No subjects increased 1-RM in the FWR condition, however 13 of 16 (81%) increased 1-RM by ~10% following VR. Preconditioning the neuromuscular system using VR significantly increased 1-RM without changes in knee extensor muscle activity or knee flexion angle, however eccentric and concentric velocities were reduced. Thus, VR can potentiate the neuromuscular system to enhance subsequent maximal lifting performance. The lack of change in EMG suggests that changes in muscle activity were small or non-existent, which may be explained by force-velocity effects (slower movement = larger forces). Alternatively a greater activation of hip musculature (not measured in the present study) may allow a greater total lower limb force to be developed. Regardless, as 1-RM increased greater lower-limb loading occurred, thus VR potentiated the neuromuscular system and could enhance training stimuli

A Review of Frailty Syndrome and Its Physical, Cognitive and Emotional Domains in the Elderly

Peer reviewedPublisher PD

Three-Dimensional Bioprinting Materials with Potential Application in Preprosthetic Surgery

Current methods in handling maxillofacial defects are not robust and are highly dependent on the surgeon’s skills and the inherent potential in the patients’ bodies for regenerating lost tissues. Employing custom-designed 3D printed scaffolds that securely and effectively reconstruct the defects by using tissue engineering and regenerative medicine techniques can revolutionize preprosthetic surgeries. Various polymers, ceramics, natural and synthetic bioplastics, proteins, biomolecules, living cells, and growth factors as well as their hybrid structures can be used in 3D printing of scaffolds, which are still under development by scientists. These scaffolds not only are beneficial due to their patient-specific design, but also may be able to prevent micromobility, make tension free soft tissue closure, and improve vascularity. In this manuscript, a review of materials employed in 3D bioprinting including bioceramics, biopolymers, composites, and metals is conducted. A discussion of the relevance of 3D bioprinting using these materials for craniofacial interventions is included as well as their potential to create analogs to craniofacial tissues, their benefits, limitations, and their application

Disability and Gender: The Case of the Philippines

Addressing gender gaps is a major development objective anywhere in the world. This paper aims to illustrate that this is far more critical in the presence of another social layer â disability. Among persons with disability (PWDs), the gap between men and women are more distinct, their conditions more dismal with poverty as their needs are different. Apart from poverty, discrimination and prejudice are the major challenges that persons with disabilities face in their everyday life. Because they face various social, physical, and economic barriers, policies should gear toward formulating rights-based and comprehensive actions to improve their well-being. In formulation of effective policy actions, data and information are critical. However, data collection on disability in many countries is at an early stage of development because it is given low priority or often excluded from official statistics. The ESCAP noted that the lack of availability and the quality of demographic and socioeconomic indicators concerning disability continue to be major challenges. This paper aims to fill in this information gap. It discusses the conditions of men and women with disability using a set of pioneering surveys conducted in the Philippines. The goal is to illustrate the gender disparities and to draw useful insights on how stakeholders can address this issue

Understanding the Extent, Composition, and Characteristics of the Poor

Probing deeper into the poverty picture, this Policy Note examines the extent, composition, and characteristics of the poor, using various rounds of the Family Income and Expenditure Survey (FIES) and Annual Poverty Indicator Survey (APIS) as panel data sets. Understanding these aspects could provide insights that may guide the government in formulating specific types of interventions for different groups of households, especially the chronic and transient poor.Philippines, chronic poor, transient poor, panel data