Detoxification in rehabilitation in England: effective continuity of care or unhappy bedfellows?

There is evidence that residential detoxification alone does not provide satisfactory treatment outcomes and that outcomes are significantly enhanced when clients completing residential detoxification attend rehabilitation services (Gossop, Marsden, Stewart, & Rolfe, 1999; Ghodse, Reynolds, Baldacchino, et al., 2002). One way of increasing the likelihood of this continuity of treatment is by providing detoxification and rehabilitation within the same treatment facility to prevent drop-out, while the client awaits a rehabilitation bed or in the transition process. However, there is little research evidence available on the facilities that offer both medical detoxification and residential rehabilitation. The current study compares self-reported treatment provision in 87 residential rehabilitation services in England, 34 of whom (39.1%) reported that they offered detoxification services within their treatment programmes. Although there were no differences in self-reported treatment philosophies, residential rehabilitation services that offered detoxification were typically of shorter duration overall, had significantly more beds and reported offering more group work than residential rehabilitation services that did not offer detoxification. Outcomes were also different, with twice as many clients discharged on disciplinary grounds from residential rehabilitation services without detoxification facilities. The paper questions the UK classification of residential drug treatment services as either detoxification or rehabilitation and suggests the need for greater research focus on the aims, processes and outcomes of this group of treatment providers

Response of river-dominated delta channel networks to permanent changes in river discharge

Using numerical experiments, we investigate how river-dominated delta channel networks are likely to respond to changes in river discharge predicted to occur over the next century as a result of environmental change. Our results show for a change in discharge up to 60% of the initial value, a decrease results in distributary abandonment in the delta, whereas an increase does not significantly affect the network. However, an increase in discharge beyond a threshold of 60% results in channel creation and an increase in the density of the distributary network. This behavior is predicted by an analysis of an individual bifurcation subject to asymmetric water surface slopes in the bifurcate arms. Given that discharge in most river basins will change by less than 50% in the next century, our results suggest that deltas in areas of increased drought will be more likely to experience significant rearrangement of the delta channel network. Copyright 2010 by the American Geophysical Union

Change in Working Length at Different Stages of Instrumentation as a Function of Canal Curvature

The aim of this study was to determine the change in working length (∆WL) before and after coronal flaring and after complete rotary instrumentation as a function of canal curvature. One mesiobuccal or mesiolingual canal from each of 43 extracted molars had coronal standardization and access performed. Once the access was completed, canal preparation was accomplished using Gates Glidden drills for coronal flaring and EndoSequence files for rotary instrumentation. WLs were obtained at 3 time points: pre-instrumentation (unflared), mid-instrumentation (flared) and post-instrumentation (concluded). Measurements were made via direct visualization (DV) and the CanalPro apex locator (EM) in triplicate by a single operator with blinding within the time points. Root curvature was measured using Schneider’s technique. The change in working length was assessed using repeated-measures ANCOVA. The direct visualization measurements were statistically larger than the electronic measurements (paired t-test difference = 0.20 mm, SE = 0.037, P \u3c .0001), although a difference this large may not be clinically important. Overall, a greater change in working length was observed in straight canals than in curved canals, and this trend was more pronounced when measured electronically than via direct visualization, especially in the unflared-concluded time points compared with unflared-flared time points. A greater change in working length was also observed in longer canals than in shorter canals.https://scholarscompass.vcu.edu/gradposters/1032/thumbnail.jp

Inventory of wetland habitat using remote sensing for the proposed Oahe irrigation unit in eastern South Dakota

An inventory of wetlands for the area included in the proposed Oahe irrigation project was conducted to provide supplemental data for the wildlife mitigation plan. Interpretation techniques for inventoring small wetlands in the low relief terrain of the Lake Dakota Plain were documented and data summaries included. The data were stored and tabulated in a computerized spatial data analysis system

Solid fuel use and cooking practices as a major risk factor for ALRI mortality among African children

Background: Almost half of global child deaths due to acute lower respiratory infections (ALRIs) occur in sub-Saharan Africa, where three-quarters of the population cook with solid fuels. This study aims to quantify the impact of fuel type and cooking practices on childhood ALRI mortality in Africa, and to explore implications for public health interventions. Methods: Early-release World Health Survey data for the year 2003 were pooled for 16 African countries. Among 32 620 children born during the last 10 years, 1455 (4.46%) were reported to have died prior to their fifth birthday. Survival analysis was used to examine the impact of different cooking-related parameters on ALRI mortality, defined as cough accompanied by rapid breathing or chest indrawing based on maternal recall of symptoms prior to death. Results: Solid fuel use increases the risk of ALRI mortality with an adjusted hazard ratio of 2.35 (95% CI 1.22 to 4.52); this association grows stronger with increasing outcome specificity. Differences between households burning solid fuels on a well-ventilated stove and households relying on cleaner fuels are limited. In contrast, cooking with solid fuels in the absence of a chimney or hood is associated with an adjusted hazard ratio of 2.68 (1.38 to 5.23). Outdoor cooking is less harmful than indoor cooking but, overall, stove ventilation emerges as a more significant determinant of ALRI mortality. Conclusions: This study shows substantial differences in ALRI mortality risk among African children in relation to cooking practices, and suggests that stove ventilation may be an important means of reducing indoor air pollution

Why the mechanisms of 12-Step behaviour change should matter to clinicians

Commentary to: Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change researc

Cosmic downsizing of powerful radio galaxies to low radio luminosities

At bright radio powers ($P_{\rm 1.4 GHz} > 10^{25}$ W/Hz) the space density of the most powerful sources peaks at higher redshift than that of their weaker counterparts. This paper establishes whether this luminosity-dependent evolution persists for sources an order of magnitude fainter than those previously studied, by measuring the steep--spectrum radio luminosity function (RLF) across the range $10^{24} < P_{\rm 1.4 GHz} < 10^{28}$ W/Hz, out to high redshift. A grid-based modelling method is used, in which no assumptions are made about the RLF shape and high-redshift behaviour. The inputs to the model are the same as in Rigby et al. (2011): redshift distributions from radio source samples, together with source counts and determinations of the local luminosity function. However, to improve coverage of the radio power vs. redshift plane at the lowest radio powers, a new faint radio sample is introduced. This covers 0.8 sq. deg., in the Subaru/XMM-Newton Deep Field, to a 1.4 GHz flux density limit of $S_{\rm 1.4 GHz} \geq 100~\mu$Jy, with 99% redshift completeness. The modelling results show that the previously seen high-redshift declines in space density persist to $P_{\rm 1.4 GHz} < 10^{25}$ W/Hz. At $P_{\rm 1.4 GHz} > 10^{26}$ W/Hz the redshift of the peak space density increases with luminosity, whilst at lower radio luminosities the position of the peak remains constant within the uncertainties. This `cosmic downsizing' behaviour is found to be similar to that seen at optical wavelengths for quasars, and is interpreted as representing the transition from radiatively efficient to inefficient accretion modes in the steep-spectrum population. This conclusion is supported by constructing simple models for the space density evolution of these two different radio galaxy classes; these are able to successfully reproduce the observed variation in peak redshift.Comment: 7 pages, 6 figures; accepted for publication in Astronomy & Astrophysic