Contingency Management Effect on Cocaine Use While Using Methadone

An estimated 50 % of patients on methadone use cocaine concurrently (Holuj et al., 2013). Participants using cocaine were three times more likely to drop out of methadone maintenance treatment (MMT)and are less likely to have cocaine/opiate free urine samples (Kosten et al., 2003). Contingency Management (CM) has been shown to be effective in the reduction of cocaine use for participant on methadone but there isn’t a comprehensive evaluation of all of the research completed. This systematic review evaluated the research on the short and long term effectiveness of CM on cocaine use, the effectiveness of the various types of CM, the effect of the magnitude of CM and the timing of CM administration. CM was found to have short and long term success in reducing cocaine use among participants on MMT. CM was most successful when continuously given and the magnitude of the reinforcement was highest. CM was shown to be effective in all forms. Differences in the research studies made it difficult to determine which type of CM was most effective with the exception of one article that showed clear benefits with cash/check CM compared to voucher CM

The Combined Effects of Physical Therapy and Music Therapy for an Older Adult with Chronic Left-Sided Hemiparesis: A Case Report

Background and Purpose: Stroke and other disorders that involve the neurological system can have adverse effects such as hemiparesis, spasticity, hypertonicity, and gait and balance deficits. Due to neurological disorders being so prevalent, proper rehabilitative treatments are necessary to return to a functional lifestyle. Multiple approaches across the therapy spectrum have been utilized, but rarely are these therapeutic approaches completed concurrently among different disciplines. The purpose of this case report is to address the interdisciplinary co-treatment by students of music therapy and physical therapy for a patient exhibiting chronic left-sided hemiparesis. Case Description: This case report describes a 56-year-old male patient who exhibits chronic left-sided hemiparesis and spasticity following two tumor resections from his right frontal lobe over the span of the past twelve years. These symptoms greatly affect his gait biomechanics and muscular endurance with activity. Interventions: Treatment was done by utilizing pre-gait and gait activities along with rhythmic auditory stimulation (RAS), or the use of external rhythmical cueing, to help aid in symmetrical and reciprocal movements bilaterally. Tests and measures used to examine functional changes included the Timed Up-and-Go, the Five-Time Sit-to-Stand, Berg Balance Scale, Two-Minute Walk Test, Short-Form 36 and GAITRite® pre- and post-intervention data. Outcomes and Discussion: The patient improved his scores on the TUG, FTSST, and BBS tests. However, no significant differences were found in pre and post-test data for the Short Form 36, 2MWT or GAITRite®. Subjectively, it was evident the patient\u27s confidence and mechanics during all tests and measures had improved. This suggested the patient within this case study may have improved function following the incorporation of combined music and physical therapy rehabilitation efforts

Improving energy efficiency of machine tools

Part of: Seliger, Günther (Ed.): Innovative solutions : proceedings / 11th Global Conference on Sustainable Manufacturing, Berlin, Germany, 23rd - 25th September, 2013. - Berlin: Universitätsverlag der TU Berlin, 2013. - ISBN 978-3-7983-2609-5 (online). - http://nbn-resolving.de/urn:nbn:de:kobv:83-opus4-40276. - pp. 125–130.Manufacturing is responsible for about one half of global consumption of primary energy, a great deal of which is consumed by machine tools producing discrete parts. The topic of energy efficiency is driven forward by machine tool users who demand low operational costs, as well as social and legislative forces requiring environmentally friendlier manufacturing. This paper aims to provide examples and good practices for improving machine tool energy efficiency with a focus on metal cutting machine tools. During the design stage, there are various opportunities to minimize inherent energy losses by selecting and dimensioning drives and peripherals. On the other hand, users have a large impact on productivity by using the machine effectively and knowledgeably. The paper also presents techniques for measurement and analysis of the energy profile of machines which help to better target energy saving measures on already existing machines

Study of characteristic variations of high-speed spindles induced by centrifugal expansion deformations

High-speed machining has continuously pushed the demand of spindles with higher speed and higher reliability. In order to design, analyze, and test spindles in a virtual environment, accurate modeling of the spindle dynamics during the running state is essential. This paper investigates the variations of interference fit and bearing preload condition induced by centrifugal expansion deformations at high speed. Firstly, the elastic expansion deformations of the rotating parts due to centrifugal force are calculated based on mechanics of elasticity. It is found that the centrifugal expansion deformation of the bearing inner ring is much larger than the deformation of the shaft when the rotational speed increases, and therefore the amount of the interference between the shaft and the bearing decreases with the speed. Then, with consideration of the centrifugal expansion deformation, a dynamic model of high-speed rolling ball bearings is presented with experimental validation. With the proposed bearing model, centrifugal effects on the bearing preload condition are studied in detail. It is shown that the bearing contact angle decreases, while the contact load increases with the centrifugal expansion deformation of the bearing inner ring. The radial bearing stiffness increases, whereas the axial bearing stiffness decreases a little, due to the resultant effects of the decreased contact angle and the increased contact load. The preload condition of the spindle bearing is strengthened by the centrifugal expansion effect of the bearing inner ring

Collaborative research between clinicians and researchers: a multiple case study of implementation

<p>Abstract</p> <p>Background</p> <p>Bottom-up, clinician-conceived and directed clinical intervention research, coupled with collaboration from researcher experts, is conceptually endorsed by the participatory research movement. This report presents the findings of an evaluation of a program in the Veterans Health Administration meant to encourage clinician-driven research by providing resources believed to be critical. The evaluation focused on the extent to which funded projects: maintained integrity to their original proposals; were methodologically rigorous; were characterized by collaboration between partners; and resulted in sustained clinical impact.</p> <p>Methods</p> <p>Researchers used quantitative (survey and archival) and qualitative (focus group) data to evaluate the implementation, evaluation, and sustainability of four clinical demonstration projects at four sites. Fourteen research center mentors and seventeen clinician researchers evaluated the level of collaboration using a six-dimensional model of participatory research.</p> <p>Results</p> <p>Results yielded mixed findings. Qualitative and quantitative data suggested that although the process was collaborative, clinicians' prior research experience was critical to the quality of the projects. Several challenges were common across sites, including subject recruitment, administrative support and logistics, and subsequent dissemination. Only one intervention achieved lasting clinical effect beyond the active project period. Qualitative analyses identified barriers and facilitators and suggested areas to improve sustainability.</p> <p>Conclusions</p> <p>Evaluation results suggest that this participatory research venture was successful in achieving clinician-directed collaboration, but did not produce sustainable interventions due to such implementation problems as lack of resources and administrative support.</p

IS IT POSSIBLE TO LIVE THE IDEAL OF NASARETH FAMILY?

The work deals with philosophical and theological consideration of marriage as the natural institution. It comes out of the implied hypothesis of inherent ideals of love, failthfullness and inseparability, whose fulfillment man often searches in marriage. The theoretical part describes marriage and family from the point of view of the Christian ethics. It characterizes the sacramental and the non-sacramental marriages, looks for common ideas and points out their differences. It touches also the problems of contemporary families e.g. abortion, fertility and divorce rate. The practical part includes the results of the survey among the present-day young people about their ideals of Christian marriage. Then it analyses the birth registry entries for the period of 1993{--}1998 in Pelhřimov and its surroundings and compares the church marriages to the civil ones from the point of view of their divorce rate and the number of the children born in these marriages. The conclusion of the work evaluates the results of the practical part, compares it with the countrywide surveys and answers the introductory question of this work: if is possible to live the ideal of Nasareth family

Gene Holkup and Paul Swenson Senior Recital April 1, 1986

Contains performances in German and Italian