Intensive Outpatient Program for Substance Abuse: Occupational Therapy Guideline to Recovery

The purpose of this scholarly project was to develop an evidence-based 12-session group protocol for occupational therapists (OTs) to use in an intensive outpatient program (IOP) for substance abuse. The target population for this scholarly project was young adults aged 18-25 who have illicit drug use issues. Guided by concepts of the Model of Human Occupation (MOHO), the protocol targeted common occupational performance and deficit issues encountered by individuals with substance use. The authors first observed one, 3-hour IOP session at Central Wyoming Counseling Center (CWCC) and participated in one, two-hour meeting with the director of substance abuse programing at CWCC to obtain information about addiction recovery from other professions and the IOP structure. Information gathered was compared to findings from a literature search and a12-session guide was developed for OT services to complement existing programming provided at CWCC. Each session protocol was designed to be held in one, three-hour group session and includes objectives, warm-up activities, an occupational focused activity, prompting questions for discussion, a wrap-up, and a take home activity. Each session builds off one another and the take home activities are intended to integrate the participant into the next session. Session topics include: 1) exploring addiction as an occupation 2) occupational exploration 3) coping skills through sensory stimulation 4) spirituality and coping 5) time management and scheduling 6) healthy habits: ADLs, sleep/rest, nutrition 7) leisure identification 8) roles and routines, productive education/work 9) intimacy and social participation 10) social participation and anger 11) daily coping skills with stress and recovery 12) takin’ care of business: how to get what you want. This scholarly project provides a foundational program to be used as a starting point for occupational therapy intervention in an intensive outpatient chemical dependency program. The protocol might be applied beyond the IOP structure to settings such as acute inpatient, state hospital, or long-term mental health facilities. Elements of the program might also be altered for application to alternative populations such as individuals over age 25, those with alcoholism, or those with other various drug dependencies. In summary, this scholarly project provides a theoretical model, occupation-based interventions, an extensive literature review, and an opportunity for future research and clinical development based on the role of OT in an IOP for substance abuse recovery

Ontslag op staande voet na schending re-integratieverplichtingen: mission impossible?

Kan de werkgever de werknemer die niet voldoet aan zijn re-integratieverplichtingen op staande voet ontslaan? In deze bijdrage staat de vraag centraal of de werkgever naast een loonstop en ontbinding ook de mogelijkheid heeft om de werknemer die niet meewerkt aan zijn re-integratieverplichting ex art. 7:660a BW op staande voet te ontslaan. Wij zul-len dit onderwerp behandelen aan de hand van re-cente jurisprudentie vanaf de inwerkingtreding van de Wet werk en zekerheid (‘Wwz’). De jurisprudentie laat zien dat over dit onderwerp veel wordt gepro-cedeerd met wisselende uitkomsten tot gevolg. Met name de hoven achten niet vaak een dringende re-den aanwezig. Ook wordt in dit artikel stilgestaan bij de vraag of ontslag op staande voet mogelijk is als een (gedeeltelijk) arbeidsongeschikte werknemer nevenwerkzaamheden verricht

Mitigation of the U.S. agrifood sector’s contribution to human and planetary health: a case study

The relationship of the United States (U.S.) agrifood sector to climate change is bidirectional; cattle production for beef consumption generates methane and nitrous oxide, both of which are potent greenhouse gases (GHGs). These gases contribute to global warming which in turn increase the frequency and strength of adverse catastrophic events, which compromise the food supply. Increased GHGs also affect crop yields and the micronutrient content of crops, which adversely affect the prevalence of food and nutrition insecurity, particularly in low- and middle-income countries. Because the U.S. is a major contributor to global warming, we have a special responsibility to reduce our contribution to the generation of GHGs. The dilemma is that beef is a highly nutritious and desirable food, with excess consumption in the U.S. and under consumption in other parts of the world, but a desirable source of nutrients in low- and middle-income countries (LMICs). Reductions in fossil fuels have been a major focus of concern, and the agrifood system has been largely ignored. Policy changes to reduce beef consumption have been resisted at the highest levels of government. Furthermore, shifts to more plant-based diets have been contentious. Successful reductions in beef consumption will require individual, institutional, municipal, and state initiatives. Building the political will for change will require a compelling communication campaign that emphasizes the unsustainable contribution of beef consumption to climate change and land and water use

Detecting transient gravitational waves in non-Gaussian noise with partially redundant analysis methods

There is a broad class of astrophysical sources that produce detectable, transient, gravitational waves. Some searches for transient gravitational waves are tailored to known features of these sources. Other searches make few assumptions about the sources. Typically events are observable with multiple search techniques. This work describes how to combine the results of searches that are not independent, treating each search as a classifier for a given event. This will be shown to improve the overall sensitivity to gravitational-wave events while directly addressing the problem of consistent interpretation of multiple trials.Comment: 11 pages, 5 figure

Mitigation of the U.S. agrifood sector’s contribution to human and planetary health: a case study

The relationship of the United States (U.S.) agrifood sector to climate change is bidirectional; cattle production for beef consumption generates methane and nitrous oxide, both of which are potent greenhouse gases (GHGs). These gases contribute to global warming which in turn increase the frequency and strength of adverse catastrophic events, which compromise the food supply. Increased GHGs also affect crop yields and the micronutrient content of crops, which adversely affect the prevalence of food and nutrition insecurity, particularly in low- and middle-income countries. Because the U.S. is a major contributor to global warming, we have a special responsibility to reduce our contribution to the generation of GHGs. The dilemma is that beef is a highly nutritious and desirable food, with excess consumption in the U.S. and under consumption in other parts of the world, but a desirable source of nutrients in low- and middle-income countries (LMICs). Reductions in fossil fuels have been a major focus of concern, and the agrifood system has been largely ignored. Policy changes to reduce beef consumption have been resisted at the highest levels of government. Furthermore, shifts to more plant-based diets have been contentious. Successful reductions in beef consumption will require individual, institutional, municipal, and state initiatives. Building the political will for change will require a compelling communication campaign that emphasizes the unsustainable contribution of beef consumption to climate change and land and water use

Likelihood-ratio ranking of gravitational-wave candidates in a non-Gaussian background

We describe a general approach to detection of transient gravitational-wave signals in the presence of non-Gaussian background noise. We prove that under quite general conditions, the ratio of the likelihood of observed data to contain a signal to the likelihood of it being a noise fluctuation provides optimal ranking for the candidate events found in an experiment. The likelihood-ratio ranking allows us to combine different kinds of data into a single analysis. We apply the general framework to the problem of unifying the results of independent experiments and the problem of accounting for non-Gaussian artifacts in the searches for gravitational waves from compact binary coalescence in LIGO data. We show analytically and confirm through simulations that in both cases the likelihood ratio statistic results in an improved analysis.Comment: 10 pages, 6 figure

DDoS Defense using MTD and SDN

Distributed large-scale cyber attacks targeting the availability of computing and network resources still remains a serious threat. In order to limit the effects caused by those attacks and to provide a proactive defense, mitigation should move to the networks of Internet Service Providers. In this context, Moving Target Defense (MTD) is a technique that increases uncertainty due to an ever-changing attack surface. In combination with Software Defined Networking (SDN), MTD has the potential to reduce the effects of a large-scale cyber attack. In this paper, we combine the defense techniques moving- target using Software Defined Networking and investigate their effectiveness. We review current moving-target defense strategies and their applicability in context of large-scale cyber attacks and the networks of Internet Service Providers. Further, we enforce the implementation of moving target defense strategies using Software Defined Networks in a collaborative environment. In particular, we focus on ISPs that cooperate among trusted partners. We found that the effects of a large-scale cyber attack can be significantly reduced using the moving-target defense and Software Defined Networking. Moreover, we show that Software Defined Networking is an appropriate approach to enforce implementation of the moving target defense and thus mitigate the effects caused by large-scale cyber attacks