Readiness and recovery : switching between methadone and buprenorphine/naloxone for the treatment of opioid use disorder : a 90 credit thesis submitted in partial fulfillment of the requirements for the degree of Master of Nursing at Massey University, Wellington, New Zealand

Opioid substitution treatment is an effective form of treatment for opioid use disorders. Long acting opiates are used as part of treatment with methadone and buprenorphine/naloxone (BUP/NX) most frequently prescribed. Current evidence suggests that BUP/NX is better than no treatment, but that methadone is marginally more effective for retention in treatment. Benefits of BUP/NX include greater ease in ceasing treatment and less use of illicit opiates while in treatment as compared to methadone. As yet there is little research asking service users about their experiences. This project aims to understand citizen perspectives of what it was like to receive BUP/NX for the treatment of opioid use disorder. A qualitative descriptive approach was used to extract themes from semi-structured interviews of seven randomly selected participants. To be selected, participants had a current diagnosis of opioid use disorder, and had been prescribed BUP/NX during the course of their treatment. The project specifically sets out to consider how citizens viewed BUP/NX as a treatment option for opioid use disorder. Thematic analysis extracted four themes that were interpreted in terms of the harm minimization and the recovery model. The four themes were: drivers for opioid substitution treatment change; readiness for BUP/NX substitution treatment; absence of effect from BUP/NX; and an increased sense of citizenship on BUP/NX. This study identified a number of factors that impacted on the participants’ decision making when it came to switching between methadone and BUP/NX for the treatment of their opioid use disorder. This thesis discusses these factors and locates them within the current literature on the topic. The thesis concludes by saying that methadone is most effective for those people who still seek sedation and currently wish to continue using other opioids, and BUP/NX is most effective for people who no longer wish to experience sedation, and see opioid abstinence as an end point in their recovery. This thesis also concludes that as an individual’s treatment expectations change, these changes are important to consider when determining medication selection. Recommendations are offered, as is a treatment model, which is intended to help with medication decision-making. Future research directions are also suggested

Precautionary Saving, Borrowing Constraints, and Fiscal Policy

Recent empirical studies suggest that the average marginal propensity to consume (MPC) has declined. This paper explains the declining trend of the MPC with a standard representative consumer model where borrowing constraints become more relaxed as suggested by data. With an increase in available credit, the consumer can easily spread out negative income shocks by credit card borrowing or consumer loans. As a result, consumers under relaxed borrowing constraints have lower MPCs than they had a generation ago. This result suggests that policy makers should now account for the less responsiveness of consumers to fiscal stimulus plans aiming at boosting consumptiMarginal Propensity to Consume, Borrowing Constraints, Precautionary Saving, Consumption Function, Effectiveness of Fiscal Policy

Reproducibility of speed, agility and power assessments in elite academy footballers

Purpose: Fitness testing is a visible part of many youth and senior football programs (Pyne et al. 2014). A high priority is given to physical assessments that relate to the demands of match performance (Rampinini et al. 2007). However somewhat surprisingly, the reproducibility of common assessments using elite football cohorts are not widely reported in the literature (Pyne et al. 2014). Field test assessments of speed, agility and power not only provide an indicator of sport-specific power producing ability but can also be used for diagnostic purposes to identify whether an athlete is suffering from fatigue, functional / non-functional overreaching or overtraining (Meeusen et al. 2013). The purpose of this study was to ascertain the reproducibility of testing protocols used to monitor speed, agility and power capabilities within elite academy footballers. Methods: Ten male apprentice professional football players (mean ± SD: age = 17.1 ± 0.7 years, stature = 1.83 ± 0.09 m, mass: 77.8 ± 8.2 kg) participated in the study. All participants completed three separate identical trials with a day’s recovery interspersed between each trial. Each trial consisted of the following assessments; a countermovement jump test (CMJ), a seated medicine ball throw test (Throw), a 40 m run sprint test (40 m), which incorporated a 0-10 m assessed phase (10 m) and the arrowhead agility test (Agility). Results: Findings from One-way ANOVA tests indicated that performance was unchanged across the three trials for all assessments (P > 0.05). Mean typical error as a percentage (TE %) [90 % confidence intervals (CI)] across the assessments indicated highly acceptable reproducibility; CMJ = 3.2% (2.5-4.7), Throw = 1.4% (1.0-2.0). 10 m = 1.6% (1.3-2.4), 40m = 1.4% (1.1-2.0), Agility = 0.9% (0.7-1.3). Conclusion: Elite academy footballers were found to have consistent performance for assessments of speed, agility and power across three trials. Typical error was found to be low for all assessments indicating a high level of reproducibility across repeated trials (Hopkins et al. 2001). Therefore, these assessments can be confidently used in the physical fitness monitoring of elite academy footballers

Status of the Pacific Mackerel resource during 1996 management recommendations for the fishery

The California fishery for Pacific mackerel (Scomber japonicus) has declined precipitously since 1990. Statewide landings during 1995 continued the downward trend, and totaled only 9,185 short tons. During the last few years, the principal cause of reduced catches has been low biomass and poor availability on the traditional fishing grounds in southern California waters. Cannery closures since 1993 may have also affected demand. Several sources of information are available on the status of the Pacific mackerel stock, all of which suggest a decline in stock biomass compared to the late 1970's and 1980's. Landing statistics, available since 1978 for both the U.S. and Mexican fisheries, show reduced catches during recent years. Catch rates for the southern California Commercial Passenger Fishing Vessel (CPFV) fleet have also shown declining trends since the 1970's. Other fishery- independent data from spotter pilot aerial observations and California Cooperative Oceanic Fisheries Investigations (CalCOFI) ichthyoplankton surveys indicate lower abundance compared to the early 1980's. We used a tuned virtual population analysis (VPA) model called ADEPT to estimate Pacific mackerel biomass. The model finds the best statistical fit between fishery-based, age-structured biomass estimates and other data from aerial observations, plankton surveys, CPFV catch data, and a spawner-recruit relation. Based on the estimated number of fish in each year class during the last quarter of 1995 (including the 1995 year class), and using certain assumptions for expected fishing mortality during the first half of 1996, we project that the Pacific mackerel biomass will be 52,000 tons at the beginning of the 1996/97 fishing season, on July 1,1996. There is a large degree of uncertainty in our 1996 biomass estimate because the 1995 year class (fish of age one) comprises most of the biomass. The Fish and Game Code specifies that when the biomass is between 20,000 and 150,000 tons, the season's quota shall be 30 percent of the total biomass in excess of 20,000 tons. Using that formula and our projection for July 1,1996, we recommend a commercial fishery quota of 9,600 tons for the 1996/97 fishing season. (26pp.

A dissipative algorithm for wave-like equations in the characteristic formulation

We present a dissipative algorithm for solving nonlinear wave-like equations when the initial data is specified on characteristic surfaces. The dissipative properties built in this algorithm make it particularly useful when studying the highly nonlinear regime where previous methods have failed to give a stable evolution in three dimensions. The algorithm presented in this work is directly applicable to hyperbolic systems proper of Electromagnetism, Yang-Mills and General Relativity theories. We carry out an analysis of the stability of the algorithm and test its properties with linear waves propagating on a Minkowski background and the scattering off a Scwharszchild black hole in General Relativity.Comment: 23 pages, 7 figure

Alien Registration- Bishop, Thomas (Brownville, Piscataquis County)

https://digitalmaine.com/alien_docs/10168/thumbnail.jp

The Effect of Black Liquor Carryover on Bleaching Effluent Chemical Oxygen Demand (COD)

This project examines the effect of black liquor carryover from the brownstock washing section on the bleach plant effluent qualities of COD. Black liquor carryover not only directly effects the organic loading to the effluent treatment plant, but also interferes with bleaching chemicals during the bleaching sequence. The goal of the project was to establish the relationship and quantify the effects of this carryover on the bleaching effluent COD. Samples of pulp were spiked with black liquor and then bleached by a D-E bleaching sequence to a specific target Kappa number. The effluents from both of the bleaching stages were analyzed for the organic wasteload in terms of COD.The effect of the carryover on the COD of the chlorine dioxide stage effluent is increasingly more significant as increasing amounts of carryover are used. The carryover cannot be shown to have any effects on the COD of the extraction stage of the bleaching process. This is a direct reversal of the carryover effects when using a typical chlorination first stage bleaching, where most of the effluent COD is from the extraction stage of the bleaching process. The information from this project can be utilized to determine if improved washing efficiency will eliminate the need for additional wastewater treatment to meet the proposed Federal regulations