The large majority of individuals who access substance use disorders (SUD) treatment do not receive evidence-based care. Little attention has been paid to the notion that the scale-up of ...evidence-based practices (EBPs) has been limited in large part due to a weakness in the “distribution system” for bringing new innovations to the attention of practitioners and into practice settings. This study explores the impact of the Training and Practice Implementation Institute (TPII; funded by the New York City Department of Health and Mental Hygiene), an intensive technical assistance initiative that offers external facilitation to outpatient SUD treatment providers via the incorporation of multiple evidence-based implementation strategies to enhance the practice of motivational interviewing (MI). Findings from this study show that staff completed a large majority (86%) of required training/technical assistance (TTA) activities across the 9-month implementation period, demonstrating a high level of engagement among staff and the feasibility of externally facilitated intensive TTA delivered to community-based organizations for the purpose of enhancing implementation of MI for SUDs. Results also show statistically significant improvements in the delivery of MI’s technical components among staff, though did not reveal corresponding improvements in the delivery of MI’s relational components. An understanding of the potential return on investment associated with externally facilitated TA, offers organizations an opportunity to inform the allocation of limited resources to areas where they will have the greatest impact and ultimately improve the quality and efficacy of services.
Natural rubber is one of the major exporting cash crops in Thailand. Shrinkage in natural rubber sheet during drying creates uneven stresses in the rubber, hampers the quality and the water activity ...predisposes it to microbial activation. Hence, the effect of drying parameters on shrinkage has been considered in this work. The finite element concept coupled with the arbitrary Lagrangian-Eulerian (ALE) method was used to solve the two-dimensional coupled physics in the rubber sheet drying chamber and account for the shrinkage effect. The spatial domain (drying chamber), material domain (rubber sheet) was analysed. An isotropic linear elastic model was assumed for the rubber sheet for analysis. Three Case studies of different velocity, temperature, relative humidity and shrinkage coefficient were considered in the numerical study using COMSOL Multiphysics. It is concluded that increase in the operating parameters increases the shrinkage of the rubber. Therefore, rubber should dry at relatively lower operating parameters to improve its quality.
This study presents a low-cost smart pipeline inspection gauge (PIG) designed for pipeline defect (leakage) detection, and for quick data access and recovery for the purpose of analysis, utilizing ...locally sourced materials and off-the-shelf sensors and electronics. The PIG’s electronic circuit is designed to house the sensors and allow for easy reception and transfer of pressure measurements to the pipeline manager’s laptop via a WiFi module. A pressure sensor, a motion sensor, a wireless communicator, and an Arduino Microcontroller are utilized in the development of this PIG. The PIG was tested experimentally by being put through stationary, no load-no defect, and no load-defect tests respectively. The PIG was kept still during the stationary tests but was conveyed within a 160 mm diameter Polyvinyl Chloride (PVC) conduit with a length of 6.7 m for both the no load-no defect and no load-defect tests, using a 0.125 Hp direct current (DC) motor, with a gearbox attachment to pull from one end to the other. Using a WiFi module and the PuTTY program, the pressure values were retrieved. The test results revealed that P1 (front pressure) values were higher than P2 (rear pressure) values for the no load tests. P1 readings ranged from 1213 to 1214 Pa, with an average of 1213.86 Pa for the no load-no defect tests. The average P2 value was 1094.24 Pa, with a range of 1094.24 Pa to 1094.75 Pa. The pressure values for the no load-defect cases began at 1226.8 Pa and steadily decreased for the first 1.5 minutes, then remained at an average of 1214.2 Pa for the next 20 seconds until they arrived at the first defected point, where a value of 1216.1 Pa was recorded. The PIG traversed the pipeline until it had caught all of the pressure pulses at the defective sites. The higher pressure pulses (spikes) observed at the points of defects created along the pipeline in the experimental results from the no load-defect tests indicates that the Smart PIG was capable of detecting the created defects and demonstrated that the low-cost Smart PIG can be used to detect leakages on a pipe and can also be deployed in real life situations.
The health problems associated with the use of asbestos based brake linings have motivated research on the use of ecofriendly-agro based biomaterials as reinforcing agents in composite materials used ...for brake pad lining production. This research work studies the possibilities of using palm kernel shell (PKS), coconut shell (CNS), and canarium sweinfurthii shell (CSS) powder for asbestos-free brake lining materials production. The powders alongside the relevant fillers were used in the production of the brake lining. Compositions of the reinforcing powders were varied from 25% to 40% thatof resin binder was varied from 58% to 43%, while those of filler metal and curing agents were kept constant. These materials were weighed, formulated, mixed, cured, and moulded. The developed composite materials were characterized and subjected to water and oil absorption, compressive strength, hardness, and wear tests. Results of the analysis revealed that increase in reinforcing materials results in an increase in the water and oil absorption of the samples. The composite’s compressive strength equally increased with the introduction of up to 35% composition. The measured value of coefficient of friction was found to be within an acceptable range. Also, when mixed with other fillers and bounded, CSS powder proved to be a very promising material for brake lining production.
Previously untreated patients with advanced esophageal cancer were randomly assigned to receive chemotherapy alone, chemotherapy plus nivolumab, or nivolumab plus ipilimumab. Among patients with ...tumor-cell PD-L1 expression of 1% or greater, the two nivolumab regimens resulted in longer overall survival than chemotherapy. The side-effect profile was consistent with past reports on these agents.
The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) collaborate ...annually to provide updated information on cancer occurrence and trends in the United States. This year's report highlights brain and other nervous system (ONS) tumors, including nonmalignant brain tumors, which became reportable on a national level in 2004.
Cancer incidence data were obtained from the National Cancer Institute, CDC, and NAACCR, and information on deaths was obtained from the CDC's National Center for Health Statistics. The annual percentage changes in age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers for men and for women were estimated by joinpoint analysis of long-term (1992-2007 for incidence; 1975-2007 for mortality) trends and short-term fixed interval (1998-2007) trends. Analyses of malignant neuroepithelial brain and ONS tumors were based on data from 1980-2007; data on nonmalignant tumors were available for 2004-2007. All statistical tests were two-sided.
Overall cancer incidence rates decreased by approximately 1% per year; the decrease was statistically significant (P < .05) in women, but not in men, because of a recent increase in prostate cancer incidence. The death rates continued to decrease for both sexes. Childhood cancer incidence rates continued to increase, whereas death rates continued to decrease. Lung cancer death rates decreased in women for the first time during 2003-2007, more than a decade after decreasing in men. During 2004-2007, more than 213 500 primary brain and ONS tumors were diagnosed, and 35.8% were malignant. From 1987-2007, the incidence of neuroepithelial malignant brain and ONS tumors decreased by 0.4% per year in men and women combined.
The decrease in cancer incidence and mortality reflects progress in cancer prevention, early detection, and treatment. However, major challenges remain, including increasing incidence rates and continued low survival for some cancers. Malignant and nonmalignant brain tumors demonstrate differing patterns of occurrence by sex, age, and race, and exhibit considerable biologic diversity. Inclusion of nonmalignant brain tumors in cancer registries provides a fuller assessment of disease burden and medical resource needs associated with these unique tumors.
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