Geoff McCombe, Anne Marie Henihan, Jan Klimas, Davina Swan, Dorothy Leahy, Rolande Anderson, Gerard Bury, Colum Dunne, Eamon Keenan, David Meagher, Clodagh O’Gorman, Tom O’Toole, Jean Saunders, Bobby P. Smyth, John S. Lambert, Eileen Kaner and Walter Cullen
Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to…
Abstract
Purpose
Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to describe a qualitative feasibility assessment of a primary care-based complex intervention to promote screening and brief intervention for PAU, which also aims to examine acceptability and potential effectiveness.
Design/methodology/approach
Semi-structured interviews were conducted with 14 patients and eight general practitioners (GPs) who had been purposively sampled from practices that had participated in the feasibility study. The interviews were transcribed verbatim and analysed thematically.
Findings
Six key themes were identified. While all GPs found the intervention informative and feasible, most considered it challenging to incorporate into practice. Barriers included time constraints, and overlooking and underestimating PAU among this cohort of patients. However, the intervention was considered potentially deliverable and acceptable in practice. Patients reported that (in the absence of the intervention) their use of alcohol was rarely discussed with their GP, and were reticent to initiate conversations on their alcohol use for fear of having their methadone dose reduced.
Research limitations/impelications
Although a complex intervention to enhance alcohol screening and brief intervention among primary care patients attending for OAT is likely to be feasible and acceptable, time constraints and patients’ reticence to discuss alcohol as well as GPs underestimating patients’ alcohol problems is a barrier to consistent, regular and accurate screening by GPs. Future research by way of a definitive efficacy trial informed by the findings of this study and the Psychosocial INTerventions for Alcohol quantitative data is a priority.
Originality/value
To the best of the knowledge, this is the first qualitative study to examine the capability of primary care to address PAU among patients receiving OAT.
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Because of its high overall pressure ratio and good propulsive efficiency, the jet engine is very efficient for supersonic propulsion. A high thrust per unit power plant frontal…
Abstract
Because of its high overall pressure ratio and good propulsive efficiency, the jet engine is very efficient for supersonic propulsion. A high thrust per unit power plant frontal area and per unit weight are primary requirements and these imply high combustion temperatures. For a Mach 2.0 aircraft, engine design problems other than this are not outside existing experience but additional problems, such as bearing cooling, become more serious at cruise Mach Numbers approaching 3.0. A variable intake is essential and the method of geometry variation and control requirements are described. Variable propulsion nozzle design is also an area of vital importance and it is not claimed that an entirely satisfactory solution, giving good performance with low drag in the transonic phase, has yet been achieved. The ‘sonic boom’ phenomenon can have an important influence on engine design, in that it may determine the maximum altitude at which the aircraft has to fly subsonically. Should this be appreciably above the tropopause, then it will not only influence the amount of thrust installed but may also dictate the fitment of reheat for the transonic acceleration. Take‐off noise is a requirement which can influence both the installed thrust and the choice of engine type. Despite the lack of firm standards for field noise and ‘coast‐over’ noise, there is good reason to believe that the noise levels of a supersonic transport need not exceed those of the quieter long‐range subsonic transports in service at this time.
W.R. Maxwell, W. Dickinson and E.F. Caldin
AN equation of state is derived for a system consisting of a perfect gas containing solid particles in suspension. It is assumed that temperature‐equilibrium is maintained…
Abstract
AN equation of state is derived for a system consisting of a perfect gas containing solid particles in suspension. It is assumed that temperature‐equilibrium is maintained throughout. The results are applied to calculate the kinetic energy obtainable from the adiabatic expansion of a stream of such a system, and related quantities. The assumptions of the treatment are critically examined.
MANY papers have been written in recent years on various technical aspects of the supersonic transportaircraft—aerodynamics, propulsion, structures and systems. In attempting to…
Abstract
MANY papers have been written in recent years on various technical aspects of the supersonic transportaircraft—aerodynamics, propulsion, structures and systems. In attempting to give yet another paper on this topic, it was felt the subject should be reviewed in a more general way, by considering a variety of engineering problems which arise in the design and development of such an aircraft.
First, the statistics. This issue of Jane's—corrected to September 1, 1962—contains a total of 504 pages apart from the two page preface by the Editor and 24 pages of indexes at…
Abstract
First, the statistics. This issue of Jane's—corrected to September 1, 1962—contains a total of 504 pages apart from the two page preface by the Editor and 24 pages of indexes at the end of the book. Divided into six separate sections, it contains descriptions of the aeroplanes of thirty‐five countries, the sailplanes of twenty‐four countries, the target drones of six countries, the air cushion vehicles of seven countries, the guided missiles, rockets and space vehicles of seventeen countries and the aero engines of fourteen countries. By adopting a new method of information presentation it has been possible to increase the amount of new data in the book without increasing the actual number of pages. The fact that this edition of Jane's is no mere rehash of the 1961–62 number is underlined further by the inclusion of almost 600 new illustrations.
This paper aims to formulate a hypothesis for the origin and position of binarism within human meaning systems. Specifically, binarism exists ineluctably as a living system's…
Abstract
Purpose
This paper aims to formulate a hypothesis for the origin and position of binarism within human meaning systems. Specifically, binarism exists ineluctably as a living system's impetus toward life over death, and then – at the symbolic level within human meaning systems – as a device by which humans more efficiently dissipate the solar-energetic gradient.
Design/methodology/approach
Organisms composing terrestrial ecosystems acquire and degrade solar energy or its derivatives, thereby reducing the thermal gradient impressed on Earth by the Sun. Kay and Schneider call this “the thermodynamic imperative of the restated second law for open systems.” This paper connects the “thermodynamic imperative” to aspects of human meaning systems and pushes Serres' notion regarding homeostasis and the origin of communication one step further to consider such an origin in terms of a binarism born of solar-energetic gradient dissipation.
Findings
It is hypothesized that the human homoiotherm extends the ineluctable binarism of life over death for all living systems to a symbolic level – as a first, or local, “energetic order” – which serves as a foundational device of human meaning systems; humans efficiently use this binary device to produce entropy and maintain homeostasis within individual organisms and comprehensive ecosystems; and human language, and ultimately the entirety of human meaning systems, emerges from the dissipation of the solar-energetic gradient.
Originality/value
Modern Western philosophical concepts related to binarism – i.e. Kantian and Hegelian dialectics – are not associated with ecological imperatives. The present hypothesis proposes the co-existence of both a fundamental binarism (i.e. impetus of life over death) and more complex symbolic differentials (in a Leibnizian/Deleuzian sense) as necessary for the emergence of complex human meaning systems in consonance with thermodynamic and ecological imperatives.
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Zuhao Li, Chenyu Wang, Chen Li, Zhonghan Wang, Fan Yang, He Liu, Yanguo Qin and Jincheng Wang
This paper aims to review the latest applications in terms of three-dimensional printed (3DP) metal implants in orthopedics, and, importantly, the design of 3DP metal implants…
Abstract
Purpose
This paper aims to review the latest applications in terms of three-dimensional printed (3DP) metal implants in orthopedics, and, importantly, the design of 3DP metal implants through a series of cases operated at The Second Hospital of Jilin University were presented.
Design/methodology/approach
This paper is available to practitioners who are use 3DP implants in orthopedics. This review began with the deficiency of traditional prostheses and basic concepts of 3DP implants. Then, representative 3DP clinical cases were summarized and compared, and the experiences using customized prostheses and directions for future potential development are also shown.
Findings
The results obtained from the follow-up of clinical applications of 3DP implants show that the 3D designed and printed metal implants could exhibit good bone defect matching, quick and safe joint functional rehabilitation as well as saving time in surgery, which achieved high patient satisfaction collectively.
Originality/value
Single center experiences of 3DP metal implants design were shared and the detailed technical points between various regions were compared and analyzed. In conclusion, the 3DP technology is infusive and will present huge potential to reform future orthopedic practice.
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Jan Klimas, Kevin Lally, Lisa Murphy, Louise Crowley, Rolande Anderson, David Meagher, Geoff McCombe, Bobby P. Smyth, Gerard Bury and Walter Cullen
The purpose of this paper is to describe the development and process evaluation of an educational intervention, designed to help general practitioners (GPs) identify and manage…
Abstract
Purpose
The purpose of this paper is to describe the development and process evaluation of an educational intervention, designed to help general practitioners (GPs) identify and manage problem alcohol use among problem drug users.
Design/methodology/approach
The educational session was developed as part of a complex intervention which was informed by the Medical Research Council framework for complex interventions. A Cochrane review and a modified Delphi-facilitated consensus process formed the theoretical phase of the development. The modelling phase involved qualitative interviews with professionals and patients. The training's learning outcomes included alcohol screening and delivery of brief psychosocial interventions and this was facilitated by demonstration of clinical guidelines, presentation, video, group discussion and/or role play.
Findings
Participants (n=17) from three general practices and local medical school participated in four workshops. They perceived the training as most helpful in improving their ability to perform alcohol screening. Most useful components of the session were the presentation, handout and group discussion with participants appreciating the opportunity to share their ideas with peers.
Originality/value
Training primary healthcare professionals in alcohol screening and brief psychosocial interventions among problem drug users appears feasible. Along with the educational workshops, the implementation strategies should utilise multi-level interventions to support these activities among GPs.
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Originally, this article took the form of the Twenty‐first Brancker Memorial Lecture delivered to a meeting of The Institute of Transport. The author began his lecture by saying…
Abstract
Originally, this article took the form of the Twenty‐first Brancker Memorial Lecture delivered to a meeting of The Institute of Transport. The author began his lecture by saying how honoured he was by the invitation to present the 1964 Brancker Memorial Lecture and that he felt especially privileged to have the opportunity of surveying a prospect which he believed would have excited Sir Sefton Brancker's most ardent enthusiasm—the prospect of reducing inter‐continental journey times‐by air to the same durations as those universally accepted for inter‐city journeys by rail and road. Previous Brancker Memorial Lectures had summarized the general development of British civil aviation from its earliest days to 1946 and had covered particular aspects of its very rapid expansion since that date. 1946 was a significant year because it marked the resurgence of commercial flying after seven years of wartime restrictions and regulation; it promised a new deal to both operators and travelling public, with the opportunity of usefully applying technical advances achieved during the war period; at the same time it threw into sharp contrast the relative design capabilities of the British and American aircraft manufacturing industries.
Nitjaree Maneerat, Karen Byrd, Carl Behnke, Douglas Nelson and Barbara Almanza
This study aimed to determine the factors affecting consumers’ perceptions and intention to purchase home meal kit services (HMK), a convenient home-cooked meal option…
Abstract
Purpose
This study aimed to determine the factors affecting consumers’ perceptions and intention to purchase home meal kit services (HMK), a convenient home-cooked meal option, considering the moderating effects of monetary restriction, through the lens of the theory of planned behaviour (TPB).
Design/methodology/approach
This cross-sectional study used an online, self-administered survey to collect data from 374 US adults. Results were tested for variable associations via multiple linear regression and moderation analyses.
Findings
HMK adoption intention was positively associated with attitude and subjective norms but negatively associated with perceived behavioural control. Consumers’ HMK attitude demonstrated a significant positive relationship with food safety concerns and perceived time constraints. Income and financial constraints were significant moderators of the associations between TPB determinants and HMK intention. The findings emphasised the possibility of using HMK as a foodservice option for time-challenged consumers with food safety concerns.
Originality/value
This study addressed the limited research on HMK, a competitive meal option that foodservice businesses could implement to boost revenue. The study establishes the contribution in understanding the motivators and barriers that potentially affect consumers’ HMK behaviour through the lens of TPB. The results expand the scope of the TPB application in food-related research, providing a deeper understanding of antecedents and other factors on consumers’ HMK behavioural attitudes. Understanding this information will enable practitioners to develop strategies that meet consumers’ concerns when embracing this service to promote HMK.