A Jewish Calendar for sixtyfour years, detailing the new moons, festivals, and fasts : ... to which are added tabl. for continuing the calendar to A. M. 6000-2240 C. Ae. and a chronological table ...

by E. H. Lindo

Cost -effectiveness of services and treatments for ambulatory dually diagnosed CMHC clients: Implications for managed care

This paper reports a cost-effectiveness analysis of standard therapeutic interventions received by ambulatory dually diagnosed clients of a Community Mental Health Center (CMHC). For the purposes of this study dually diagnosed was defined as a DSM-III-R or IV diagnosis of a major mental disorder and a concomitant substance abuse disorder. The prevalence of dually diagnosed people among the mentally ill and their unique and problematic nature continues to challenge and encumber CMHCs and poses grave public health risks. An absence of research on these clients in community-based settings and the cost-effectiveness of their standard CMHC care has hindered the development of effective community-based intervention strategies. This exploratory and descriptive effort is a first step toward providing information on which to base programmatic management decisions.^ Data for this study were derived from electronic client records of a CMHC located in a large Southwestern, Sun-belt metropolitan area. A total of 220 records were collected on clients consecutively admitted during a two-and-one-half year period. Information was gathered profiling the clients' background characteristics, receipt of standard services and treatments, costs of the care they received, and length of CMHC enrollment and subsequent psychiatric hospitalizations. The services and treatments were compared with regard to their costs and predicted contributions toward maintaining clients in the community and out of public psychiatric hospitals.^ This study investigated: (1) the study groups' background, mental illness, and substance abuse characteristics; (2) types, extent, and patterns of their receipt of standard services and treatments; (3) associations between the receipt of services and treatments, community tenure, and risk of psychiatric hospitalization; and, (4) comparisons of average costs for services and treatments in terms of their contributions toward maintaining the clients in the community.^ The results suggest that substance abuse and other lifestyle factors were related to the dually diagnosed clients' admissions to the CMHC. The dually diagnosed clients' receipt of care was associated strongly with their insurability and global functioning. Medication Services were the most expensive yet effective service or treatment. Supported Education was the third most expensive and second most effective. Psychosocial Services, the second most expensive, were only effective in terms of maintaining clients in the community. Group Counseling, the fourth most expensive, had no effect on community maintenance and increased the risk of hospitalization when accompanied by Medication Services. Individual Counseling, the least expensive, had no effect on community maintenance. But it reduced the risk of hospitalization when accompanied by Medication Services. Networking/Referral, the fifth most expensive service or treatment, was ineffective.^ The study compared the results with findings in the literature. Implications are discussed regarding further research, study limitations, practical applications and benefits, and improvements to theoretical understandings, in particular, concepts underscoring Managed Care. ^

Constraints on nebular dynamics and chemistry based on observations of annealed magnesium silicate grains in comets and in disks surrounding Herbig Ae/Be stars

Understanding dynamic conditions in the Solar Nebula is the key to prediction of the material to be found in comets. We suggest that a dynamic, large-scale circulation pattern brings processed dust and gas from the inner nebula back out into the region of cometesimal formation—extending possibly hundreds of astronomical units (AU) from the sun—and that the composition of comets is determined by a chemical reaction network closely coupled to the dynamic transport of dust and gas in the system. This scenario is supported by laboratory studies of Mg silicates and the astronomical data for comets and for protoplanetary disks associated with young stars, which demonstrate that annealing of nebular silicates must occur in conjunction with a large-scale circulation. Mass recycling of dust should have a significant effect on the chemical kinetics of the outer nebula by introducing reduced, gas-phase species produced in the higher temperature and pressure environment of the inner nebula, along with freshly processed grains with “clean” catalytic surfaces to the region of cometesimal formation. Because comets probably form throughout the lifetime of the Solar Nebula and processed (crystalline) grains are not immediately available for incorporation into the first generation of comets, an increasing fraction of dust incorporated into a growing comet should be crystalline olivine and this fraction can serve as a crude chronometer of the relative ages of comets. The formation and evolution of key organic and biogenic molecules in comets are potentially of great consequence to astrobiology.

Transgender Group Therapy: Process and Issues with Male to Female Clients

Transgender issues are garnering more attention within the mental health field. With the increased social awareness of transgender issues, the mental health field is recognizing the need for effective psychological services for this population. Transgender individuals face unique challenges related to gender non-conformity, the coming-out and transitioning processes, and in society at large, all of which can lead to a number mental health concerns. Group therapy is a promising treatment modality for transgender individuals. The purpose of this paper is to offer a rationale for the effectiveness of group therapy, and recommendations for best practices utilizing the current literature and my experience with facilitating a Male to Female transgender therapy group.

Acceptance and Commitment Therapy: Increasing Psychologists' Willingness to Assess and Treat Substance-abusing Clients.

The high prevalence of substance abuse in the United States and the low rates of assessment and treatment of these disorders by mental health providers points to a growing need to understand the factors that prevent substance-abusing individuals from receiving adequate services. Psychologists are one group of mental health providers that show little interest in working with this population and receive little research attention on the topic. This paper explores the potential role that education, previous experience, and the impact that holding stigmatizing beliefs towards substance-abusing individuals has on psychologists' willingness to provide clinical services for clients struggling with addiction. Acceptance and Commitment Therapy (ACT) is explored as a potential intervention for psychologists.

Representing Clients in the Marijuana Industry: Navigating State and Federal Rules

As the number of states legalizing medicinal and recreational marijuana increases and marijuana emerges as a growing lawful industry, lawyers find themselves in an awkward position. In most states, lawyers who represent clients in the marijuana industry risk discipline for assisting clients in the commission of a (federal) crime. Even in jurisdictions like Colorado, where the rules of professional conduct have been amended to permit lawyers to assist clients who comply with marijuana state laws, lawyers who are admitted to practice in federal courts risk being disciplined by these tribunals for assisting clients in the commission of a crime pursuant to the courts’ local rules of conduct. This short article explores the thorny issue of navigating state and federal rules of professional conduct while representing clients in the marijuana industry.

Impedance spectroscopy study of the effect of environmental conditions in the microstructure development of OPC and slag cement mortars

In this work, the microstructure of mortars made with an ordinary Portland cement and slag cement has been studied. These mortars were exposed to four different constant temperature and relative humidity environments during a 180-day period. The microstructure has been studied using impedance spectroscopy, and mercury intrusion porosimetry as a contrast technique. The impedance spectroscopy parameters make it possible to analyze the evolution of the solid fraction formation for the studied mortars and their results are confirmed with those obtained using mercury intrusion porosimetry. The development of the pore network of mortars is affected by the environment. However, slag cement mortars are more influenced by temperature while the relative humidity has a greater influence on the OPC mortars. The results show that slag cement mortars hardened under non-optimal environments have a more refined microstructure than OPC mortars for the studied environmental conditions.

Homelessness : programs and the people they serve : findings of the National Survey of Homeless Assistance Providers and Clients : summary /

"December 1999."

Aëroplanes and dirigibles of war /

Mode of access: Internet.

AE (George W. Russell), a study of a man and a nation.

Mode of access: Internet.

Observations on man, his frame, his duty, and his expectations : in two parts, to which ae now first added, paryers and religious meditations, by David Hartley. To the first part are prefixed A sketch of the life and character ... of the author.

Mode of access: Internet.

Incidence of disability and characteristics of clients closed from plan with severe spinal cord injury, fiscal year 1972-73 /

"December 30, 1975."

Time and cost of vocational rehabilitation, comparing social security trust fund rehabilitations with all other rehabilitated clients /

"July 1, 1973."