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The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process.

Interviews with 40 clients were conducted shortly after them finishing treatment and five years later. All the interviewees had attended treatment programmes based on the 12-step philosophy, and they all described abstinence as crucial to their recovery process in an initial interview.

At follow-up, the majority remained abstinent. For many, attending AA meetings was still important – some described attending as a routine, whereas others stressed that the meetings were crucial for remaining abstinent. For those who reported controlled drinking (CD), this was described either as a natural step in their recovery process or as associated with worries and self-doubts.

The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.

There are heterogeneous views on the possibilities of CD after recovery from substance use disorder both in research and in treatment systems. This study on client views on abstinence versus CD after treatment advocating total abstinence can contribute with perspectives on this ongoing discussion.

This study aims to investigate the effect of vibration on ceramic tools under dry cutting conditions and find the optimum cutting condition for the hardened steel machining process in a computer numerical control (CNC) lathe machine.

In this research, an integrated fuzzy TOPSIS-based Taguchi L9 optimization model has been applied for the multi-objective optimization (MOO) of the hard-turning responses. Additionally, the effect of vibration on the ceramic tool wear was investigated using Analysis of Variance (ANOVA) and Fast Fourier Transform (FFT).

The optimum cutting conditions for the multi-objective responses were obtained at 98 m/min cutting speed, 0.1 mm/rev feed rate and 0.2 mm depth of cut. According to the ANOVA of the input cutting parameters with respect to response variables, feed rate has the most significant impact (53.79%) on the control of response variables. From the vibration analysis, the feed rate, with a contribution of 34.74%, was shown to be the most significant process parameter influencing excessive vibration and consequent tool wear.

The MOO of response parameters at the optimum cutting parameter settings can significantly improve productivity in the dry turning of hardened steel and control over the input process parameters during machining.

Most studies on optimizing responses in dry hard-turning performed in CNC lathe machines are based on single-objective optimization. Additionally, the effect of vibration on the ceramic tool during MOO of hard-turning has not been studied yet.

While aiming to create methods for fibre recycling, the question of colours in waste textiles is also in focus; whether the colour should be kept or should be removed while recycling textile fibre. More knowledge is needed for colour management in a circular economy approach.

The research included the use of different dye types in a cotton dyeing process, the process for decolourizing and the results. Two reactive dyes, two direct dyes and one vat dye were used in the study. Four chemical treatment sequences were used to evaluate colour removal from the dyed cotton fabrics, namely, HCE-A, HCE-P-A, HCE-Z-P-A and HCE-Y-A.

The objective was to evaluate how different chemical refining sequences remove colour from direct, reactive and vat dyed cotton fabrics, and how they influence the specific cellulose properties. Dyeing methods and the used refining sequences influence the degree of colour removal. The highest achieved final brightness of refined cotton materials were between 71 and 91 per cent ISO brightness, depending on the dyeing method used.

Only cotton fibre and three different colour types were tested.

With cotton waste, it appears to be easier to remove the colour than to retain it, especially if the textile contains polyester residues, which are desired to be removed in the textile refining stage.

Colour management in the CE context is an important new track to study in the context of the increasing amount of textile waste used as a raw material.

The purpose of this paper is to present a Design for Additive Manufacturing (DfAM) methodology that connects several methods, from geometrical design to post-process selection, into a common optimisation framework.

A design methodology is formulated and tested in a case study. The outcome of the case study is analysed by comparing the obtained results with alternative designs achieved by using other design methods. The design process in the case study and the potential of the method to be used in different settings are also discussed. Finally, the work is concluded by stating the main contribution of the paper and highlighting where further research is needed.

The proposed method is implemented in a novel framework which is applied to a physical component in the case study. The component is a structural aircraft part that was designed to minimise weight while respecting several static and fatigue structural load cases. An addition goal is to minimise the manufacturing cost. Designs optimised for manufacturing by two different AM machines (EOS M400 and Arcam Q20+), with and without post-processing (centrifugal finishing) are considered. The designs achieved in this study show a significant reduction in both weight and cost compared to one AM manufactured geometry designed using more conventional methods and one design milled in aluminium.

The method in this paper allows for the holistic design and optimisation of components while considering manufacturability, cost and component functionality. Within the same framework, designs optimised for different setups of AM machines and post-processing can be automatically evaluated without any additional manual work.

Polyurethane (PUR) foam parts are traditionally manufactured using metallic molds, an unsuitable approach for prototyping purposes. Thus, rapid tooling of disposable molds using fused filament fabrication (FFF) with polylactic acid (PLA) and glycol-modified polyethylene terephthalate (PETG) is proposed as an economical, simpler and faster solution compared to traditional metallic molds or three-dimensional (3D) printing with other difficult-to-print thermoplastics, which are prone to shrinkage and delamination (acrylonitrile butadiene styrene, polypropilene-PP) or high-cost due to both material and printing equipment expenses (PEEK, polyamides or polycarbonate-PC). The purpose of this study has been to evaluate the ease of release of PUR foam on these materials in combination with release agents to facilitate the mulding/demoulding process.

PETG, PLA and hardenable polylactic acid (PLA 3D870) have been evaluated as mold materials in combination with aqueous and solvent-based release agents within a full design of experiments by three consecutive molding/demolding cycles.

PLA 3D870 has shown the best demoldability. A mold expressly designed to manufacture a foam cushion has been printed and the prototyping has been successfully achieved. The demolding of the part has been easier using a solvent-based release agent, meanwhile the quality has been better when using a water-based one.

The combination of PLA 3D870 and FFF, along with solvent-free water-based release agents, presents a compelling low-cost and eco-friendly alternative to traditional metallic molds and other 3D printing thermoplastics. This innovative approach serves as a viable option for rapid tooling in PUR foam molding.

Prediction of increased risk of suicide is difficult. We had the opportunity to follow up 20 patients receiving electroconvulsive therapy (ECT) because of severe depression. They filled in the Antonovsky sense of coherence test (SOC) and Beck depression inventory (BDI) before and after a series of ECT treatments. Seventeen surviving patients had a mean observation time of 20.6 months, whereas the three deceased patients had 11.3 months. There was a lower mean age at onset of illness and a longer mean duration of disease in the deceased. Other clinical parameters did not differ. The surviving patients had a significant decrease on the BDI from 35 to 18 (P<0.001) and an increase on the SOC test after ECT from 2.45 to 3.19 (P<0.001), indicating both less depression and better functioning in life. The deceased had a larger change on the BDI from 32 to 13, not attaining significance because of the low number of deceased. The SOC test, however, did not increase to a purported normal level; that is, from 2.43 to 2.87. Although the SOC scale has been shown to predict mortality in substance abusers, the SOC test has not been part of earlier reviews of predictive power. Tentatively, a low pathological score on the SOC test may indicate low sense of coherence in life that might increase the propensity for suicide. These preliminary results need replication in larger studies.

This study aims to investigate the impact of the innovative ritual-based redesign of a routine in the challenging context of the dining-out sector, characterized by low employee commitment and high turnover.

This study adopts a mixed methods experimental design. This study focuses on a field experiment in a real restaurant centered on the restaurant’s welcome entrée routine. The routine is first observed as it happens, after which it is redesigned as a ritual.

The ritual-based redesign of the routine enhances employee sharing of the purpose of the routine and reduces the variability of the execution time of the routine, which increases group cohesion among the restaurant staff. Besides the positive impact on the routine’s participants, the ritual-based redesign has a beneficial effect on the performance of the routine by increasing the enjoyment of the end-consumers at the restaurant.

The ritual-based redesign of routines is a powerful managerial tool that bonds workers into a solidary community characterized by strong and shared values. This allows guidance of the behavior of new and existing employees in a more efficient and less time-consuming way.

Rituals have been traditionally analyzed from the customer perspective as marketing tools. This research investigates the employees’ perspective, leveraging ritual-based redesign as a managerial tool for increasing cohesion among workers.

Legislation plays a vital role in solving carbon emissions reduction and climate change issues. China began to implement a low-carbon economic policy in 2010, but the effect of the policy needs to be evaluated. Accordingly, this paper aims to discuss China’s low-carbon policy through exploring the following two questions, namely, whether the policy effect reaches the expected goal and whether the policy effects will balance economic development and emission reduction. Then, the paper puts forward suggestions for the improvement of China’s low-carbon policy.

This paper is organized around three distinct aspects of policy effect evaluation. This paper uses the synthetic control method to construct a policy effect evaluation model and conducts a quasi-natural experiment. The paper selects annual panel data from 2003 to 2015, which is selected from 33 provinces. A comparative analysis of carbon dioxide emissions, energy consumption and economic development between Hubei Province and Liaoning Province.

The results reveal that the implementation of the low-carbon pilot province policy in 2010 has a significant impact on the emission reduction effect of Liaoning Province, but the impact on the emission reduction effect of Hubei Province is not significant. The carbon emission trading system implemented in 2012 has reduced the emission reductions in Hubei Province and Liaoning Province has achieved better emission reduction effects after the implementation of this policy. After the implementation of the policy, the economic development of Hubei Province has been improved, but it has not brought help to the economic development of Liaoning Province. These findings provide new insights into the use of an emissions trading system for improving economic development and ultimately facilitate the attainment of the broader goal of sustainability.

This paper proposes an innovative policy effect evaluation method by considering the status of unit gross domestic product, fixed asset investment in the energy industry, energy consumption, emission reduction technology innovation and other evaluation indicators. This paper contributes to broadening current methods of policy effect evaluation in China.

Negative disclosure tone in 10-K annual reports has economic consequences, yet relatively little is known about how it is generated. Boards of directors play an important governance role with respect to mandatory disclosures and personally sign off on Form 10-K, leading us to expect directors to influence financial reporting narratives. This study investigates whether the negative tone of firms' narrative annual report disclosures is associated with the human and social capital of its board of directors.

Multivariate regression analyses of negative disclosure tone (Loughran and McDonald, 2011) on board members' average age, gender, education, financial expertise and turnover is performed. A host of supplemental tests to corroborate our primary analysis, including using Sarbanes-Oxley's financial expert mandate as an exogenous shock to board composition, impact threshold for a confounding variable, placebo analysis, portfolio tests of more and less negative disclosing firms and portfolio tests of “loud” versus “quiet” boards are conducted.

Evidence that directors' gender, education, financial expertise and board turnover are associated with more negative disclosure tone, while directors' age is associated with less negative disclosure tone is found. The study also looked within the board to differentiate whether these findings are driven by characteristics of inside directors or outside directors serving on the audit committee, or both, as these are the specific groups of directors we would expect to play a role in disclosure. It was found that negative disclosure tone is associated with a lower bid-ask spread, so this study interpreted more negative tone as containing more descriptive information.

This study helps decode the “black box” of annual report disclosure tone, which Loughran and McDonald (2011) show has important economic implications. The results help inform stakeholders such as policymakers, executives and capital market participants as to how board member traits are associated with disclosure. The findings are particularly important as this study bears witness to the increasing prominence of gender/diversity mandates (e.g. Israel, Norway, California) and financial expertise mandates (e.g. Sarbanes-Oxley).

Rtsa-byugs, a massage oil from Bhutan, is a traditional herbal formula known for its anti-inflammatory properties and used in osteoarthritis treatment. This study investigates the efficacy of rtsa-byugs vs diclofenacgel in relieving knee pain in osteoarthritis patients.

A single-blind, randomized controlled trial was conducted amongst osteoarthritis knee patients at an orthopedic outpatient department of Thammasat University Hospital. Participants were randomly allocated to the rtsa-byugs (N = 31) or the Diclofenac gel (N = 31) group. Primary outcomes were assessed by the knee injury and osteoarthritis outcome scores (KOOS), visual analog scale (VAS) and goniometer at day 0, 1, 3, 7.

62 participants completed the study. The result of the KOOS scores demonstrated a significant improvement of symptoms at the end of the study in both treatment groups. Improvement of symptoms, pain, daily life living, sport and recreational score and quality of life assessment showed a significant difference from baseline (p < 0.001) within both groups. The quality of life score for the rtsa-byugs group increased significantly on day 3 and 7. The VAS score in both groups decreased with a significant difference from baseline to day 7. The mean value of extension of angle measurement was decreased in day 7, and the mean of flexion score increased in both groups when compared with the baseline.

The duration of the study was very limited and included a small sample consisting of men and women.

Rtsa-byugs is safe and effective in relieving pain from osteoarthritis of the knee and can be used as an alternative treatment for knee osteoarthritis.