Fleet Management: Establishing your vehicle fleet

Often the demands placed on a Fleet Manager, HR Manager or Company Director by the various aspects of running a vehicle fleet day to day are extremely high. It is very time consuming and it is often a better option to engage the services of a Fleet Management company who can ease that burden and save you both time and money.

Fleet management and fleet maintenance companies can often assist with the following:

1. Car Policy Formulation

Help in creating a flexible and usable car policy that suits the size of your fleet. This can be model based, allowance based or even grade based and Fleet Management companies will decide, having discussed the issues with you, which is the most suitable option for you.

2. Multi-franchise New Vehicle Supply.

Many Fleet Management companies have superb relationships with all major vehicle manufacturers and individual dealerships and are therefore able to source and secure cars at very beneficial terms, saving your company money. Depending on your fleet size they can also often negotiate extra support terms directly on your behalf.

3. VAT Qualifying Used Cars.

Fleet Management companies often have access to a number of VAT qualifying nearly-new used cars for use in direct purchase schemes.

4. Fleet Funding.

Fleet management companies are sometimes able to offer a tailored scheme of purchasing and financing your fleet, by operating their own funding plan alongside working with other prestige funders to offer access to the most competitive terms in the marketplace.

5. Fleet Add Ons.

They will also help you decide what services should be included in the running of your fleet, from fuel cards to maintenance plans.

About Fleet Management:

Fleet management is the management of a company's vehicle fleet. Fleet management includes commercial motor vehicles such as cars, vans and trucks and can include a range of functions, such as vehicle financing, vehicle maintenance, vehicle telematics (tracking and diagnostics), driver management, fuel management and health & Safety Management. Fleet Management is a function which allows companies which rely on transportation in their business to remove or minimise the risks associated with vehicle investment, improving efficiency, productivity and reducing their overall transportation costs, providing 100% compliance with government legislation (duty of care) and many more. These functions can be dealt with by either an in-house fleet-management department or an outsourced fleet-management provider.

For further information regarding help establishing your fleet, please call Brofleet FREE on 0800 612 4094 or email Brofleet Vehicle and Fleet Management

Chelation and Its Harmful Effects

The word Chelation means chemical substance which use to eliminate molecules which are raw materials from body. The molecules are hold jointly and tightly so that the body can facilitate its excretion. For protection of the body it also takes out toxic metals. This is widely used in the case of poison. Among the entire chelating agent EDTA is most common and it is made by amino acid so it is man made. It takes out all minerals and also metals from entire body.

These minerals are made up of various elements such as iron, calcium, etc. In U.S.A. this chelating agent is accepted by an administration which is known as Food and drug Administration. EDTA is medically proved for guide and other metals which are poisoning.

It is also old in the handling of atherosclerosis although the FDA has not agreed it. But as an unusual medicine chelation helps progress blood circulation and eliminates the plaques formed in the blood vessels. It has the skill to liquefy the metals. There is a wide relevance of chelation. It is also used in element analysis and water softeners. It is extensively used as a factor in shampoos and preservatives. Water management plans, such steam commerce and boiler water management use chelators as a decontamination agent.

Some corporal circumstances in which chelation are helpful are circulatory muddle, coronary artery virus, gangrene and angina. Other than this management require some medical tests. These tests comprise blood force test, cholesterol test, kidney occupation test and sugar test. These tests are done to make sure safety of the patients. In this treatment intravenous injections are used. The injection contains EDTA. It is administer 3 times in a week. One session of injection 3 hours long and at least 30 sessions are needed for the much loved result.

The probability of side effects in the chelation treatments is not very high. It also depends on the dose of the chelating agent. The administration of this medicine gives a burning end product on the body. Some of the side effects likely to occur include headache, fever, nausea, vomiting, stomach upset and low blood force. But this therapy may be dodgy if it is not done correctly.

That is why safety concerns and danger involved in the chelation treatment has made it controversial. Some people raised alarm against the chelating agent but still there is no convincing report confirms the danger of chelation analysis has been found. Nowadays figure of patients visiting hospitals for chelating therapy is large in America and European country.
Cardiorestore, is one of the leading website for Chelation. It has oral chelation program and Chelation therapy.

Flock Buster - 100% Ecologically Friendly Bird Repellent

Blackbirds, a migratory nuisance to farmers and an environmentally friendly approach to manage them.Some 70 million blackbirds come through the Northern Plains each year, including about 6 million that stop in North Dakota, biologists say. Each blackbird protected by the Migratory Bird Treaty Act can feed on about an ounce of sunflower seeds daily. The USDA estimates blackbirds feed on more than $10 million worth of sunflowers each year in North Dakota, which accounts for about half the nation's sunflower production.What appeals to them? Water, cattails and sunflowers, the perfect combination.Now that we know what appeals to them, how can we best manage them? What has been tried, what has been ineffective and is there anything that works or has promise of working and is safe to the environment? Flock Buster, a 100% ecologically friendly bird repellent effective in managing blackbirds and Canadian Geese in a variety of crops and in various stages of growth. To learn more, visit http://www.flockbuster.com.Some of the methods used in trying to manage blackbirds include Federal wildlife officials targeting entire parcels of cattail-choked wetlands in North Dakota to kill the favorite habitat of sunflower-scarfing blackbirds. To date, some 60,000 acres of cattail marshes in North Dakota have been destroyed since 1991 in an attempt keep blackbirds at bay. In 2008, about 4,500 acres of wetlands in 16 counties were treated in North Dakota and 8,000 acres are planned for 2009. The favorite chemical for this is a herbicide that at best is only effective for 5 years. WildEarth Guardians, based in Santa Fe., N.M. alleges the Federal Agricultural Department's Wildlife Services agency is violating the Federal Clean Water Act by applying herbicides on wetlands in North and South Dakota to kill cattails. In April 2009, it notified the USDA that they were filing a lawsuit in Federal Court. A spokesman of the group says it's ironic that some of the cattails sprayed with herbicide are on government-established wetlands created using federal funds. A spokesman from the same group claims "A special interest group is benefiting at the expense of taxpayers, at the expense of our clean water and our wildlife". I would have to argue that the North Dakota Farmer is not a special interest group. The North Dakota farmer is an important part of "American" agriculture. In 2008, the cost of killing cattails was $166,000.00 to spray 3,700 acres of wetlands in North Dakota and 99 acres in South Dakota. Scott McLeod, a biologist for the conservation group Ducks Unlimited based in Bismarck, North Dakota said, "Killing cattails has minimal impact to waterfowl, good or bad." He called the federally funded cattail-removal program a "Band-Aid approach" to an impossible problem.Sunflower growers have tried a variety of other control methods over the years, including propane cannons, electronic noise devises, radio-controlled airplanes and shotguns to scare birds out of fields. The Wildlife Services also funded a program that involved seeding small "decoy plots of sunflowers near wetlands where the blackbirds roost, hoping that it would keep them from feasting on farmers' larger commercial fields. The trouble with these type of repellent methods are acoustical, visual and physical exclusion do not work well or long since birds get accustomed to these types of methods, and they become ineffective.To date, no bird repellents are currently registered for maturing grain, sunflower, bean or corn crops. Flock Buster however, a 100% ecologically friendly bird repellent, has proven effective at managing blackbirds in sunflowers and corn. Over the years, many chemical bird repellents have come and gone, partly due to lack of effectiveness, but also because of adverse health side-effects. At present, there are no effective, food grade chemical bird repellents. The use of avicides, a chemical used to kill birds will continue to be controversial and lack general public acceptance. A major constraint to the development of chemical repellents is the lack of profit incentives for private companies that see limited markets for new bird control products. Every new wildlife damage management method will undergo public scrutiny through the National Environmental Policy Act.Currently a product which is totally chemical free and environmentally friendly, named "Flock Buster", is being marketed and distributed out of West Fargo, North Dakota and has proven to be quite successful at keeping blackbirds out of sunflowers. It is also showing some very positive characteristics at deterring Canadian Geese and sea-gulls. For deterring blackbirds however where wetlands or water are nearby, a blackbird control program needs to be implemented using a variety of repellent methods with the cooperation of the grower, EPA, Wildlife Services agency and the USDA. A several step approach without the use of chemicals to destroy wetlands, the use of chemicals as a desiccant on sunflower fields, or poisons to kill birds needs to be implemented. This would include an educational program and funding by the Federal Government since the birds and wetlands are governed by them. The program's primary goal needs to be to improve profitability to agricultural producers, enhance the health and safety of urban dwellers, protect the environment through development of newly improved management strategies and implementing new wildlife management strategies. We can accomplish this by:1. The use of only non-chemical environmentally friendly products like Flock Buster applied to crops as a deterrent method.2. The use of small "decoy" plots of sunflowers adjacent to commercial plots of sunflowers near wetland areas that would not be treated with any type of blackbird repellents.3. Manually harvesting cattail wetlands and restricting or totally eliminating the use of herbicides to manage them.4. The use of acoustical and visual repellents for heavy infestations in conjunction with the non-chemical products.5. Public education programs about the bird problem for farmers and the economic costs to the state in which these pests migrate to and why Federal dollars need to be used to assist the producer maintain an adequate profit margin as they are such a vital link to the production of this product.The five items listed above are only a few of the many possible tools that would augment and enhance the effectiveness of a environmentally friendly pest management program; but whatever program is adopted and integrated, it must focus and rely more heavily or exclusively on environmentally friendly products and concepts. Coordinated efforts need to start early in the off season with the producer and the Wildlife Services agency to identify the production areas, the wetland areas that would cause a problem for the grower and the strategies of an environmentally-friendly wildlife management program that will be implemented to assist the grower.To learn more about Flock Buster or to visit with one of our consultants visit http://www.flockbuster.com.

Vehicle Safety Habits For The Beginner Driver

It is good practice to check you’re vehicle out before proceeding out on the road, and know all the safety features of the vehicle that you are operating. It is part of defensive driving to do these checks before you take you’re vehicle on the road.

Vehicle inspection should be first on the list, before proceeding out on the road.

Take out the tire wrench. You are going to need it to check the tires. Hit the tire to make sure there is sufficient air. You may want to carry a tire gauge in you’re car. Do a visable inspection of tires, looking for possible cracks or worn tires.

Are there any visible leaks under the car? Do the signals work? Do the headlights work? (High and low beam.) Do the brake lights work?

Check to make sure there’s enough engine oil; break fluid, and power steering fluid. Also check battery water level and coolant level. Do not open radiator cap! Vehicle must be cooled down first, if parked recently. (caution: see owners manual before opening cap.) Last will be transmission fluid. (Vehicle must be running to read proper level.) (Make sure you’re emergency park brake is applied.)

Now you are ready to enter the car. Go over the safety features of your vehicle. .

Communication features:

• Signals help you warn other drivers, which way you intend to turn.
• Brakes warn other drivers your slowing down or stopping.
• Horn warns other drivers and pedestrians to be alert.
• Emergency signals warn other drivers of a problem that you may have.

Visibility features:

• Mirrors should be adjusted before you leave any parked position.
• Mirrors should be used quite often to see what is happening around you at all times. When you think your going to have to stop, check you’re rearview mirror first. You may have to touch your brake, to warn others behind you. You may have to stop a little further ahead to give the driver behind you room to stop safely. It’s all part of driving defensively.
• Headlights should be working, high and low beam.
• Wipers are a must in bad weather conditions.
• Windshield must be clean.

Safety features:

• Emergency brakes should be applied when in a parked position at all times. Test you’re emergency brake by applying the handle, or pushing to the floor, depending on the make and model of the vehicle. Remove gear out of park position with foot on brake pedal and put in drive position. Ease up on brake pedal. Vehicle should not roll forward. It is a good habit to always release park brake after putting vehicle in gear. The vehicle will not roll forward if you forget to put you’re foot on the brake pedal, if the park brake is functioning properly.
• Seat belts: Make sure you’re seatbelt is on. Including passengers. It is a violation in most, if not every city and state not to wear it.

Comfort:

• Heater should be adjusted accordingly, for maximum comfort. Driver must open windows if too hot.
• Seat adjustments should be adjusted for maximum visibility and comfort.

(Check owner’s manual for further knowledge of vehicle features and safety features.)

These topics that we covered should be second nature when reaching for them, especially when you get an unexpected downpour, or hit with mud from a passing vehicle, if you have to look for you’re wipers, you may find yourself on top of another vehicle or in a ditch! Do not attempt to drive without this knowledge.

H2S Overview

The following is a brief overview of Hydrogen Sulfide (H2S) as it pertains to work safety in the oil and gas industry.

H2S is naturally formed when bacteria break down organic material in the absence of oxygen. This formation can occur deep within the earth, such as in volcanoes and in crude petroleum, or relatively close to the surface in swamps, sewers, wells, and hot springs. Known by other names such as Hydrogen Sulphide, Sulfane, Sulphur Hydride, Dihydrogen Monosulfide, Sulfurated Hydrogen, Sewer Gas and Stink Damp; it is a highly toxic and colorless flammable gas that has a smell similar to rotten eggs. It should be noted, however, that using smell as a way of determining the presence of H2S is not reliable, as the sense of smell can be quickly eliminated in the presence of the gas.

H2S can seriously injure or kill exposed individuals. The gas is heavier than air, so it tends to drift to the bottom of poorly ventilated spaces such as in well holes and underground tanks. Inhalation of the escaping gas from an open orifice in the ground usually, but not always, results in death. At lower levels of concentration, a burning sensation in the eyes, nose, throat and lungs can be felt, where at higher levels of concentration a single breath can be fatal. Second man fatalities can occur when trying to rescue a fallen victim as by the time it is known that H2S is the cause it is too late for the rescuer. Training programs and proper equipment must be provided for all workers who deal with the presence of H2S gas in their environment even if the gas is remotely expected to be encountered.

The Earth Song - "Honoring Gaia"

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The Earth Song - "Honoring Gaia"

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How to Protect Your Heart and the Cardiovascular System

You should really take better care of your health, and the good news is that you can do it in more ways than one. Protecting your heart and the cardiovascular system is particularly important. You can get effective results by using a few essential rules. In fact, you do not have to do anything special in order to get the desired results. Quite the opposite, you can protect yourself from getting a heart attack or a stroke as well as from type 2 diabetes.

The right nutrition is the key to cardiovascular health. You can include a number of beneficial foods in your diet that can protect you from high cholesterol. There are foods that can effectively reduce the amount of cholesterol that has already built up. You can change your nutrition to have foods that can provide for the lowering of blood pressure. There are foods that can protect you from getting diabetes as well. Black beans contain nutrients that can help you in all three of these diseases. Almonds can effectively reduce the cholesterol levels and prevent diabetes. Oranges are great for the reduction of high blood pressure as well for the improvement of the blood vessels. Fish such as tuna and salmon that contain omega-3 fatty acids are also extremely beneficial for the heart and can prevent arrhythmia.

Exercising is another important factor for the protection of the cardiovascular system. By being physically active you improve the functioning of the heart and provide for the optimal blood flow in your body. Also, it has been proven that exercising can effectively allow for the reduction of cholesterol levels. You can choose to do any sport from jogging to swimming, but even walking for 30 minutes every day will do a great job too.

It has been scientifically proven that the way we feel affects our cardiovascular health. People who experience constant stress and the ones suffering from anxiety attacks and chronic depression are more likely to get heart disease. On the other hand, recent studies reveal that individuals who are happy have a lower chance of suffering from these. Thus, you should try to get as much rest as possible, avoid worrying and do enjoyable things more often.

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Protect Yourself with a Porn Filter

The harmful affects of pornography use and addiction are well documented by science. As with most things in life, prevention is the most effective way to avoid ever having a problem with pornography.

The internet is a wonderful place to access information, read updated news, and connect with people from all over the globe. Unfortunately, pornography on the internet is everywhere, and it isn’t always easy to avoid. Even people taking responsible measures to keep porn off of their computer screens can stumble across it sometimes. The tips found in this article will help you protect yourself and your family online from inappropriate pictures and text.

Take measures to filter spam. Spammers can make money if only one person of the thousands of people they send sexually explicit emails to clicks on their ad and pays for their service. Do everything you can to keep those emails from ever reaching your inbox. If you have allowed your children to have their own email accounts, filtering spam is the best way to ensure inappropriate images never become accessible to them through email. A quick list of things you can do to eliminate spam includes:

• Only give your email address out to people you know and trust. Do not put your personal email address down for every mailing list or website that asks for it. Many free email services exist now – set up a free account with one of them and use that to sign up for mailing lists.

• Never click on any links in spam and if at all possible, avoid ever opening the email. Both of these actions confirms to spammers that you actively use your email account and you will likely start to receive more spam.

• Purchase and use a spam filter. Many come packaged with a porn filter as well as other features that will help keep inappropriate content off of your computer screen.

Be careful what you download. This should be a universal precaution you take by now each and every time you download something off the internet. Viruses, spyware, and pornography can very easily be hidden in the files that you download – prevention in this case is much easier than fixing the problem after the files have already made their way onto your hard drive. Only download files from sources that you trust, and if you ever have a question as to whether something contains a virus or pornography, do NOT download it.

Use a search engine to find websites. Pornographers use domain names that are similar to popular websites or brands in hopes that people will type in the address incorrectly and end up at their pornography site. I knew a child that wanted to look up codes for his favorite video game, so he typed in the name of the game and “.com.” He had the presence of mind to close the browser and tell his parents, but was still exposed to the material. One of the best ways to avoid this is searching for the address in Google. Then you can preview the results in a text-only format before clicking on the link to go to the page. Many of the popular search engines have a built-in porn filter that you can adjust to control the type of content you don’t want to appear in the search results. Others even offer “for kids” versions of their search engines that only return pages deemed appropriate for children.

Use filtering software that includes a porn filter. No matter how careful you are about the sites you visit, chances are good that someday you will accidentally come across a porn site. A porn filter will help ensure that inappropriate material is blocked when you or someone in your family stumbles across a pornographic website. The parents of the boy who stumbled across pornography while looking for his favorite Nintendo game quickly installed a porn filter to make sure their son was protected in the future.

Avoid pornography offline. Porn was around long before the internet. Carry around your own internal porn filter and avoid places that you know will have inappropriate images, movies, or books displayed. If your children are with you, be extra cautious of where they are in the store. If you think there is a chance that they may be able to access inappropriate material while you are shopping, let the store manager know of your concerns. Likely, you are not the only one who is worried about the issue, and real changes can come about from one person simply speaking up.

Take the appropriate precautions now to avoid pornography. If you or someone you know has a problem with pornography use or addiction, seek professional help. Pornography problems not only affect the individual viewing the picture but everyone who interacts with that person.

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Cheap printer ink cartridges: helps in cost cutting

With the increase in the usage of printers in businesses and office, demand for printer ink cartridges has gone up as well. At the same time, quality of the pages and the ink cartridges has become the essential factors in printing the pages. Many a times, people lookout for the original equipment manufacturer (OEM) ink cartridges whenever their printers fall short of ink. Why throw money down the drain, when you can buy cheap printer ink cartridges. When you go for the OEM ink cartridges, you are likely to spend huge amount of money on the printing needs. They will end up increasing your overall stationery costs.

With the entry of the third party vendors producing cheap printer ink cartridges, the monopolistic market of the branded and genuine ink cartridges is almost shut. These cartridges are cheaper than the original ones. The ink cartridges are non bio-degradable. Every year, people from across the globe add into millions of tons of garbage in landfills. Used printer ink cartridges are dumped without thinking of re-filling. The cartridges are formed of high grade plastic and take up thousands of years before they break down. It is advisable to practice secure ink cartridges recycling to assist and save the environment from damage caused by the unsuitable disposal of the printer ink cartridges. Online world is one of the great places to purchase cheap printer ink cartridges.

There are several online suppliers who provide cheap printer ink cartridges. All you need to do is to woof on the one that provides you with the great services and best prices. The web world is a wonderful tool and it can help you put the cash back in your pocket. Saving money on cheap printer ink has never been easier, however, with the online advancements; you can be assured about the costs. Online traders have their websites with product information. Therefore, inspect some of the known online suppliers and also browse through the prices they are providing.

If you are looking out for cost cutting in your office stationeries, then it is advisable to go for cheap printer ink cartridges. Although, the digital era has taken over in offices across the globe, yet there are many such companies that rely on the documents. Printing is important in carrying out both business and office tasks. Whether you are looking to print mere documents like minutes of a meeting or other essential documents like financial reports or any other project progress report, you just cannot avoid printing. For all such tasks, you can bank on cheap printer ink cartridges.

These days, printer ink is a sore spot for consumers. The consumers are searching for ways to save money in buying ink. Hence, one can save a lot of money by buying cheap printer ink cartridges. Now start saving immediately just by ordering cheap printer ink from the online source.

Do You Ever Wonder Why It's Important to Save the Wetlands?

Maybe it's because I live in Miami and there is a lot of talk about saving the Everglades, but do you ever wonder why it's so important to save these wetlands? If you are a casual observer driving up (or down) I-75 (affectionately known as Alligator Alley), you may see some of the big guys lounging by the side of the road. These huge alligators are fenced in, but there must be a reason why we want to save and protect alligators and other animals that inhabit these wet and marshy locales.

The 3 values of wetlands

It's not only about the birds, fish and other wildlife that live in the wetlands. Wetlands and the natural processes that take place in and because of the wetlands, and the purpose that wetlands fill affect humans too.

1. Storage facility for excess water.Think of a wetland like you would a normal kitchen sponge. If you fill your sink with water and place the sponge in it, the sponge soaks up as much of the water as it can. Wetlands are nature's sponge. It soaks up excess water during floods, and stores the water, slowly releasing it into the environment as it is needed. This release of water waters parched ground during dry periods.


2. Water filter.When water reaches a wetland and is absorbed by native plants, pollutants, fertilizer and other contaminants in the water drop to the bottom. When the water leaves the wetland, it is cleaner than when it arrived. Environmental managers build water filtration systems modeled after the natural filtration system of the wetlands.

3.Wetlands are one of the most diverse ecosystems. The variance and amount of species that live in and are supported by the wetlands is as great as the rain forest and coral reefs. The lush vegetation and shallow water creates an environment where fish and wildlife flourish. Energy given off by the plant life is passed to fish, wildlife, waterfowl and humans. This also helps nurture the shellfish and commercial fishing industry.

So saving the wetlands is not just about the plants, fish and wildlife that inhabit them. Saving the wetlands ultimately saves us too. Acting as a natural water agent, filtration system and energy producer, the wetlands provide a naturally better environment for its inhabitants and humans.

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Santa Monica Teens Saving the Environment - WEG #1 (Part 2)

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Santa Monica Teens Saving the Environment - WEG #1 (Part 2)

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How State Law Defines the Ideal Employee-Employer Relationship

Conflict between workers and the employer is a commonplace issue in the workplace. Federal and state laws related to employment issues help maintain the balance of power in the workplace by defining the characteristics of an ideal employee-employer relationship.



Generally, employment law encompasses employers' rights and obligations within the employer-employee relationship - between employers and their current employees, job applicants, and former employees. Because employment relationships are complex and the several different situations can arise out of it, employment law also involves legal issues such as discrimination, wages and taxation, wrongful termination, and Workplace safety.



As such, many of these issues are governed by applicable federal and state laws. However, in instances where the employment relationship is based on a valid contract entered into by the employer and the employee, the state contract law alone may dictate the rights and duties of the parties.



Employment laws, rules and regulations also help protect workers when conflicts arise with their employers. In an ideal work place, these rules define the relationship between workers and their superiors. Because of the great number of rules and regulations established by various levels of government agencies governing both the employee and employer, it would be necessarily to take the services of lawyers to guide both parties through the rights and obligations of this relationship.



In addition, employment law also tries to mitigate the effects of that conflict and to equalize the factors so that conflicts can be resolved. While good intentions on both sides can help reduce the level of conflict, it is inevitable that an employment lawyer will be called in to mediate or resolve the conflict.



Here are some of the common issues affecting both the employees and the employers:



• Complaints about a policy or manual - a company policy manual to a lawyer unless there is some underlying complaint that takes them to the lawyer first, labor unions and some worker's rights organizations will certainly have their legal staff review such manuals as a matter of course. The individual employee should read and be familiar with the company policy manual. Then, if the employer takes any adverse action against the employee that appears to contradict that manual, the employee should contact a lawyer versed in labor or employment law to help protect the employee's rights.



• Any discrimination based on sex, race, religion, age, or disability, if not immediately corrected by the employer when the employee complains through established channels, should be brought to a lawyer. Similarly, any harassment complaints if not addressed, should also be brought up to a lawyer.



• When health and safety rules of employees were violated and employees bring these to the attention of the appropriate government agencies. Employees can also seek appropriate protections under whistle blower laws when filing these complaints.



• Terminations - Employee termination is an area where both sides of the relationship may benefit. Rules and regulations regarding termination can affect the employee-employer relationship. A clearly written termination rules must be put in place to protect both the rights of employees and the interest of the employers.





Ask our team of legal experts on issues regarding employee-employer relationship and other concerns in Employment Law. Visit our site for further information.

Safety and Types of Flooring

Slips and falls are the number one cause of accidents in hotels, restaurants, and public buildings, 70% of which occur on flat and level surfaces. That being said, there are many factors to consider when choosing new flooring and among those is safety.

Resistance to slips and falls is a critical component of the overall safety of any flooring. Although there are risks, this shouldn’t limit your choices when choosing one type of flooring over another, especially if the flooring is treated to reduce this risk. There are solutions out there that will actually render a highly slippery floor safer than before, whether it is wet or dry, by being treated with certain chemicals. Below, we discuss some different flooring material options.

Ceramic flooring is an excellent option for a variety of reasons, but can also be a major hazard when wet, especially ceramic that is highly glossed. Ceramic is durable, long-lasting and requires very little maintenance. It is however, a very hard material which can cause fatigue after standing on it for a prolonged period of time and, moreover, is one of the more difficult materials to install.

Quarry flooring is another frequently used material because it is durable and affordable. Historically it has been used primarily for commercial applications, but it is now being seen more and more in private homes. Quarry tiles have the advantage of being available in a variety of shapes as well as being frost-proof which makes them durable enough to be used outdoors, but they can be a dangerous surface if not treated.

Stone flooring is an all-time favorite. Marble, Limestone, and Slate are just a few varieties that are frequently used. Marble in particular has an elegant appearance and a tough resistant surface. Marble flooring, however, does run on the expensive side and can be a major hazard when wet.

While each flooring material will have varying levels of resistance to slips and falls, there are flooring treatments available to make your floors slip-and-fall resistant. A good option is SURE STEP, a flooring and tub treatment by Interlake Chemicals.

Regardless of the type of flooring, it is important to remember that a high trafficked floor which is subject to excess moisture can present a high-risk of injury. To ensure slip and fall resistance, a surface treatment is an excellent option.

AGING IN A SAFE ENVIRONMENT

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AGING IN A SAFE ENVIRONMENT

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Protecting the Burren

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Bilbies Burrows with joeys at James Price Point, August 2011.wmv

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The 7 Dimension Addiction Treatment Model

Introducing a Multidimensional Public Health Approach for Poly-behavioral Addictions


By James Slobodzien, Psy.D., CSAC





The sun was thought to revolve around the earth for 1500 years. It wasn’t until a European astronomer named - Nicolaus Copernicus first formulated a modern heliocentric theory of the solar system that we began to change our thinking. This insight ultimately ushered in a major paradigm shift in astronomy and physics.





Every model or viewpoint for recovery maintains the integrity and importance of its own position, often to the exclusion of other explanations. For example, there are recovery models and theories for: biological, psychological, social, cultural, and spiritual viewpoints that can all explain human behavior. Unfortunately, these viewpoints may thus "blind" their adherents to alternative interpretations until some new insight is achieved that resolves the problems left unsolved. This article describes a public health model that could possibly be a step towards a "Copernicus" type paradigm shift.





The Unitary Syndrome Healthcare Model (The Problem)





Acute Care





Our present healthcare system is set up to focus on acute care rather than chronic illnesses (e.g., obesity, high blood pressure, heart disease, and addictions, etc.). An acute illness is sudden and severe and an immediate response is needed for events like heart attack, stroke, or violent injury. Acute disease is episodic, relatively brief and often fatal.





Acute care focuses on a Unitary Syndrome model in which the sole marker of treatment response or success is specific symptom-reduction, rather than a multi-dimensional approach that can address the multitude of risk factors and contributory causes.





Chronic Care





A chronic illness is defined as a disease that is ongoing, rarely cured, afflicts young and old, varies in severity, and typically lasts more than a year. The goals of treatment for chronic disorders and diseases are to preserve body function, minimize symptoms, ensure the best quality of life possible and maximize a patient's independence.





In 1990, 50 percent of the mortality (over 1-million deaths annually) in the United States from the 10 leading causes of death were linked to chronic addictive behaviors such as tobacco use, poor dietary habits, alcohol misuse, illicit drug use, and risky sexual practices, (McGinnis and Foege, 1994). The term "Poly-behavioral Addiction," will be used in this article to categorize the combination of substance and chronic behavioral (lifestyle) addictions (e.g., pathological gambling, food addiction, sex addiction, and other potentially obsessive-compulsive behavioral patterns such as exercise, shopping, internet, and religion, etc.).





If the goal is to eliminate or at least reduce alcohol, substance abuse, and other poly-behavioral addictions in the United States and the rest of the world, then a major shift in thinking will be required. We will need to expand our efforts not only in treating these disorders, but also in preventing them through early (multi-dimensional) interventions (Foley & Hochman, 2006).





The Public Health Model (7 Dimensions)





In the 1990s, the U.S. Congress directed the National Institute of Mental Health (NIMH) to work with the Institute of Medicine (IOM) to develop a Public Health Model that encompasses the following 7 strategies for the prevention, treatment, and maintenance of emotional problems that include addictions (Dozois & Dobson, 2004).





1. Universal Interventions: Efforts aimed at influencing the general population.





2. Selective Interventions: Efforts aimed at specific subgroups of the population that are considered at risk for developing problems, such as adolescents or ethnic minorities.





3. Indicated Interventions: Efforts directed toward high-risk groups of individuals who are identified as having minimal symptoms but do not meet the criteria for a clinical diagnosis.





4. Case Identification: Efforts aimed at screening, assessing, and diagnosing high-risk individuals.





5. Short-term Treatment: Efforts aimed at utilizing standard approaches to treat individuals.





6. Long-term Treatment: Efforts aimed at assisting individuals with the compliance of their long-term treatment goals to reduce relapse and recurrence.





7. Aftercare: Efforts aimed at maintaining gains including rehabilitation.





The 7 Dimensions Addiction Treatment Model





According to a recent (2010), addendum published by the American Society of Addiction Medicine (ASAM), concerning the criteria for preventing and managing the relapse of addictions - patients now being referred to treatment are presenting with much greater complexity of pathology and chronicity of relapse behaviors.





Early treatment for Alcoholism patients was modeled on the philosophy of the Twelve Steps of Alcoholics Anonymous, and they underwent "rehabilitation," that is they had already acquired the skills to function effectively, but their drinking interfered with the application of these skills. Later, as the field broadened its scope, patients required "habilitation," with treatment focused on the acquisition of skills to function effectively for the first time.





It became clear that to offer effective treatment, the field must expand its set of tools to include psychosocial interventions to improve life functioning skills to overcome problems with living conditions, housing, education, employment, job skills, childcare, and transportation , etc.





"Increasingly, our appreciation of addiction as a chronic, relapsing disorder - reflects scientific advances in our understanding of the structure and function of the brain, the genetics of addiction, and the pharmacology of motivation and behavior," (ASAM, 2010).





Healthcare consumers are increasingly advocating for a Multidimensional Healthcare model that takes into account an array of life-functioning domains that influence patient treatment progress. Evidenced-based meta-analysis studies purport the prognostic power of life-functioning variables to predict outcome as well as their importance for treatment planning over a Unitary Syndrome Healthcare model that has had little empirical support.





Accurate diagnosis is also dependent on a thorough multidimensional assessment process along with the possible help of a multidisciplinary treatment team approach. Behavioral Medicine practitioners have come to realize that although a disorder may be primarily physical or primarily psychological in nature, it is always a disorder of the whole person – not just of the body or the mind.





In 2005, the "Addictions Recovery Measurement System (ARMS)," was published - describing the following 7 life-functioning therapeutic activity dimensions for progress outcome measurements. 





The 7 Life-functioning Dimensions of Wellness:





Medical/ Physical Dimension


Self-regulation/ Impulse-control Dimension


Educational/ Occupational Dimension


Social/ Cultural Dimension


Financial/ Legal Dimension


Mental/ Emotional Dimension


Spiritual/ Religious Dimension





Each of the 7 Dimensions of wellness encompasses the following individualized criteria:





I. Medical/ Physical Dimension





A. The Medical/ Physical Dimension of wellness includes the following combination of


attitudes and behaviors:





1. Building endurance, strength, flexibility, and fitness through adequate exercise,





2. Eating a variety of healthy foods to maintain proper nutrition and diet,





3. Maintaining healthy sleep patterns to acquire a restful nights sleep,





Having the ability to identify symptoms of disease, and taking personal responsibility for minor illnesses and self-care such as getting regular medical checkups.





5. Pursuing an active lifestyle on a daily basis to maintain consistent health,





6. Understanding the importance of the relationship between nutrition, activity, performance and health, and





7. Monitoring your stress levels to get through your daily activities without feeling fatigued or physically stressed.





II. Self-regulation/ Impulse Control Dimension





A. The Self-regulation/ Impulse Control Dimension of wellness includes the following combination of attitudes and behaviors:





1. Recognizing that by replacing unhealthy habits with healthy habits - we can attain the psychological benefits of enhanced self-esteem, self-control, determination and a sense of direction,





2. Avoiding excessive alcohol consumption: Drinking no more than 4 drinks in a sitting, not drinking and driving, avoiding risky behaviors and situations while drinking, and choosing non-alcoholic, non-caffeine, and low sugar beverages,





3. Avoiding nicotine and tobacco products that are unsafe and that can potentially cause cancer. Also avoiding second-hand exposure to tobacco smoke that is very dangerous and that can cause cancer,





Avoiding the use of illegal drugs, non-prescribed drugs, addictive substances and/ or abusing over-the-counter drugs, and choosing a drug free life-style,





5. Avoiding excessive sexual compulsive behaviors, practicing safer sex, if you are sexually active, by using condoms and dental dams that can greatly reduce your risk of contracting sexually transmitted diseases,





6. Avoiding behavioral addictions, such as excessive gambling, food - binging/ purging, (control meal portions) obsessive religious practices, and excessive internet use, shopping, exercise and work activities,





7. Avoiding high-risk and dangerous behaviors, such as speeding/ reckless driving, and/ or assaults/ violence/ self-harm, and by proactively using seat belts, helmets, and other protective equipment.





III. Educational/ Occupational Dimension





A. The Educational/ Occupational Dimension of wellness includes the following combination of attitudes and behaviors:





Creating a vision for your future career that will be meaningful, enjoyable and rewarding,





2. Exploring a variety of career options that are consistent with your personal values, interests, and beliefs,





3. Choosing educational/ vocational goals to pursue a career that suits your personality, interests, and talents,





4. Visiting a career planning/placement office and using the available resources to make you marketable in your field,





5. Being open to change and learning new skills to balance your work, family and leisure time activities,





6. Preparing and making use of your gifts, skills and talents in order to gain purpose, happiness and enrichment in your life, and





7. Maintaining a positive attitude in your place of employment.





IV. Social/ Cultural Dimension





A. The Social/ Cultural Dimension of wellness includes the following combination of attitudes and behaviors:





1. Establishing and maintaining positive relationships with family, friends and co-workers,





2. Learning social skills to develop a good support system and deep, meaningful relationships,





3. Developing good communication and listening skills by practicing empathy and compassion as well as caring for others to generate more satisfying and meaningful relationships,





4. Interacting with people of other cultures, backgrounds, and beliefs by cultivating healthy relationships, sharing your talents and skills, contributing to your community, and communicating your thoughts, ideas and feelings to others,





5. Living in harmony with fellow human beings, seeking positive interdependent relationships with others, and developing healthy interpersonal behaviors,





6. Being involved in socially responsible activities to protect the culture and environment such as: conserving water and other natural resources; reducing, reusing, recycling, minimizing your exposure to chemicals, and renewing your relationship with the earth,





7. Promoting health measures that improve the standard of living and quality of life in the community, including laws and agencies that safeguard the physical environment.





V. Financial/ Legal Dimension





A. The Financial/ Legal Dimension of wellness includes the following combination of attitudes and behaviors:





1. Contemplating your personal beliefs concerning: security, peace of mind, economic freedom and choice to determine your concept of financial/ legal health and wellness,





2. Assessing your debt-to-income ratio, your savings rate and your ability to respond to a financial emergency,





3. Creating, planning, managing, monitoring, and conserving your money and assets,





4. Avoiding spending more than you’re earning, and sticking to a budget to keep debt in check,





5. Seeking advice from a reputable financial planner,





6. Buying the necessary health, auto, and life insurance,





7. Obeying the law, complying with rules and regulations, and becoming a community role-model.





VI. Mental/ Emotional Dimension





A. The Mental/ Emotional Dimension of wellness includes the following combination of attitudes and behaviors:





1. Learning, problem-solving and creative pursuits as well as reading, writing and other mentally-stimulating and challenging activities,





2. Striving to improve your intellect and your creative spark by: taking a course or workshop, learning a foreign language, reading for personal enjoyment, seeking out persons who challenge you intellectually, and/ or taking up a hobby,





3. Cultivating optimism, self-esteem, self-acceptance, and the ability to share your feelings by tuning-in to your thoughts and feelings, seeking and providing support to others and accepting and forgiving yourself,





4. Understanding yourself and coping with the challenges of life by acknowledging and sharing your feelings of anger, fear, sadness, stress, hope, love, joy and happiness in a productive manner,





5. Coping with normal life stressors, relationships with others, job satisfaction and success as well as quality of life and happiness,





6. Assessing your limitations, developing your autonomy, and being aware of your personal limitations and understanding the value of seeking support and assistance from others,





7. Expressing feelings freely, managing feelings effectively and learning to accept a wide range of feelings in yourself and others.





VII. Spiritual/ Religious Dimension





A. The Spiritual/ Religious Dimension of wellness includes the following combination of attitudes and behaviors:





1. Possessing a unique set of guiding beliefs, principles, values or spiritual guidelines that help give direction to your life,





2. Establishing peace and harmony in your life by developing congruency between your values and your actions,





3. Seeking meaning and purpose in life through meditation, religion, music, art, literature, nature and through connections with loved ones and other people in your community,





4. Exploring your spiritual core, being inquisitive and curious, listening to your heart and following your principles, and allowing yourself and others around you the freedom to be who they are,





5. Having a sense of selflessness and empathy for others, and a commitment to a higher, greater power,





6. Being able to ponder the meaning of life and being tolerant of the beliefs of others instead of being close minded and intolerant, and





7. Being mindful, appreciative and accepting of the opportunities for growth in the challenges that life brings you.





The "7 Dimensional" Public Health Model Components





The 7 Dimension Addiction Treatment Model has various components that can be incorporated into the public health models' focus on the individual within the psychosocial environment in the following ways:





Universal Interventions: Public education and prevention campaigns can promote the 7 Dimension Health and Wellness Programs (See the 7 University Campaigns below).





Selective Interventions: The 7 Dimension Health and Wellness Program can be targeted at specific subgroups (College students, Military members, etc.).





Indicated Interventions: The 7 Dimensional Intervention can be utilized to screen and assess high-risk individuals (See below for a brief description of this intervention).





Case Identification: The 7 Dimension Diagnostic Classification system can be utilized to diagnose patients without labeling or stigmatization (A Prototype Model for the Alcohol/Substance Dependence diagnosis has been developed and proposed for DSM-V).





Short-term Treatment: Standardized 7 Dimensional treatment plans can be utilized.





Long-term Treatment: The 7 Dimensional Tracking Team can be utilized to assist with treatment compliance.





Aftercare: 7 Dimensional Treatment progress reports can be utilized to assist with acquiring outcome measures.





Note: These seven dimensional program components have been delineated in the book entitled, Poly-behavioral Addiction and the Addictions Recovery Measurement System (Slobodzien, 2005), and also in the article entitled: The 7 - Dimension Intervention - A Holistic Diathesis-Stress Approach to Stress-Management





The 7 Dimension Intervention





The Diathesis-Stress Model





The 7 Dimension Intervention is a unique stress-management assessment process that is based on the Diathesis-Stress Model. Researchers have proposed that many disorders are believed to develop when some kind of stressor affects a person who already has a vulnerability or diathesis for that disorder (Ingram & Luxton, 2005; Meehl, 1962; Monroe & Simons, 1991). The diathesis or vulnerability which could be a genetic predisposition or adverse childhood experience is not generally sufficient to cause the disorder itself, but it is a contributory factor. For example, a child who experiences the death of a parent would be at a higher risk to develop depression as an adult. In this case the vulnerability itself was a childhood stressor.





The 7 Dimension Intervention utilizes the following three instruments - to systematically document and assist a client with visualizing their childhood vulnerabilities, current life stressors, and current positive activities on a "Wheel of Life." The goal is to decrease stress, build resiliency, and improve their overall wellness to hopefully motivate them to develop and monitor a health and wellness plan for their lives:





1. Adverse Childhood Experiences (ACE) Questionnaire


2. The 7 Dimensional - Psycho-social Stressor Inventory (7D-PSI)


3. The 7 Dimensional - Therapeutic Activity Survey (7D-TAS)





What is the ACE Study?





The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted on the links between childhood maltreatment and later-life health and well-being. As a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego, Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination provided detailed information about their childhood experience of abuse, neglect, and family dysfunction. Over 17,000 members chose to participate. To date, over 50 scientific articles have been published and over 100 conference and workshop presentations have been made (Slobodzien, 2009).





For more information see the article: The 7 - Dimension Intervention - A Holistic Diathesis-Stress Approach to Stress-Management (Slobodzien, 2009).





The 7 Dimensional Hypothesis





The 7 - Dimensions hypothesis acknowledges that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, cocaine and sex, etc.).





Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction.





The 7 Dimensional Theory





Many healthcare consumers of addiction recovery services have a genetic pre-dispositional history for addiction. They have suffered and continue to suffer from past traumatic life experiences (e.g. physical, sexual, and emotional abuse, etc.) and often present with psychosocial stressors (e.g. occupational stress, family/ marital problems, etc.) leaving them with intense and confusing feelings (e.g. anger, anxiety, bitterness, fear, guilt, grief, loneliness, depression, and inferiority, etc.) that reinforce their already low self-esteem. The complex interaction of these factors can leave the individual with much deeper mental health problems involving self-hatred, self-punishment, self-denial, low self-control, low self-respect, and a severe low self-esteem condition, with an overall (sometimes hidden) negative self-identity.





The standardized performance-based 7 Dimension Addiction Treatment philosophy incorporates a bio-psychosocial disease model that focuses on a cognitive behavioral perspective in attempting to alter maladaptive thinking and improve a person’s abilities and behaviors to solve problems and plan for sustained recovery.





The 7 Dimensions’ theory promotes a synergistically positive effect that can ignite and set free the human spirit when an individual’s life functioning dimensions are elevated in a homeostatic system. The reciprocity between spirituality and multidimensional life functioning progress, establish the deepest intrinsic self-image and behavioral changes.





The 7 Dimension "Long-term Goal"





The long-term goal is the health-consumer’s highest optimal functioning, not merely the absence of pathology or symptom reduction. The short-term goal is to change the health care system to accommodate and assimilate to a multidimensional health care perspective. The 7 Dimensions model addresses the low self-esteem - "addiction - common denominator" by helping individuals establish values, set and accomplish goals, and monitor successful performance.





Additionally, when we consider that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the 7 Dimension philosophy promotes that there is a supernatural-like spiritually synergistic effect that occurs when an individuals’ multiple life functioning dimensions are elevated in a homeostatic human system. This bilateral spiritual connectedness reduces chaos and increases resilience to bring an individual harmony, wellness, and productivity.





Other Evidenced Based Multi-dimensional Models





Diagnostic and Statistical Manual of Mental Disorders (DSM)





It was suggested that the DSM-IV Classification be organized following a dimensional model rather than the categorical model used in DSM-III-R. A dimensional system classifies clinical presentations based on quantification of attributes rather than the assignment to categories and works best in describing phenomena that are distributed continuously and that do not have clear boundaries.





A joint committee of the American Psychiatric Association and the National Institute of Mental Health charged with identifying pressing issues for the DSM – Fifth Edition (DSM-V) concluded that: ‘there is a clear need for dimensional models to be developed and for their utility to be compared with the existing typologies.'





American Society of Addiction Medicine (ASAM)





The American Society of Addiction Medicine’s (2003), "Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition", has set the standard in the field of addiction treatment for recognizing a multidimensional, bio-psychosocial assessment process. These dimensional assessments involve asking if the patient’s daily living activities were significantly impaired to interfere with or distract from abstinence, recovery, and/ or stability treatment goals and efforts.





The Community Reinforcement Approach (CRA)





CRA is a comprehensive behavioral program for treating substance-abuse problems.  It is based on the belief that environmental contingencies can play a powerful role in encouraging or discouraging drinking or drug use.  Consequently, it utilizes social, recreational, familial, and vocational reinforcers to assist consumers in the recovery process.  Its goal is to make a sober lifestyle more rewarding than the use of substances.  Oddly enough, however, while virtually every review of alcohol and drug treatment outcome research lists CRA among approaches with the strongest scientific evidence of efficacy, very few clinicians who treat consumers with addictions are familiar with it.





Comprehensive Soldier Fitness (CSF)





CSF a multi-dimensional holistic fitness program for Soldiers, families, and Army civilians implemented in 2009 in order to enhance performance and build resilience.





7 Dimension Health and Wellness Campaigns





The following 7 Universities/ Colleges have instituted 7 Dimensional Health and Wellness Programs:





1. University of California, Riverside


2. Ball State University, IN


3. University of North Dakota


4. North Dakota State University, Fargo


5. Illinois State University


6. University of Wisconsin - Stevens Point


7. Salem College, North Carolina





Conclusion





The 7 – Dimensions Model is not claiming to be the panacea for the ills of addictions treatment progress and outcomes, but it is a step in the right direction for getting clinicians to change the way they practice, by changing treatment facility systems to incorporate evidence-based research findings on effective interventions. The challenge for those interested in conducting outcome evaluations to improve their quality of care is to incorporate a system that will standardize their assessment procedures, treatment programs, and clinical treatment practices. By diligently following a standardized system to obtain base-line outcome statistics of their treatment program effectiveness despite the outcome, they will be able to assess the effectiveness of subsequent treatment interventions.





For more info see: 7dimensions.net





Books: Poly-Behavioral Addiction and the Addictions Recovery Measurement System (ARMS) at:





http://www.amazon.com/Poly-Behavioral-Addiction-Addictions-Recovery-Measurement/dp/1591136903





Published Articles:





1. Contemplating a 7 - Dimensional Theory of Everything


2. Ancient Mysteries of the Seven Dimensions


3. The 7 Dimensional God and Ancient Mystery Religion


4. 2012 And the 7 Dimension End Time Prophecies


5. Spirituality 101 (Part-1)


6. Spirituality 101 (Part 2 - Religion)


7. The Pope and the "Holy War"





For further information see the following books:





1. Hawaii and Christian Religious Addiction: A Survey of Attitudes Toward Healthy Spirituality and Religious Addiction Within Christianity





http://www.amazon.com/Hawaii-Christian-Religious-Addiction-Spirituality/dp/158





2. Christian Psychotherapy & Criminal Rehabilitation: An Integration Of Psychology And Theology For Rehabilitative Effectiveness





http://www.amazon.com/Christian-Psychotherapy-Criminal-Rehabilitation-Rehabilitative/dp/1581125399


Read more at http://www.articlealley.com/article_1817416_51.html?ktrack=kcplink





References





American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,


Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731.


American Society of Addiction Medicine’s (2003), "Patient Placement Criteria for the


Treatment of Substance-Related Disorders, 3rd Edition, Retrieved, June 18, 2005, from:


http://www.asam.org/


Arthur Aron, Ph.D., professor, psychology, State University of New York, Stony Brook; Helen


Fisher, research professor, department of anthropology, Rutgers University, New Brunswick, N.J.;


Dozois, D. J. A., & Dobson, K. S. (Eds.). (2004). The prevention of anxiety and depression: Theory, research, and practice. Washington, D.C: American Psychological Association.


Foley, G. M. & Hochman, J. D. (2006), Mental health in early intervention: Achieving unity in principles and practice.: Baltimore Brooke Publishing.


Kessler, R.C., (1994), Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national comorbidity survey. Arch. Gen. Psychiat., 51, 8-19.


Paul Sanberg, Ph.D.,professor, neuroscience, and director, Center of Excellence for Aging and Brain Repair,University of South Florida College of Medicine, Tampa; June 2005, the Journal of Neurophysiology Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web


Publications. Retrieved June 20, 2005, from: http://www.tgorski.com


Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40.


Monroe, S.M., & Simons, A.D. (1991). Diathesis-stress theories in the context of life stress research: Implications for the depressed disorders. Psychol. Bull., 110, 406-25.


Morgan, G.D.; and Fox, B.J. Promoting Cessation of Tobacco Use. The Physician and Sports medicine. Vol 28- No. 12, December 2000.


Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5.


U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.

You can find additional info at the following links:

Click Here for more information
Click Here for more information

The 7 Dimension Addiction Treatment Model

Introducing a Multidimensional Public Health Approach for Poly-behavioral Addictions


By James Slobodzien, Psy.D., CSAC





The sun was thought to revolve around the earth for 1500 years. It wasn’t until a European astronomer named - Nicolaus Copernicus first formulated a modern heliocentric theory of the solar system that we began to change our thinking. This insight ultimately ushered in a major paradigm shift in astronomy and physics.





Every model or viewpoint for recovery maintains the integrity and importance of its own position, often to the exclusion of other explanations. For example, there are recovery models and theories for: biological, psychological, social, cultural, and spiritual viewpoints that can all explain human behavior. Unfortunately, these viewpoints may thus "blind" their adherents to alternative interpretations until some new insight is achieved that resolves the problems left unsolved. This article describes a public health model that could possibly be a step towards a "Copernicus" type paradigm shift.





The Unitary Syndrome Healthcare Model (The Problem)





Acute Care





Our present healthcare system is set up to focus on acute care rather than chronic illnesses (e.g., obesity, high blood pressure, heart disease, and addictions, etc.). An acute illness is sudden and severe and an immediate response is needed for events like heart attack, stroke, or violent injury. Acute disease is episodic, relatively brief and often fatal.





Acute care focuses on a Unitary Syndrome model in which the sole marker of treatment response or success is specific symptom-reduction, rather than a multi-dimensional approach that can address the multitude of risk factors and contributory causes.





Chronic Care





A chronic illness is defined as a disease that is ongoing, rarely cured, afflicts young and old, varies in severity, and typically lasts more than a year. The goals of treatment for chronic disorders and diseases are to preserve body function, minimize symptoms, ensure the best quality of life possible and maximize a patient's independence.





In 1990, 50 percent of the mortality (over 1-million deaths annually) in the United States from the 10 leading causes of death were linked to chronic addictive behaviors such as tobacco use, poor dietary habits, alcohol misuse, illicit drug use, and risky sexual practices, (McGinnis and Foege, 1994). The term "Poly-behavioral Addiction," will be used in this article to categorize the combination of substance and chronic behavioral (lifestyle) addictions (e.g., pathological gambling, food addiction, sex addiction, and other potentially obsessive-compulsive behavioral patterns such as exercise, shopping, internet, and religion, etc.).





If the goal is to eliminate or at least reduce alcohol, substance abuse, and other poly-behavioral addictions in the United States and the rest of the world, then a major shift in thinking will be required. We will need to expand our efforts not only in treating these disorders, but also in preventing them through early (multi-dimensional) interventions (Foley & Hochman, 2006).





The Public Health Model (7 Dimensions)





In the 1990s, the U.S. Congress directed the National Institute of Mental Health (NIMH) to work with the Institute of Medicine (IOM) to develop a Public Health Model that encompasses the following 7 strategies for the prevention, treatment, and maintenance of emotional problems that include addictions (Dozois & Dobson, 2004).





1. Universal Interventions: Efforts aimed at influencing the general population.





2. Selective Interventions: Efforts aimed at specific subgroups of the population that are considered at risk for developing problems, such as adolescents or ethnic minorities.





3. Indicated Interventions: Efforts directed toward high-risk groups of individuals who are identified as having minimal symptoms but do not meet the criteria for a clinical diagnosis.





4. Case Identification: Efforts aimed at screening, assessing, and diagnosing high-risk individuals.





5. Short-term Treatment: Efforts aimed at utilizing standard approaches to treat individuals.





6. Long-term Treatment: Efforts aimed at assisting individuals with the compliance of their long-term treatment goals to reduce relapse and recurrence.





7. Aftercare: Efforts aimed at maintaining gains including rehabilitation.





The 7 Dimensions Addiction Treatment Model





According to a recent (2010), addendum published by the American Society of Addiction Medicine (ASAM), concerning the criteria for preventing and managing the relapse of addictions - patients now being referred to treatment are presenting with much greater complexity of pathology and chronicity of relapse behaviors.





Early treatment for Alcoholism patients was modeled on the philosophy of the Twelve Steps of Alcoholics Anonymous, and they underwent "rehabilitation," that is they had already acquired the skills to function effectively, but their drinking interfered with the application of these skills. Later, as the field broadened its scope, patients required "habilitation," with treatment focused on the acquisition of skills to function effectively for the first time.





It became clear that to offer effective treatment, the field must expand its set of tools to include psychosocial interventions to improve life functioning skills to overcome problems with living conditions, housing, education, employment, job skills, childcare, and transportation , etc.





"Increasingly, our appreciation of addiction as a chronic, relapsing disorder - reflects scientific advances in our understanding of the structure and function of the brain, the genetics of addiction, and the pharmacology of motivation and behavior," (ASAM, 2010).





Healthcare consumers are increasingly advocating for a Multidimensional Healthcare model that takes into account an array of life-functioning domains that influence patient treatment progress. Evidenced-based meta-analysis studies purport the prognostic power of life-functioning variables to predict outcome as well as their importance for treatment planning over a Unitary Syndrome Healthcare model that has had little empirical support.





Accurate diagnosis is also dependent on a thorough multidimensional assessment process along with the possible help of a multidisciplinary treatment team approach. Behavioral Medicine practitioners have come to realize that although a disorder may be primarily physical or primarily psychological in nature, it is always a disorder of the whole person – not just of the body or the mind.





In 2005, the "Addictions Recovery Measurement System (ARMS)," was published - describing the following 7 life-functioning therapeutic activity dimensions for progress outcome measurements. 





The 7 Life-functioning Dimensions of Wellness:





Medical/ Physical Dimension


Self-regulation/ Impulse-control Dimension


Educational/ Occupational Dimension


Social/ Cultural Dimension


Financial/ Legal Dimension


Mental/ Emotional Dimension


Spiritual/ Religious Dimension





Each of the 7 Dimensions of wellness encompasses the following individualized criteria:





I. Medical/ Physical Dimension





A. The Medical/ Physical Dimension of wellness includes the following combination of


attitudes and behaviors:





1. Building endurance, strength, flexibility, and fitness through adequate exercise,





2. Eating a variety of healthy foods to maintain proper nutrition and diet,





3. Maintaining healthy sleep patterns to acquire a restful nights sleep,





Having the ability to identify symptoms of disease, and taking personal responsibility for minor illnesses and self-care such as getting regular medical checkups.





5. Pursuing an active lifestyle on a daily basis to maintain consistent health,





6. Understanding the importance of the relationship between nutrition, activity, performance and health, and





7. Monitoring your stress levels to get through your daily activities without feeling fatigued or physically stressed.





II. Self-regulation/ Impulse Control Dimension





A. The Self-regulation/ Impulse Control Dimension of wellness includes the following combination of attitudes and behaviors:





1. Recognizing that by replacing unhealthy habits with healthy habits - we can attain the psychological benefits of enhanced self-esteem, self-control, determination and a sense of direction,





2. Avoiding excessive alcohol consumption: Drinking no more than 4 drinks in a sitting, not drinking and driving, avoiding risky behaviors and situations while drinking, and choosing non-alcoholic, non-caffeine, and low sugar beverages,





3. Avoiding nicotine and tobacco products that are unsafe and that can potentially cause cancer. Also avoiding second-hand exposure to tobacco smoke that is very dangerous and that can cause cancer,





Avoiding the use of illegal drugs, non-prescribed drugs, addictive substances and/ or abusing over-the-counter drugs, and choosing a drug free life-style,





5. Avoiding excessive sexual compulsive behaviors, practicing safer sex, if you are sexually active, by using condoms and dental dams that can greatly reduce your risk of contracting sexually transmitted diseases,





6. Avoiding behavioral addictions, such as excessive gambling, food - binging/ purging, (control meal portions) obsessive religious practices, and excessive internet use, shopping, exercise and work activities,





7. Avoiding high-risk and dangerous behaviors, such as speeding/ reckless driving, and/ or assaults/ violence/ self-harm, and by proactively using seat belts, helmets, and other protective equipment.





III. Educational/ Occupational Dimension





A. The Educational/ Occupational Dimension of wellness includes the following combination of attitudes and behaviors:





Creating a vision for your future career that will be meaningful, enjoyable and rewarding,





2. Exploring a variety of career options that are consistent with your personal values, interests, and beliefs,





3. Choosing educational/ vocational goals to pursue a career that suits your personality, interests, and talents,





4. Visiting a career planning/placement office and using the available resources to make you marketable in your field,





5. Being open to change and learning new skills to balance your work, family and leisure time activities,





6. Preparing and making use of your gifts, skills and talents in order to gain purpose, happiness and enrichment in your life, and





7. Maintaining a positive attitude in your place of employment.





IV. Social/ Cultural Dimension





A. The Social/ Cultural Dimension of wellness includes the following combination of attitudes and behaviors:





1. Establishing and maintaining positive relationships with family, friends and co-workers,





2. Learning social skills to develop a good support system and deep, meaningful relationships,





3. Developing good communication and listening skills by practicing empathy and compassion as well as caring for others to generate more satisfying and meaningful relationships,





4. Interacting with people of other cultures, backgrounds, and beliefs by cultivating healthy relationships, sharing your talents and skills, contributing to your community, and communicating your thoughts, ideas and feelings to others,





5. Living in harmony with fellow human beings, seeking positive interdependent relationships with others, and developing healthy interpersonal behaviors,





6. Being involved in socially responsible activities to protect the culture and environment such as: conserving water and other natural resources; reducing, reusing, recycling, minimizing your exposure to chemicals, and renewing your relationship with the earth,





7. Promoting health measures that improve the standard of living and quality of life in the community, including laws and agencies that safeguard the physical environment.





V. Financial/ Legal Dimension





A. The Financial/ Legal Dimension of wellness includes the following combination of attitudes and behaviors:





1. Contemplating your personal beliefs concerning: security, peace of mind, economic freedom and choice to determine your concept of financial/ legal health and wellness,





2. Assessing your debt-to-income ratio, your savings rate and your ability to respond to a financial emergency,





3. Creating, planning, managing, monitoring, and conserving your money and assets,





4. Avoiding spending more than you’re earning, and sticking to a budget to keep debt in check,





5. Seeking advice from a reputable financial planner,





6. Buying the necessary health, auto, and life insurance,





7. Obeying the law, complying with rules and regulations, and becoming a community role-model.





VI. Mental/ Emotional Dimension





A. The Mental/ Emotional Dimension of wellness includes the following combination of attitudes and behaviors:





1. Learning, problem-solving and creative pursuits as well as reading, writing and other mentally-stimulating and challenging activities,





2. Striving to improve your intellect and your creative spark by: taking a course or workshop, learning a foreign language, reading for personal enjoyment, seeking out persons who challenge you intellectually, and/ or taking up a hobby,





3. Cultivating optimism, self-esteem, self-acceptance, and the ability to share your feelings by tuning-in to your thoughts and feelings, seeking and providing support to others and accepting and forgiving yourself,





4. Understanding yourself and coping with the challenges of life by acknowledging and sharing your feelings of anger, fear, sadness, stress, hope, love, joy and happiness in a productive manner,





5. Coping with normal life stressors, relationships with others, job satisfaction and success as well as quality of life and happiness,





6. Assessing your limitations, developing your autonomy, and being aware of your personal limitations and understanding the value of seeking support and assistance from others,





7. Expressing feelings freely, managing feelings effectively and learning to accept a wide range of feelings in yourself and others.





VII. Spiritual/ Religious Dimension





A. The Spiritual/ Religious Dimension of wellness includes the following combination of attitudes and behaviors:





1. Possessing a unique set of guiding beliefs, principles, values or spiritual guidelines that help give direction to your life,





2. Establishing peace and harmony in your life by developing congruency between your values and your actions,





3. Seeking meaning and purpose in life through meditation, religion, music, art, literature, nature and through connections with loved ones and other people in your community,





4. Exploring your spiritual core, being inquisitive and curious, listening to your heart and following your principles, and allowing yourself and others around you the freedom to be who they are,





5. Having a sense of selflessness and empathy for others, and a commitment to a higher, greater power,





6. Being able to ponder the meaning of life and being tolerant of the beliefs of others instead of being close minded and intolerant, and





7. Being mindful, appreciative and accepting of the opportunities for growth in the challenges that life brings you.





The "7 Dimensional" Public Health Model Components





The 7 Dimension Addiction Treatment Model has various components that can be incorporated into the public health models' focus on the individual within the psychosocial environment in the following ways:





Universal Interventions: Public education and prevention campaigns can promote the 7 Dimension Health and Wellness Programs (See the 7 University Campaigns below).





Selective Interventions: The 7 Dimension Health and Wellness Program can be targeted at specific subgroups (College students, Military members, etc.).





Indicated Interventions: The 7 Dimensional Intervention can be utilized to screen and assess high-risk individuals (See below for a brief description of this intervention).





Case Identification: The 7 Dimension Diagnostic Classification system can be utilized to diagnose patients without labeling or stigmatization (A Prototype Model for the Alcohol/Substance Dependence diagnosis has been developed and proposed for DSM-V).





Short-term Treatment: Standardized 7 Dimensional treatment plans can be utilized.





Long-term Treatment: The 7 Dimensional Tracking Team can be utilized to assist with treatment compliance.





Aftercare: 7 Dimensional Treatment progress reports can be utilized to assist with acquiring outcome measures.





Note: These seven dimensional program components have been delineated in the book entitled, Poly-behavioral Addiction and the Addictions Recovery Measurement System (Slobodzien, 2005), and also in the article entitled: The 7 - Dimension Intervention - A Holistic Diathesis-Stress Approach to Stress-Management





The 7 Dimension Intervention





The Diathesis-Stress Model





The 7 Dimension Intervention is a unique stress-management assessment process that is based on the Diathesis-Stress Model. Researchers have proposed that many disorders are believed to develop when some kind of stressor affects a person who already has a vulnerability or diathesis for that disorder (Ingram & Luxton, 2005; Meehl, 1962; Monroe & Simons, 1991). The diathesis or vulnerability which could be a genetic predisposition or adverse childhood experience is not generally sufficient to cause the disorder itself, but it is a contributory factor. For example, a child who experiences the death of a parent would be at a higher risk to develop depression as an adult. In this case the vulnerability itself was a childhood stressor.





The 7 Dimension Intervention utilizes the following three instruments - to systematically document and assist a client with visualizing their childhood vulnerabilities, current life stressors, and current positive activities on a "Wheel of Life." The goal is to decrease stress, build resiliency, and improve their overall wellness to hopefully motivate them to develop and monitor a health and wellness plan for their lives:





1. Adverse Childhood Experiences (ACE) Questionnaire


2. The 7 Dimensional - Psycho-social Stressor Inventory (7D-PSI)


3. The 7 Dimensional - Therapeutic Activity Survey (7D-TAS)





What is the ACE Study?





The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted on the links between childhood maltreatment and later-life health and well-being. As a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego, Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination provided detailed information about their childhood experience of abuse, neglect, and family dysfunction. Over 17,000 members chose to participate. To date, over 50 scientific articles have been published and over 100 conference and workshop presentations have been made (Slobodzien, 2009).





For more information see the article: The 7 - Dimension Intervention - A Holistic Diathesis-Stress Approach to Stress-Management (Slobodzien, 2009).





The 7 Dimensional Hypothesis





The 7 - Dimensions hypothesis acknowledges that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, cocaine and sex, etc.).





Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction.





The 7 Dimensional Theory





Many healthcare consumers of addiction recovery services have a genetic pre-dispositional history for addiction. They have suffered and continue to suffer from past traumatic life experiences (e.g. physical, sexual, and emotional abuse, etc.) and often present with psychosocial stressors (e.g. occupational stress, family/ marital problems, etc.) leaving them with intense and confusing feelings (e.g. anger, anxiety, bitterness, fear, guilt, grief, loneliness, depression, and inferiority, etc.) that reinforce their already low self-esteem. The complex interaction of these factors can leave the individual with much deeper mental health problems involving self-hatred, self-punishment, self-denial, low self-control, low self-respect, and a severe low self-esteem condition, with an overall (sometimes hidden) negative self-identity.





The standardized performance-based 7 Dimension Addiction Treatment philosophy incorporates a bio-psychosocial disease model that focuses on a cognitive behavioral perspective in attempting to alter maladaptive thinking and improve a person’s abilities and behaviors to solve problems and plan for sustained recovery.





The 7 Dimensions’ theory promotes a synergistically positive effect that can ignite and set free the human spirit when an individual’s life functioning dimensions are elevated in a homeostatic system. The reciprocity between spirituality and multidimensional life functioning progress, establish the deepest intrinsic self-image and behavioral changes.





The 7 Dimension "Long-term Goal"





The long-term goal is the health-consumer’s highest optimal functioning, not merely the absence of pathology or symptom reduction. The short-term goal is to change the health care system to accommodate and assimilate to a multidimensional health care perspective. The 7 Dimensions model addresses the low self-esteem - "addiction - common denominator" by helping individuals establish values, set and accomplish goals, and monitor successful performance.





Additionally, when we consider that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the 7 Dimension philosophy promotes that there is a supernatural-like spiritually synergistic effect that occurs when an individuals’ multiple life functioning dimensions are elevated in a homeostatic human system. This bilateral spiritual connectedness reduces chaos and increases resilience to bring an individual harmony, wellness, and productivity.





Other Evidenced Based Multi-dimensional Models





Diagnostic and Statistical Manual of Mental Disorders (DSM)





It was suggested that the DSM-IV Classification be organized following a dimensional model rather than the categorical model used in DSM-III-R. A dimensional system classifies clinical presentations based on quantification of attributes rather than the assignment to categories and works best in describing phenomena that are distributed continuously and that do not have clear boundaries.





A joint committee of the American Psychiatric Association and the National Institute of Mental Health charged with identifying pressing issues for the DSM – Fifth Edition (DSM-V) concluded that: ‘there is a clear need for dimensional models to be developed and for their utility to be compared with the existing typologies.'





American Society of Addiction Medicine (ASAM)





The American Society of Addiction Medicine’s (2003), "Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition", has set the standard in the field of addiction treatment for recognizing a multidimensional, bio-psychosocial assessment process. These dimensional assessments involve asking if the patient’s daily living activities were significantly impaired to interfere with or distract from abstinence, recovery, and/ or stability treatment goals and efforts.





The Community Reinforcement Approach (CRA)





CRA is a comprehensive behavioral program for treating substance-abuse problems.  It is based on the belief that environmental contingencies can play a powerful role in encouraging or discouraging drinking or drug use.  Consequently, it utilizes social, recreational, familial, and vocational reinforcers to assist consumers in the recovery process.  Its goal is to make a sober lifestyle more rewarding than the use of substances.  Oddly enough, however, while virtually every review of alcohol and drug treatment outcome research lists CRA among approaches with the strongest scientific evidence of efficacy, very few clinicians who treat consumers with addictions are familiar with it.





Comprehensive Soldier Fitness (CSF)





CSF a multi-dimensional holistic fitness program for Soldiers, families, and Army civilians implemented in 2009 in order to enhance performance and build resilience.





7 Dimension Health and Wellness Campaigns





The following 7 Universities/ Colleges have instituted 7 Dimensional Health and Wellness Programs:





1. University of California, Riverside


2. Ball State University, IN


3. University of North Dakota


4. North Dakota State University, Fargo


5. Illinois State University


6. University of Wisconsin - Stevens Point


7. Salem College, North Carolina





Conclusion





The 7 – Dimensions Model is not claiming to be the panacea for the ills of addictions treatment progress and outcomes, but it is a step in the right direction for getting clinicians to change the way they practice, by changing treatment facility systems to incorporate evidence-based research findings on effective interventions. The challenge for those interested in conducting outcome evaluations to improve their quality of care is to incorporate a system that will standardize their assessment procedures, treatment programs, and clinical treatment practices. By diligently following a standardized system to obtain base-line outcome statistics of their treatment program effectiveness despite the outcome, they will be able to assess the effectiveness of subsequent treatment interventions.





For more info see: 7dimensions.net





Books: Poly-Behavioral Addiction and the Addictions Recovery Measurement System (ARMS) at:





http://www.amazon.com/Poly-Behavioral-Addiction-Addictions-Recovery-Measurement/dp/1591136903





Published Articles:





1. Contemplating a 7 - Dimensional Theory of Everything


2. Ancient Mysteries of the Seven Dimensions


3. The 7 Dimensional God and Ancient Mystery Religion


4. 2012 And the 7 Dimension End Time Prophecies


5. Spirituality 101 (Part-1)


6. Spirituality 101 (Part 2 - Religion)


7. The Pope and the "Holy War"





For further information see the following books:





1. Hawaii and Christian Religious Addiction: A Survey of Attitudes Toward Healthy Spirituality and Religious Addiction Within Christianity





http://www.amazon.com/Hawaii-Christian-Religious-Addiction-Spirituality/dp/158





2. Christian Psychotherapy & Criminal Rehabilitation: An Integration Of Psychology And Theology For Rehabilitative Effectiveness





http://www.amazon.com/Christian-Psychotherapy-Criminal-Rehabilitation-Rehabilitative/dp/1581125399


Read more at http://www.articlealley.com/article_1817416_51.html?ktrack=kcplink





References





American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,


Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731.


American Society of Addiction Medicine’s (2003), "Patient Placement Criteria for the


Treatment of Substance-Related Disorders, 3rd Edition, Retrieved, June 18, 2005, from:


http://www.asam.org/


Arthur Aron, Ph.D., professor, psychology, State University of New York, Stony Brook; Helen


Fisher, research professor, department of anthropology, Rutgers University, New Brunswick, N.J.;


Dozois, D. J. A., & Dobson, K. S. (Eds.). (2004). The prevention of anxiety and depression: Theory, research, and practice. Washington, D.C: American Psychological Association.


Foley, G. M. & Hochman, J. D. (2006), Mental health in early intervention: Achieving unity in principles and practice.: Baltimore Brooke Publishing.


Kessler, R.C., (1994), Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national comorbidity survey. Arch. Gen. Psychiat., 51, 8-19.


Paul Sanberg, Ph.D.,professor, neuroscience, and director, Center of Excellence for Aging and Brain Repair,University of South Florida College of Medicine, Tampa; June 2005, the Journal of Neurophysiology Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web


Publications. Retrieved June 20, 2005, from: http://www.tgorski.com


Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40.


Monroe, S.M., & Simons, A.D. (1991). Diathesis-stress theories in the context of life stress research: Implications for the depressed disorders. Psychol. Bull., 110, 406-25.


Morgan, G.D.; and Fox, B.J. Promoting Cessation of Tobacco Use. The Physician and Sports medicine. Vol 28- No. 12, December 2000.


Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5.


U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.

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