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Over the past 35 years, mindfulness meditation practices have increasingly been integrated into Western medical settings. Research into the benefits of mindfulness-based interventions (MBIs) continues to expand, such that there are currently more than a dozen different protocolled MBIs for patients suffering from a variety of physical and psychological disorders. In the last decade, a number of MBIs specifically designed to treat addictive behaviors have been developed and tested. This review first provides a brief overview of the current state of the science with respect to the efficacy of MBIs for addictive behaviors, and some of the proposed mechanisms underlying the efficacy of MBIs. Second, the review highlights unresolved implementation issues and provides suggestions for how future research can address the implementation challenges in order to advance the delivery of MBIs. Specifically, this review focuses on the lack of clear empirical guidelines in the following areas: 1) effective training for MBI treatment providers; 2) adaptations of the traditional two-hour closed-cohort group format; 3) delivery of MBIs in one-on-one treatment contexts; 4) delivery of MBIs at different points in the change process; 5) delivery of MBIs via technology-based platforms; and 6) facilitation of precision medicine in the delivery of MBIs. Specific research directions are suggested with an eye towards a meaningful increase in access to MBIs for front-line clinicians and clients.

Results from this initial pilot trial support feasibility and acceptability, and provide preliminary data on outcomes for future trials of mindfulness-based approaches within the MMT community.

No abstract

Following what was considered a routine realignment of liquid product lines and tankage at a storage and transfer facility, an incident occurred that resulted in significant movement of a 20-inch pipeline, causing a large section of it to fall from its supports. The event also resulted in the failure of a gasket at a valve flange and loss of containment. The alignment activities and pump startup were investigated for the potential to generate a hydraulic transient capable of generating sufficient force to cause the movement. A transient hydraulic model of the fluid in the piping as it was aligned at the time of the event was generated to assist in determining the cause and to help prevent a similar occurrence in the future. Several scenarios were modeled and are discussed in this paper: 1) pump shutdown from steady flow, 2) pump start up with the discharge valve open, 3) pump startup with the discharge valve closed, and 4) pump start up with a vapor cavity present near a closed valve at the high point in the line. Pipe stress and finite element analysis were used to assess the displaced pipe and to determine if it could be placed back into service. The piping stress analysis indicated that the highest stress in the piping was below the yield stress of the material. Results from a detailed finite element analysis with material nonlinearity confirmed that there was no global plastic strain in the piping due to the event. This left a potential for local plastic strain due to the impact of the pipe against any hard surfaces, and this was addressed with visual examination. In the end, the pipe was lifted back onto the supports, lateral restraints were added at pipe support locations, and procedural changes were implemented to reduce the likelihood of future events.