WorldWideScience

Sample records for dependency treatment programs

  1. A multicultural approach to HIV prevention within a residential chemical dependency treatment program: the Positive Steps Program.

    Science.gov (United States)

    Harris, Elizabeth; Kiekel, Preston; Brown, Kim; Sarmiento, Ana; Byock, Gayle

    2010-01-01

    Positive Steps is a six month residential program in southeastern Los Angeles County. The program seeks to assist residents in recovery from chemical dependency and to prevent sexual and other risk factors which promote HIV transmission. Positive Steps serves a multicultural population of women and transgender male to female. Program participants are allowed to bring up to two children with them in residence. Motivational interviewing serves as the foundation for chemical dependency treatment and HIV transmission risk reduction. Positive Steps also provides intensive group education. Individual counseling with a licensed mental health professional is provided for HIV Positive residents. External evaluation of the program involves a comprehensive assessment at baseline, six months post-baseline, and follow up. Program outcomes include statistically significant reductions in substance use, sexual risk behaviors, and symptoms of mental distress.

  2. A multidimensional education program at substance dependence treatment centers improves patient knowledge and hepatitis C care.

    Science.gov (United States)

    Marinho, Rui Tato; Costa, António; Pires, Teodomiro; Raposo, Helena; Vasconcelos, Carlos; Polónia, Cristina; Borges, Joaquim; Soares, Mariana; Vilar, Graça; Nogueira, Ana Maria

    2016-10-12

    HCV treatment among people who inject drugs (PWID) is low. Education programs may be suitable strategies to improve patients' knowledge about their condition and to overcome barriers to access treatment. The Health Educational Program (HEP) consisted of patient workshops and educational videos and leaflets, and healthcare professionals' workshops. HEP was implemented at seven substance dependence treatment centers (STDC) in Portugal. The study comprised two cross-sectional evaluations conducted before and after HEP. At both evaluations, adult patients with confirmed HCV diagnosis and registered in the STDC were consecutively included. For patients that completed both evaluations, the overall knowledge score were calculated and compared with McNemar test. Linear regression modelling was used to evaluate factors associated with baseline knowledge. Rates of referral and attendance to referral specialist, treatment proposal, initiation and retention at both evaluations were also compared with McNemar test. Overall, 504 patients with chronic hepatitis C were included: 78 % male, mean age 42.3 ± 6.6 years, 14 % school education ≤ 4 years, disease duration 11.0 ± 6.0 years and 26 % HIV co-infected. A higher baseline knowledge was independently associated with educational level ≥ 10 years (regression coefficient [B] =15.13, p C, even among patients with a high baseline knowledge. The HEP has also increased the rate of referral to the liver specialist and showed a great potential to support healthcare professionals in managing HCV. Education programs may promote treatment access among PWID, a population that represents the majority of HCV infected patients.

  3. [Personality changes in opioid-dependent subjects in a methadone maintenance treatment program].

    Science.gov (United States)

    Trémeau, F; Darreye, A; Leroy, B; Renckly, V; Ertlé, S; Weibel, H; Khidichian, F; Macher, J-P

    2003-01-01

    Personality disorders and particularly antisocial personality disorders (APD) are quite frequent in opioid-dependent subjects. They show various personality traits: high neuroticism, high impulsivity, higher extraversion than the general population. Previous studies have reported that some but not all personality traits improved with treatment. In a previous study, we found a low rate of APD in a French population of opioid-dependent subjects. For this reason, we evaluated personality traits at intake and during maintenance treatment with methadone. Methods - The form A of the Eysenck Personality Inventory (EPI) was given to opioid addicts at intake and after 6 and 12 months of methadone treatment. Results - 134 subjects (96 males and 38 females) took the test at intake, 60 completed 12 months of treatment. After 12 months, the EPI Neuroticism (N) and the Extraversion-introversion (E) scale scores decreased significantly. The N score improved in the first 6 months, while the E score improved only during the second 6 months of treatment. Compared to a reference group of French normal controls, male and female opioid addicts showed high N and E scores. Demographic data and EPI scores of patients who stayed in treatment for 12 months did not differ significantly from those of dropouts (n=23). Patients with a history of suicide attempts (SA) started to use heroin at an earlier age and they showed a higher E score and a tendency for a higher N score at intake. Discussion - The two personality dimensions of the EPI changed during MMT, and the N score converged towards the score of normal controls. Opioid addicts differ from normal controls mostly in their N score. The EPI did not help to differentiate 12-month completers from dropouts. Higher E scores in patients with an SA history might reflect a higher impulsivity, which has been linked to suicidality in other patient groups.

  4. Comorbid psychiatric diagnoses among individuals presenting to an addiction treatment program for alcohol dependence.

    LENUS (Irish Health Repository)

    Lyne, John Paul

    2011-01-01

    A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.

  5. Is an "ideal" service institution image the same for all referral sources? The case of chemical dependency treatment programs.

    Science.gov (United States)

    Johnson, K; LaTour, M S

    1993-01-01

    In a competitive market like chemical dependency treatment, segmenting the professional referral market according to an "ideal" service image may offer a service institution a strategic advantage. Results of this study suggest that while different professionals in a referral market may attach differential importance to the same service feature, a favorable or unfavorable "image" seems to encompass how well both the professional and the professionals' client are treated by the service institution.

  6. Impulsivity and voucher versus money preference in polydrug-dependent participants enrolled in a contingency-management-based substance abuse treatment program.

    Science.gov (United States)

    Reilly, M P; Roll, J M; Downey, K K

    2000-10-01

    Thirty-four polydrug-dependent participants enrolled in a voucher-based substance abuse treatment program were given choices between hypothetical amounts of money and hypothetical amounts of vouchers, which are traded for goods and services, to determine their preferences for the two payment modalities. It was hypothesized that the majority of participants would prefer money to voucher because under the circumstances of the treatment program, the delay associated with money exchange is shorter than the delay associated with voucher exchange. It was further hypothesized that those participants who selected money over voucher also would have greater levels of impulsivity as assessed by the Barratt Impulsiveness Rating Scale (BIS) (Barratt, 1965). The results show large individual differences in money/voucher preference with approximately half of the participants preferring money to voucher when the two amounts are equivalent. In addition, as the magnitude of the money/voucher comparisons increased from 0.50 dollars to 32.00 dollars, the percentage of participants that preferred money increased. No correlations were found between money/voucher preference and impulsivity scores.

  7. Fault Localization for Java Programs using Probabilistic Program Dependence Graph

    CERN Document Server

    Askarunisa, A; Babu, B Giri

    2012-01-01

    Fault localization is a process to find the location of faults. It determines the root cause of the failure. It identifies the causes of abnormal behaviour of a faulty program. It identifies exactly where the bugs are. Existing fault localization techniques are Slice based technique, Program- Spectrum based Technique, Statistics Based Technique, Program State Based Technique, Machine learning based Technique and Similarity Based Technique. In the proposed method Model Based Fault Localization Technique is used, which is called Probabilistic Program Dependence Graph . Probabilistic Program Dependence Graph (PPDG) is an innovative model that scans the internal behaviour of the project. PPDG construction is enhanced by Program Dependence Graph (PDG). PDG is achieved by the Control Flow Graph (CFG). The PPDG construction augments the structural dependences represented by a program dependence graph with estimates of statistical dependences between node states, which are computed from the test set. The PPDG is base...

  8. Pharmacological treatments for tobacco dependence

    Directory of Open Access Journals (Sweden)

    K. O. Fagerström

    2008-12-01

    development for the treatment of tobacco dependence are cannabinoid antagonists, immunotherapy against nicotine, monoaminooxidase inhibitors, dopamine receptor D3 receptor antagonists and partial agonists, glutamatergic and GABA-ergic compounds and novel selective nicotine cholinergic receptor agonists and antagonists.

  9. Maintainence treatment of opioid dependence with tramadol

    OpenAIRE

    Siddharth Sarkar; Mohit Varshney; Vaibhav Patil; Rakesh Lal

    2017-01-01

    Background: Although tramadol has been used in the management of acute withdrawal in patients with opioid dependence, its use for maintenance treatment as a harm reduction approach has not been assessed systematically. This case series describes patients with opioid dependence who were treated with tramadol for long-term maintenance. Methods: Patients with opioid dependence who received treatment at the National Drug Dependence Treatment Centre of All India Institute of Medical Sciences, New ...

  10. Treatment seeking in cannabis dependence: The role of social cognition.

    Science.gov (United States)

    Papinczak, Zoe E; Connor, Jason P; Feeney, Gerald F X; Young, Ross McD; Gullo, Matthew J

    2017-01-01

    Relatively few cannabis dependent individuals seek treatment and little is known about the determinants of treatment seeking. Social Cognitive Theory (SCT) provides a useful framework for examining human behaviour and motivation which may be helpful in explaining treatment seeking. This study examined the differences in cannabis outcome expectancies and cannabis refusal self-efficacy between treatment seekers and non-treatment seekers with cannabis dependence. Non-treatment seekers were referred to an illicit drug diversion program. Treatment seekers commenced an outpatient cannabis treatment program and completed a comprehensive assessment that included measures of cannabis outcome expectancies and refusal self-efficacy. A public hospital alcohol and drug outpatient clinic. 269 non-treatment seekers and 195 individuals commencing cannabis dependence treatment. The Cannabis Expectancy Questionnaire (CEQ), Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), Severity of Dependence Scale - Cannabis (SDS-C), General Health Questionnaire (GHQ-28) and Readiness to Change Questionnaire (RTC) were completed. Treatment seekers had significantly higher levels of negative cannabis outcome expectancies and significantly lower levels of emotional relief refusal self-efficacy (belief in ability to resist using cannabis when experiencing negative affect) (pspsychological distress and self-perceived cannabis dependence compared to non-treatment seekers (pscannabis outcome expectancies and low emotional relief refusal self-efficacy may play a key role in motivation to seek treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Varenicline in the treatment of tobacco dependence

    Directory of Open Access Journals (Sweden)

    Karl Fagerström

    2008-04-01

    Full Text Available Karl Fagerström1, John Hughes21Smokers Information Centre, Fagerström Consulting AB, Berga Alle 1, 25452 Helsingborg, Sweden; 2University of Vermont, Burlington, Vermont, USAAbstract: Varenicline, a partial agonist of α4β2 nicotinic acetylcholine receptors, is the most recently approved drug for smoking cessation. This paper reviews the outcomes of Phase 2 and Phase 3 clinical trials that assess the efficacy of varenicline in comparison to placebo and other smoking cessation pharmacotherapies, ie, sustained-release bupropion (bupropion SR and nicotine transdermal patch. Varenicline has higher abstinence rates than placebo and the alternative active treatments at the end of standard regimen treatment periods. Significantly higher abstinence rates were also found with varenicline in comparison to both placebo and bupropion SR at the end of a 40-week non-treatment follow-up period. Varenicline typically tripled the abstinence rates compared with placebo. In addition, varenicline reduced craving and withdrawal symptoms as well as some of the positive experiences associated with smoking to a greater extent than placebo, bupropion SR, and nicotine replacement therapy (NRT. These findings are consistent with the proposed agonist/antagonist effects of varenicline. Preliminary studies assessing individual variables such as smoking dependency level and smoking reinforcement types provide justification to examine further the effects of varenicline according to these individual factors. Outcomes from such research could improve our understanding of varenicline’s mechanism of action and could ultimately help clinicians to develop individualized smoking cessation programs. Also, given varenicline’s ability to reduce the reward from smoking, it might be helpful to use it before cessation to motivate or prepare smokers for a quit attempt.Keywords: varenicline, smoking cessation, nicotinic partial agonist

  12. Global Bridges: building an international network for tobacco dependence treatment

    Directory of Open Access Journals (Sweden)

    Katie Kemper

    2016-03-01

    Full Text Available Global Bridges, hosted at Mayo Clinic, is the most diverse international network of healthcare professionals dedicated to tobacco dependence treatment. Global Bridges works with grantees and partners in all six WHO regions to educate healthcare providers on evidence-based treatment and advocate for effective tobacco policy. This session will describe accomplishments and lessons learned in the Global Bridges program over nearly six years, and opportunities to better integrate cessation support into comprehensive tobacco control.

  13. Maintainence Treatment of Opioid Dependence with Tramadol.

    Science.gov (United States)

    Sarkar, Siddharth; Varshney, Mohit; Patil, Vaibhav; Lal, Rakesh

    2017-08-01

    Although tramadol has been used in the management of acute withdrawal in patients with opioid dependence, its use for maintenance treatment as a harm reduction approach has not been assessed systematically. This case series describes patients with opioid dependence who were treated with tramadol for long-term maintenance. Patients with opioid dependence who received treatment at the National Drug Dependence Treatment Centre of All India Institute of Medical Sciences, New Delhi, were included in the study. Patients who received at least 6 months of tramadol and had follow-up adherence of more than 80% were included in the case series. A total of 25 cases were included, all of whom were males. The types of opioids being taken at the time of initiation of tramadol were natural opiates (poppy husk and raw opium), followed by heroin. The median dose of tramadol at initiation and maintenance was 300 mg/day. Nineteen patients were able to achieve complete abstinence to other opiates on tramadol. Tramadol may be an effective option in the long-term management of patients with opioid dependence. Further studies are required for establishing the efficacy of tramadol for agonist management of patients with opioid dependence.

  14. Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.

    Directory of Open Access Journals (Sweden)

    Kenneth Blum

    Full Text Available This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; P<.001 had every treatment medication found in both first and last urine specimens (compliance. In addition, 39.2% of the patients (n = 1143; P<.001 had no substance of abuse detected in either the first or last urine samples (abstinence. Moreover, in 2010, 16.9% of the patients (n = 57 were abstinent at first but not at last urine (deteriorating abstinence, the percentage dropped to 13.3% (n = 174 in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511 representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8 of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16 was found. Being cognizant of the trend toward drug urine testing being linked

  15. Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.

    Science.gov (United States)

    Blum, Kenneth; Han, David; Femino, John; Smith, David E; Saunders, Scott; Simpatico, Thomas; Schoenthaler, Stephen J; Oscar-Berman, Marlene; Gold, Mark S

    2014-01-01

    This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD) data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens) were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; P<.001) had every treatment medication found in both first and last urine specimens (compliance). In addition, 39.2% of the patients (n = 1143; P<.001) had no substance of abuse detected in either the first or last urine samples (abstinence). Moreover, in 2010, 16.9% of the patients (n = 57) were abstinent at first but not at last urine (deteriorating abstinence), the percentage dropped to 13.3% (n = 174) in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511) representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8) of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16) was found. Being cognizant of the trend toward drug urine testing being linked to

  16. Experiences with an outpatient relapse program (CRA) combined with naltrexone in the treatment of opioid dependence: effect on addictive behaviours and the predictive value of psychiatric comorbidity.

    NARCIS (Netherlands)

    Roozen, H.G.; Kerkhof, A.J.F.M.; Brink, van den W.

    2003-01-01

    Background: There is increasing interest in naltrexone, an opiate antagonist, in the treatment of opiate addicts. The effects of naltrexone are often compromised by a lack of compliance and drop-out. The effects of this compound are probably more favorable when combined with a psychosocial intervent

  17. [Benzodiazepine dependence: causalities and treatment options].

    Science.gov (United States)

    Heberlein, A; Bleich, S; Kornhuber, J; Hillemacher, T

    2009-01-01

    Benzodiazepines are very often prescribed because of their anxiolytic, sedative and hypnotic properties. However, long term treatment is associated with development of benzodiazepine dependence. Besides development of physical dependence, which is linked to a typical benzodiazepine withdrawal syndrome when drug intake is discontinued, also behavioural addiction to benzodiazepines has been described. Benzodiazepines are known to enhance GABAergic neurotransmission. Counter regulation of enhanced GABAergic neurotransmission by enhancement of glutamatergic neurotransmission is thought to be one reason underlying the typical symptoms of benzodiazepine withdrawal. Also alterations in the expression of neuropeptides like Corticotropin Releasing Hormone and Neuropeptide Y are thought to be involved in the development of benzodiazepine dependence. However, until today the knowledge of neural mechanisms underlying the development of benzodiazepine dependence remains incomplete. Because even long term treatment with small doses of benzodiazepines is associated with adverse reactions like cognitive dysfunctions withdrawal from benzodiazepines should be aimed. Anticonvulsants and antidepressants seem to reduce the intensity of benzodiazepine withdrawal and to enhance long term prognosis of dependence.

  18. Long term substitution treatment (maintenance treatment of opioid dependent persons

    Directory of Open Access Journals (Sweden)

    Wirl, Charlotte

    2007-03-01

    Full Text Available Health political background: Methadone substitution treatment in Germany is introduced in 1988 in the framework of a scientific pilot study in North Rhein Westphalia. Recent statistics show that by now a broad offer of substitution treatment exists. From 1 June 2002 to 31 December 2003 113,000 substitution treatments have been recorded as being started of which around 56,000 have been recorded as ongoing treatments by 1 December 2003. Scientific background: Substitution treatment (treatment of opioid-dependent persons using substitution substances is one part of addiction treatment. Its goals are harm reduction and the stabilisation of opioid dependent persons. Integration of opioid-dependent persons in a treatment-setting, reduction of consumption of psychoactive substances, reduction of risk behaviour (primarily related to infectious diseases, decrease of mortality and improvements concerning the social, psychic and physic situation are seen as a success of substitution treatment as maintenance therapy. Research questions: The aim of this HTA report is to investigate which indicators can be used to evaluate the effectiveness of substitution treatment. Based on these indicators an evaluation of the medical, social and economical benefit of substitution treatment - also in relation to abstinence oriented treatment - is carried out. Methods: A systematic literature search was performed in 31 international databases which yielded 2451 articles with publication date between 1995 and February 2005. Results: After a twofold selection process 32 publications were included for assessment and 276 publications were used as background literature. Despite serious restrictions due to selection bias and dropout in most studies focusing on substitution treatment, reduction of consumption of illegal opioids, reduction of risk behaviour, criminal behaviour, mortality and incidence of HIV can be seen as an empirically proven success of substitution treatment

  19. Social cognitive predictors of treatment outcome in cannabis dependence.

    Science.gov (United States)

    Gullo, Matthew J; Matveeva, Marya; Feeney, Gerald F X; Young, Ross McD; Connor, Jason P

    2017-01-01

    Drug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence. Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested. A university hospital alcohol and drug outpatient clinic. 221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence. Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session. Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p=0.004), more days of use (pcannabis expectancies predicted greater likelihood of abstinence (p=0.024). Higher positive expectancies were associated with lower emotional relief self-efficacy, mediating its association with outcome (pcannabis dependence. Positive expectancies may indirectly predict poorer outcome because of a negative association with self-efficacy, but this conclusion remains tentative as directionality could not be established. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Opioid dependence treatment, including buprenorphine/naloxone.

    Science.gov (United States)

    Raisch, Dennis W; Fye, Carol L; Boardman, Kathy D; Sather, Mike R

    2002-02-01

    To review opioid dependence (OD) and its treatment. Pharmacologic treatments, including the use of buprenorphine/naloxone, are presented. Pharmaceutical care functions for outpatient OD treatment are discussed. Primary and review articles were identified by MEDLINE and HEALTHSTAR searches (from 1966 to November 2000) and through secondary sources. Tertiary sources were also reviewed regarding general concepts of OD and its treatment. Relevant articles were reviewed after identification from published abstracts. Articles were selected based on the objectives for this article. Studies of the treatment of OD with buprenorphine were selected based on the topic (pharmacology, pharmacokinetics, adverse reactions) and study design (randomized, controlled clinical trials in patients with OD with active/placebo comparisons and/or comparisons of active OD treatments). Articles regarding pharmacists' activities in the treatment and prevention of OD were reviewed for the pharmaceutical care section. OD is considered a medical disorder with costly adverse health outcomes. Although methadone maintenance treatment (MMT) is cost-effective for OD, only about 12% of individuals with OD receive this treatment. Psychological and pharmacologic modalities are used to treat OD, but patients often relapse. Drug therapy includes alpha 2-agonists for withdrawal symptoms, detoxification regimens with or without opioids, opioid antagonists, and opioid replacement including methadone, levomethadyl acetate, and buprenorphine. The Drug Addiction Treatment Act of 1999 allows for office-based opioid replacement therapies. Sublingual buprenorphine with naloxone can be used in this milieu. Buprenorphine with naloxone is currently under new drug application review with the Food and Drug Administration. Clinical research shows buprenorphine to be equal in effectiveness to methadone, but safer in overdose due to its ceiling effect on respiratory depression. It has lower abuse potential and fewer

  1. 40 CFR 264.271 - Treatment program.

    Science.gov (United States)

    2010-07-01

    ...) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land... land treatment program that is designed to ensure that hazardous constituents placed in or on the... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Treatment program. 264.271 Section 264...

  2. Do students' programming skills depend on programming language?

    Science.gov (United States)

    Savić, Miloš; Ivanović, Mirjana; Budimac, Zoran; Radovanović, Miloš

    2016-06-01

    Bachelor studies in Computer Science at our department in the last decades cover several successive core courses in programming: Introduction to Programming, Data Structures and Algorithms 1 and 2, Operating Systems and Compiler Construction. For a long time our intention was not to insist on the realization of subjects in a specific programming language, but to put emphasis on abstract reasoning and appropriate data structures and algorithms. Also, to avoid teaching different languages and programming environments, we decided to use one good educational language - Modula-2. In the last several years we were under different kinds of pressure to change the language. Starting from the last school-year we decided to adopt Java within the introductory programming course, using the imperative approach first. Some comparisons of students' advancements and success between Modula-2 and Java generations are presented in the paper. The results of the analytical evaluation indicate that the choice of the first programming language does not have a deep influence to students' success at the course.

  3. Role of Mecp2 in Experience-Dependent Epigenetic Programming

    Directory of Open Access Journals (Sweden)

    Christoph A. Zimmermann

    2015-03-01

    Full Text Available Mutations in the X-linked gene MECP2, the founding member of a family of proteins recognizing and binding to methylated DNA, are the genetic cause of a devastating neurodevelopmental disorder in humans, called Rett syndrome. Available evidence suggests that MECP2 protein has a critical role in activity-dependent neuronal plasticity and transcription during brain development. Moreover, recent studies in mice show that various posttranslational modifications, notably phosphorylation, regulate Mecp2’s functions in learning and memory, drug addiction, depression-like behavior, and the response to antidepressant treatment. The hypothalamic-pituitary-adrenal (HPA axis drives the stress response and its deregulation increases the risk for a variety of mental disorders. Early-life stress (ELS typically results in sustained HPA-axis deregulation and is a major risk factor for stress related diseases, in particular major depression. Interestingly, Mecp2 protein has been shown to contribute to ELS-dependent epigenetic programming of Crh, Avp, and Pomc, all of these genes enhance HPA-axis activity. Hereby ELS regulates Mecp2 phosphorylation, DNA binding, and transcriptional activities in a tissue-specific and temporospatial manner. Overall, these findings suggest MECP2 proteins are so far underestimated and have a more dynamic role in the mediation of the gene-environment dialog and epigenetic programming of the neuroendocrine stress system in health and disease.

  4. State of the art treatments for cannabis dependence.

    Science.gov (United States)

    Danovitch, Itai; Gorelick, David A

    2012-06-01

    The treatment of cannabis dependence can be viewed as a cup half empty or half full. On the one hand, few people who might benefit from treatment actually receive it. Among those who undergo treatment in randomized trials, long-term abstinence is achieved by fewer than 20%. Moderate use goals have been associated with decreases in consequences, but the differential impact of such goals on the long-term course of cannabis dependence is unknown. Optimal duration of treatment is unclear, and certain populations, particularly patients with co-occurring disorders, have not been studied adequately. Twelve-step programs are low cost, effective for other substance use disorders, and readily available in most regions of the world. However, their role and efficacy in cannabis dependence has not been examined. Finally, effective pharmacologic treatments are under development, but none have yet been firmly established. On the other hand, psychotherapeutic strategies used to treat other substance use disorders can be effective for cannabis dependence. A recent meta-analysis of psychosocial interventions for illicit substance use disorders found that treatments for cannabis dependence had comparatively larger effect sizes than treatments for other substance use disorders. Combination therapies have proven most effective, particularly those that begin with a motivational intervention, utilize incentives to enhance the commitment to change, and teach behavioral and cognitive copings skills to prevent relapse. Among adolescents, family engagement and collaboration with community stakeholders adds substantial value. Although only 9% of cannabis users develop cannabis dependence, the volume of people who smoke cannabis ensures that the total number of people in need of help is larger than the capacity of substance abuse specialty services. Thus, although efforts to refine and improve the efficacy of treatment interventions continue, innovations that increase the availability and

  5. [Vitamin D dependency and its treatment].

    Science.gov (United States)

    Kitanaka, Sachiko

    2016-02-01

    Vitamin D dependency is classified to vitamin D-dependent rickets type 1 which shows defective 1,25(OH)(2)D production, and vitamin D-dependent rickets type 2 which shows end-organ unresponsiveness to 1,25(OH)(2)D. Recent advance in the molecular analysis of these diseases revealed variety in the presentation and in the inheritance patterns. Molecular diagnosis would be preferable for adequate therapy especially in type 2.

  6. Expansion of China's free antiretroviral treatment program

    Institute of Scientific and Technical Information of China (English)

    ZHAO De-cai; ZHANG Fu-jie; WEN Yi; MA Ye; ZHAO Yan; ZHANG Yao; WU Ya-song; LIU Xia; Elizabeth Au; LIU Zhong-fu

    2012-01-01

    Background In 2003,China's National Free Antiretroviral Treatment Program (NFATP) was initiated as a pilot,which covered only 100 HIV/AIDS patients.By 2011,the pilot had evolved into a nationwide program and had provided free treatment for over 150 000 patients.The objective of this study was to report and evaluate the progress of China's free antiretroviral treatment program.Methods The NFATP Database was systematically reviewed and a total of 150 692 HIV/AIDS patients were included in this study.Program progress indicators including the number of treated HIV/AIDS patients,follow-up visit rate,CD4 test rate,and viral load test rate were summarized and examined over a calendar year to evaluate the progress of NFATP quantitatively and qualitatively.Results By the end of 2011,a total of 150 692 HIV/AIDS patients had been treated through the NFATP and 122 613 of them were still on treatment.Of all patients,about 72% were enrolled during the past four years.The dominant transmission route was blood related in the early phase of the NFATP,but gradually changed to sexual contact.Besides quantitative improvements,progress indicators also demonstrated significant qualitative improvements that the program had made during the past 9 years.Conclusions Great achievement has been made by China's NFATP.China's experience indicates the importance of a comprehensive response to the success of its treatment program.However,to ensure the quality and sustainability of treatment in the long term,more attention and resources should be paid towards program management.Chin Med J 2012; 125(19):3514-3521

  7. Program and staff characteristics in successful treatment.

    Science.gov (United States)

    Brown, E R

    1992-01-01

    Women come to drug treatment with lower self-esteem (Regan et al. 1984), more social isolation, and more difficult life situations than men. Women are more likely to present with mental health comorbidity such as depression (Regan et al. 1982). Treatment programs modeled on outcome research on male patients may not yield strategies that are successful with women. Only in the past decade has research been undertaken into the specific population characteristics of women in drug treatment. Programs must be designed with a clear understanding of women's psychological makeup and particular life stress, including the need to care for their children and the reality of physical and sexual abuse. Drug treatment often unmasks a variety of psychosocial problems that, if not adequately addressed by the drug treatment program, may result in relapse into drug use. Many women live in poverty and are inadequately educated, two factors that can interfere with reintegration of the recovered addict into the community. Thus, the drug treatment program, to provide successful long-term outcomes with respect to drug use, must provide long-term aftercare that includes attention to the variety of social, medical, and emotional problems faced by women who use drugs.

  8. Pharmacotherapeutic Treatment of Alcohol Dependence: An Overview

    Science.gov (United States)

    Graves, Erin; Goodwin, Lloyd R., Jr.

    2008-01-01

    Pharmacotherapy medications can reduce the likelihood of relapse, decrease craving intensity and severity of withdrawal symptoms, and bolster the likelihood of achieving and maintaining recovery goals for many individuals seeking recovery from alcohol dependence. An overview of the benefits and concerns of integrating pharmacotherapeutic…

  9. Positive Education Program's Day Treatment Centers

    Science.gov (United States)

    Fecser, Frank A.

    2003-01-01

    The Positive Education Program in Cleveland, Ohio, is grounded in the Re-EDucation philosophy and serves more than 700 students with emotional and behavioral disorders in eight day treatment centers. The centers blend special education with mental health in a school environment in which students and families are both supported and challenged as…

  10. Suicidal behaviour among alcohol-dependent Danes attending outpatient treatment

    DEFF Research Database (Denmark)

    Bjørk Petersen, Christina; Grønbæk, Morten; Bussey Rask, Marie;

    2009-01-01

    . Characteristics of, predictors for and outcome among suicidal patients were studied. Alcohol-dependent patients with a history of suicide attempts were found to constitute a highly selected group in alcohol abuse treatment as they often had a more severe course of alcohol dependence, were unemployed, younger......, were more often lowly educated, and had more physical and psychiatric problems. Traumatic childhood experience related to physical or sexual abuse was found as a major predictor for suicidal behaviour among alcohol-dependent patients. We found no significant difference in the effect of treatment...... that suicidal patients in treatment for alcohol abuse are treated effectively within the present treatment settings....

  11. Characterization of Individuals Seeking Treatment for Caffeine Dependence

    OpenAIRE

    Juliano, Laura M.; Evatt, Daniel P.; Richards, Brian D.; Griffiths, Roland R.

    2012-01-01

    Previous investigations have identified individuals who meet criteria for DSM-IV-TR substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-t...

  12. A rationale and model for addressing tobacco dependence in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Richter Kimber P

    2006-08-01

    Full Text Available Abstract Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.

  13. Issues in chemical dependency treatment and aftercare for people with learning differences.

    Science.gov (United States)

    Campbell, J A; Essex, E L; Held, G

    1994-02-01

    Without major adaptations, current substance abuse treatment models may not be productive for people with learning differences. The study described in this article examined ways to create accessibility to generic chemical dependency treatment for people with learning differences. A key informant survey of chemical dependency workers and developmental disabilities workers was conducted to determine the needs of chemical dependency treatment programs, staff, and people with learning differences in making treatment accessible. Training and information needs were identified, and responses were compared between the two groups of providers. Chemical dependency treatment staff need more information and training on differing learning and socialization skills, differences in reading comprehension, and personal prejudices or stereotypes. In-depth screening is also required to determine the appropriateness of integrated or specialized services or some combination of both.

  14. Fast and Cache-Oblivious Dynamic Programming with Local Dependencies

    DEFF Research Database (Denmark)

    Bille, Philip; Stöckel, Morten

    2012-01-01

    are widely used in bioinformatics to compare DNA and protein sequences. These problems can all be solved using essentially the same dynamic programming scheme over a two-dimensional matrix, where each entry depends locally on at most 3 neighboring entries. We present a simple, fast, and cache......-oblivious algorithm for this type of local dynamic programming suitable for comparing large-scale strings. Our algorithm outperforms the previous state-of-the-art solutions. Surprisingly, our new simple algorithm is competitive with a complicated, optimized, and tuned implementation of the best cache-aware algorithm...

  15. Fast and Cache-Oblivious Dynamic Programming with Local Dependencies

    DEFF Research Database (Denmark)

    Bille, Philip; Stöckel, Morten

    2012-01-01

    are widely used in bioinformatics to compare DNA and protein sequences. These problems can all be solved using essentially the same dynamic programming scheme over a two-dimensional matrix, where each entry depends locally on at most 3 neighboring entries. We present a simple, fast, and cache......-oblivious algorithm for this type of local dynamic programming suitable for comparing large-scale strings. Our algorithm outperforms the previous state-of-the-art solutions. Surprisingly, our new simple algorithm is competitive with a complicated, optimized, and tuned implementation of the best cache-aware algorithm....... Additionally, our new algorithm generalizes the best known theoretical complexity trade-offs for the problem....

  16. THE LEVEL OF PUPILS KNOWLEDGE DEPENDING OF TEACHING PROGRAM

    Directory of Open Access Journals (Sweden)

    Maja Batez

    2011-09-01

    Full Text Available At the sample of 117 schoolgirls, 10 years old (+-6 monts, the experimental reserch had been applaid. The goal was to reserch the influence of two different teaching program to the level of pupils knowledge (motor skills. Differences of the level of knowledge were tested by multivariat analisis of variance, discrimniative analisis, as wel as the differences for every variable by univariat analisis of variance. It was concluded that there were the significant statistical difference in pupils knowledge depending of teaching program.

  17. Dependency and self-criticism in treatments for depression.

    Science.gov (United States)

    Chui, Harold; Zilcha-Mano, Sigal; Dinger, Ulrike; Barrett, Marna S; Barber, Jacques P

    2016-07-01

    Dependency and self-criticism are vulnerability factors for depression. How these personality factors change with treatment for depression and how they relate to symptom change across different types of treatment require further research. In addition, cultural differences that interact with the dependency/self-criticism-depression relation remain underinvestigated. We randomly assigned 149 adults with major depression to receive active medication (MED; n = 50), supportive-expressive therapy (SET; n = 49), or placebo pill (PBO; n = 50). Participants completed the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976) before and after treatment and completed the Hamilton Rating Scale for Depression (Hamilton, 1967) throughout the course of treatment. Self-criticism as measured on the DEQ decreased with treatment similarly across conditions. DEQ Dependency decreased in MED but remained unchanged in SET and PBO. Higher initial dependency, but not higher initial self-criticism, predicted poor treatment response across conditions. Greater reduction in self-criticism was associated with greater reduction in depressive symptoms, but the effect was weaker for racial minorities (vs. White). Increase in connectedness, an adaptive form of dependency, was associated with symptom improvement in SET but not MED. Hence, different pathways of change seem to be implicated in the treatment of depression depending on culture and type of intervention. Implications for future research are discussed. (PsycINFO Database Record

  18. Effects of Depression on Treatment Motivation in Male Alcohol Dependence

    Science.gov (United States)

    CENGİSİZ, Cengiz; DEVECİ, Artuner; YAPICI, Aslıhan

    2015-01-01

    Introduction Treatment motivation in alcohol dependents is usually viewed as a strong predictor of seeking treatment and treatment success. The conditions affecting motivation in alcohol dependence, however, has not been clarified. In this study, it is aimed to determine the effects of depression on treatment motivation in male alcohol dependence. Methods The present study included 34 male alcohol dependents presenting to outpatient clinics in Manisa Hospital of Mental Disorders and Hospital of Celal Bayar University. The patients underwent evaluation using the socio-demographic and clinical information form, DSM-IV SCID-I Clinical Version, Treatment Motivation Questionnaire (TMQ), and Hamilton Depression Rating Scale (HDRS). Results A significant relationship was found between the total score of TMQ and HDRS (p=.039). Conclusion We believe that the present study, in which we examined the relationship between treatment motivation in male alcohol dependence and depression, would provide a significant contribution to literature. It is also important to investigate other factors that may affect treatment motivation in male alcohol dependence. Studies with larger samples are needed on this topic.

  19. Retention in naltrexone implant treatment for opioid dependence.

    Science.gov (United States)

    Kunøe, Nikolaj; Lobmaier, Philipp; Vederhus, John Kåre; Hjerkinn, Bjørg; Hegstad, Solfrid; Gossop, Michael; Kristensen, Oistein; Waal, Helge

    2010-09-01

    Naltrexone's usefulness in the treatment of opioid dependence stems from its ability to block the action of heroin and other opioids. However, many patients are ambivalent towards naltrexone and often drop out of treatment with orally administered naltrexone. Sustained release naltrexone seems promising in reducing opioid use, but the extent to which patients remain in treatment beyond the first dosage of naltrexone is not clear. Patients (n=61) receving treatment with sustained release naltrexone implants were offered a second naltrexone implant after 6 months. Patients who remained in treatment were compared to those who did not, on drug use, mental health, and social problems before and during naltrexone implant treatment. Information was obtained on other treatments sought by patients who discontinued naltrexone. Blood samples were used to verify naltrexone release, and hair samples to confirm opioid intake. Of the patients who received the first naltrexone implant, 51% (n=31) remained in naltrexone implant treatment. Among those who discontinued treatment, 21% expressed a wish to reimplant but failed to attend for reimplantation and 28% declined reimplantation: 6 non-retained patients initiated maintenance or residential treatment. Remaining in naltrexone treatment was related to pre-study length of employment, illicit drug use, and concern for family problems. Higher levels of substance misuse and criminal activity during naltrexone treatment were negatively related to subsequent retention. Rates of retention among opioid-dependent patients receiving naltrexone implant treatment are encouraging and support this as a feasible long-term treatment option. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Dependable software through higher-order strategic programming.

    Energy Technology Data Exchange (ETDEWEB)

    Winter, Victor Lono (University of Nebraska at Omaha); Fraij, Fares (University of Texas at El Paso); Roach, Steve (University of Texas at El Paso)

    2004-03-01

    Program transformation is a restricted form of software construction that can be amenable to formal verification. When successful, the nature of the evidence provided by such a verification is considered strong and can constitute a major component of an argument that a high-consequence or safety-critical system meets its dependability requirements. This article explores the application of novel higher-order strategic programming techniques to the development of a portion of a class loader for a restricted implementation of the Java Virtual Machine (JVM). The implementation is called the SSP and is intended for use in high-consequence safety-critical embedded systems. Verification of the strategic program using ACL2 is also discussed.

  1. Pharmacogenomics of alcohol addiction: Personalizing pharmacologic treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Ragia Georgia

    2014-01-01

    Full Text Available Alcohol dependence is a serious psychiatric disorder with harmful physical, mental and social consequences, and a high probability of a chronic relapsing course. The field of pharmacologic treatment of alcohol dependence and craving is expanding rapidly; the drugs that have been found to reduce relapse rates or drinking in alcohol-dependent patients and are approved for treatment of alcohol dependence are naltrexone, acamprosate and disulfiram, whereas also topiramate appears as a promising therapy. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that genetic variation is a significant contributor to interindividual variation of clinical presentation of alcohol problems and response to a given treatment. The aim of the present review is to summarize and discuss the findings on the association between gene polymorphisms and the response to alcohol dependence treatment medications. It is anticipated that future implementation of pharmacogenomics in clinical practice will help personalize alcohol dependence drug treatment, and development personalized hospital pharmacology.

  2. Abstinence Rates Following Behavioral Treatments for Marijuana Dependence

    OpenAIRE

    Kadden, Ronald M.; Litt, Mark D.; Kabela-Cormier, Elise; Petry, Nancy M.

    2006-01-01

    Previous studies have noted particular difficulty in achieving abstinence among those who are marijuana dependent. The present study employed a dismantling design to determine whether adding contingency management (ContM) to motivational enhancement therapy plus cognitive behavioral therapy (MET+CBT), an intervention used in prior studies of treatment for marijuana dependence, would enhance abstinence outcomes. 240 marijuana dependent participants were recruited via advertisements and assigne...

  3. [Effectiveness evaluation of the drug dependency outpatient program "STEM"].

    Science.gov (United States)

    Kondo, Ayumi; Satou, Yoshitaka; Matsumoto, Toshihiko

    2016-02-01

    A cognitive behavioral therapy program entitled "STEM" was implemented with 42 drug dependent outpatients at Okayama Psychiatric Medical Center. Characteristics of 1 group who completed the program were examined, with the effectiveness of the program evaluated through monitoring longitudinal changes over a period of 8.5 months. Results showed that the percentage of patients who completed the program was 52.4% (22 out of 42 people), those who completed had a longer educational history than the dropouts, a high proportion of those who completed held some form of employment and that their motivation to recover was high. Evaluation results of the program effectiveness showed significant improvement in short-term drug self-efficacy, with a tendency for later improvement in feelings and emotions also observed. While a certain level of effectiveness was proven, approximately half the group dropped out; so it is necessary to consider alternative options at an early stage for participants with a high risk of dropout, such as strengthening individual support based on their specific characteristics.

  4. Complexity of Data Dependence problems for Program Schemas with Concurrency

    CERN Document Server

    Danicic, Sebastian; Laurence, Michael R

    2010-01-01

    The problem of deciding whether one point in a program is data dependent upon another is fundamental to program analysis and has been widely studied. In this paper we consider this problem at the abstraction level of program schemas, in which computations occur in the Herbrand domain of terms and predicate symbols, which represent arbitrary predicate functions, are allowed. Given a vertex l in the flowchart of a schema S having only equality assignments and variables v,w, we show that it is PSPACE-hard to decide whether there exists an execution of a program defined by S in which v holds the initial value of w at at least one occurrence of l on the path of execution, with membership in PSPACE holding provided there is a constant upper bound on the arity of any predicate in S. We also consider the `dual' problem in which v is required to hold the initial value of w at every occurrence of l, for which the analogous results hold. Additionally, the former problem for programs with non-deterministic branching (in ...

  5. Implementation of a Smoking Cessation Treatment Study at Substance Abuse Rehabilitation Programs: Smoking Behavior and Treatment Feasibility Across Varied Community-based Outpatient Programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Nunes, Edward V; Lima, Jennifer; Jiang, Huiping; Tyson, Clare; Hiott, Robert; Arfken, Cynthia; Bohs, Rhonda; Orr, Deborah; Muir, Joan; Pihlgren, Eric; Loree, Amy; Fuller, Brett E; Giordano, Louis; Robinson, James; Rotrosen, John

    2007-09-01

    Cigarette smoking is widely prevalent among individuals in treatment for drug or alcohol dependence; however, the treatment of nicotine addiction in this population has numerous obstacles at both programmatic and patient levels. Despite these difficulties, recent studies have demonstrated moderate success in implementing smoking cessation treatment in drug rehabilitation programs. The National Drug Abuse Treatment Clinical Trials Network sponsored a smoking cessation study in 13 community-based outpatient substance abuse rehabilitation programs across the country. The study evaluated the effectiveness of smoking cessation treatment provided as an adjunct to substance abuse treatment-as-usual. This report summarizes the practical and clinical experiences encountered at each of the study sites with regard to implementing the smoking cessation treatment intervention. Smoking behavior of the treatment clientele was assessed by anonymous survey at each site. In addition, sites were systematically characterized by using program review and assessment tools completed by the respective staff and program directors at the site. Survey and recruitment data indicated that cigarette smoking is more prevalent and that smoking cessation treatment is more feasible, in methadone maintenance treatment programs. Other factors associated with smoking behavior and with the recruitment of drug- and alcohol-dependent individuals into the smoking cessation treatment study are described.

  6. [Relationship between cocaine dependence treatment and personal values of openness to change and conservation].

    Science.gov (United States)

    Galdós, Jesús Saiz; Sánchez, Isabel Martínez

    2010-01-01

    To analyze the relationship between participation in a drug addiction treatment program and Schwartz's values of Openness to change (Self-direction, Stimulation and Hedonism) and Conservation (Tradition, Conformity and Security) in cocaine users. The present quasi-experimental study was carried out on a sample of 411 adult cocaine users, grouped according to whether they had begun treatment more than three months earlier or less than three months earlier or they were not receiving any treatment. Using Schwartz's Personal Values Questionnaire (PVQ), we measured the priority given by each of these groups to the values of Conservation and Openness to change. Participants who had initiated the treatment more than three months earlier tended to score lower in the values of Openness to change than those who were not in treatment, though there were no significant differences in these values between those who were not in treatment and those who had been in treatment for less than three months. On the other hand, it was observed that participants in treatment, regardless of the time spent in treatment, scored higher in values of Conservation than the cocaine users who were not in treatment. These results reveal the relationship between attendance on a cocaine-dependence treatment program and personal values, together with their potential importance in treatment and rehabilitation programs for cocaine users.

  7. Characterization of Individuals Seeking Treatment for Caffeine Dependence

    Science.gov (United States)

    Juliano, Laura M.; Evatt, Daniel P.; Richards, Brian D.; Griffiths, Roland R.

    2013-01-01

    Previous investigations have identified individuals who meet criteria for DSM-IV-TR substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-to-face diagnostic clinical interview. They also completed measures concerning caffeine use and quitting history, reasons for seeking treatment, and standardized self-report measures of psychological functioning. Caffeine treatment seekers (mean age 41 yrs, 55% women) consumed an average of 548 mg caffeine per day. The primary source of caffeine was coffee for 50% of the sample and soft drinks for 37%. Eighty-eight percent reported prior serious attempts to modify caffeine use (mean 2.7 prior attempts) and 43% reported being advised by a medical professional to reduce or eliminate caffeine. Ninety-three percent met criteria for caffeine dependence when generic DSM-IV-TR substance dependence criteria were applied to caffeine use. The most commonly endorsed criteria were withdrawal (96%), persistent desire or unsuccessful efforts to control use (89%), and use despite knowledge of physical or psychological problems caused by caffeine (87%). The most common reasons for wanting to modify caffeine use were health-related (59%) and not wanting to be dependent on caffeine (35%). This investigation reveals that there are individuals with problematic caffeine use who are seeking treatment, and suggests that there is a need for effective caffeine dependence treatments. PMID:22369218

  8. Condition-dependent mate choice: A stochastic dynamic programming approach.

    Science.gov (United States)

    Frame, Alicia M; Mills, Alex F

    2014-09-01

    We study how changing female condition during the mating season and condition-dependent search costs impact female mate choice, and what strategies a female could employ in choosing mates to maximize her own fitness. We address this problem via a stochastic dynamic programming model of mate choice. In the model, a female encounters males sequentially and must choose whether to mate or continue searching. As the female searches, her own condition changes stochastically, and she incurs condition-dependent search costs. The female attempts to maximize the quality of the offspring, which is a function of the female's condition at mating and the quality of the male with whom she mates. The mating strategy that maximizes the female's net expected reward is a quality threshold. We compare the optimal policy with other well-known mate choice strategies, and we use simulations to examine how well the optimal policy fares under imperfect information.

  9. Retention in substance dependence treatment: the relevance of in-treatment factors

    NARCIS (Netherlands)

    Weert-van Oene, G.H. de; Schippers, G.M.; Jong, C.A.J. de; Schrijvers, A.J.P.

    2001-01-01

    In addition to “fixed” patient demographic and background variables, treatment process constructs play an important role in the prediction of treatment retention in substance dependence treatment. The objective of this paper is to analyze the predictive role of repeated measures of treatment readine

  10. Retention in substance dependence treatment: the relevance of in-treatment factors

    NARCIS (Netherlands)

    Weert-van Oene, G.H. de; Schippers, G.M.; Jong, C.A.J. de; Schrijvers, A.J.P.

    2001-01-01

    In addition to “fixed” patient demographic and background variables, treatment process constructs play an important role in the prediction of treatment retention in substance dependence treatment. The objective of this paper is to analyze the predictive role of repeated measures of treatment readine

  11. 42 CFR 8.11 - Opioid treatment program certification.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Opioid treatment program certification. 8.11... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.11 Opioid... Substances Act (21 U.S.C. 823(g)(1)) to dispense opioid drugs in the treatment of opioid addiction. An OTP...

  12. Dependent Types for Multi-Rate Flows in Synchronous Programming

    Directory of Open Access Journals (Sweden)

    William Blair

    2017-02-01

    Full Text Available Synchronous programming languages emerged in the 1980s as tools for implementing reactive systems, which interact with events from physical environments and often must do so under strict timing constraints. In this report, we encode inside ATS various real-time primitives in an experimental synchronous language called Prelude, where ATS is a statically typed language with an ML-like functional core that supports both dependent types (of DML-style and linear types. We show that the verification requirements imposed on these primitives can be formally expressed in terms of dependent types in ATS. Moreover, we modify the Prelude compiler to automatically generate ATS code from Prelude source. This modified compiler allows us to solely rely on typechecking in ATS to discharge proof obligations originating from the need to typecheck Prelude code. Whereas ATS is typically used as a general purpose programming language, we hereby demonstrate that it can also be conveniently used to support some forms of advanced static checking in languages equipped with less expressive types.

  13. Late Onset of Prescription Drug Abuse or Dependence Among Older Adults: Implications for Treatment

    Directory of Open Access Journals (Sweden)

    Kathy Lay

    2007-12-01

    Full Text Available Prescription drug abuse and dependence is an increasing concern for older adults. This article describes issues specific to older adults with late onset abuse or dependence on prescription sedatives and/or opiates.The older adult with late onset should not be viewed as having the same issues as individuals who have a life pat- tern of drug and alcohol abuse/dependence.A chart review of older adults in a treatment program contrasts late onset prescription dependence clients (n=12 and early onset addiction clients (n=104 and outlines differences and similarities between the two samples. Social workers need to understand the specific and changing needs of older adults as they relate to assessment and treatment of drug abuse and dependence.

  14. A control study on treatment for benzodiazepine dependence with trazodone

    Directory of Open Access Journals (Sweden)

    ZHANG Hong-ju

    2013-05-01

    Full Text Available Objective To determine the efficacy and safety of trazodone in the treatment of benzodiazepine dependence. Methods Forty insomnia patients who met the Classification and Diagnostic Criteria of Mental Disorders in China Third Edition (CCMD-3 of dependence syndrome due to benzodiazepine were involved in the study. Patients were randomly assigned to trazodone group and placebo group for 3 months. The efficacy were assessed by Withdrawal Symptoms Checklist, Hamilton Anxiety Rating Scale (HAMA and polysomnography (PSG. Adverse events were assessed by Treatment Emergent Symptom Scale (TESS. Results The Withdrawal Symptoms Checklist of trazodone group was significantly lower after 7 d treatment than that of placebo group (P = 0.000, and HAMA score of the trazodone group was also significantly lower after 15 d treatment than that of placebo group (P = 0.000. There were no difference in Withdrawal Symptoms Checklist and HAMA of placebo group before and after treatment. Withdrawal Symptoms Checklist and HAMA of the trazodone group were decreased after treatment (P = 0.000. In comparison with placebo group, sleep parameters of the trazodone, including total sleep time (TST, sleep efficiency (SE, sleep latency (SL and slow wave sleep (SWS time presented improvement after 7 d treatment (P = 0.000, for all. After trazodone treatment, total sleep time, slow wave sleep time, sleep efficiency and sleep latency were improved (P = 0.000, for all. No obvious adverse reaction occurred. There were no significant differences in TESS scores between pre? and post?treatment in both groups (P > 0.05. Conclusion Trazodone is markedly effective and safe in the treatment for benzodiazepine dependence.

  15. Drug Dependence Treatment Awareness among Japanese Female Stimulant Drug Offenders

    Directory of Open Access Journals (Sweden)

    Shinzo Yatsugi

    2016-11-01

    Full Text Available Few stimulant drug users receive adequate treatment. This cross-sectional study describes the characteristics of female drug offenders that use stimulants and clarifies the factors related to the awareness of treatment for drug dependencies. We included 80 females imprisoned due to stimulant control law violations from 2012 to 2015. The characteristics of the female prisoners were stratified according to various treatment awareness levels, and associations between each characteristic and treatment awareness were evaluated using logistic regression models. The average period of stimulant drug use was 17.7 years. Participants imprisoned for the second time were significantly more likely to consider treatment compared to those imprisoned only once: odds ratio (OR = 3.2 (95% confidence interval (CI: 1.0–10.7. This elevated OR was diluted in repeat offenders. Participants who had experienced multiple aftereffects (≥7 or serious depressive symptoms were also more likely to consider treatment: OR = 6.1 (95% CI: 1.8–20.8 and OR = 2.5 (95% CI: 1.0–6.2, respectively. Second-time stimulant offenders or offenders who had experienced health problems were more likely to consider it important to receive drug dependence treatment. To overcome relapses of stimulant use, it is recommended that stimulant use offenders are encouraged to accept adequate treatment.

  16. Substance use, education, employment, and criminal activity outcomes of adolescents in outpatient chemical dependency programs.

    Science.gov (United States)

    Balsa, Ana I; Homer, Jenny F; French, Michael T; Weisner, Constance M

    2009-01-01

    Although the primary outcome of interest in clinical evaluations of addiction treatment programs is usually abstinence, participation in these programs can have a wide range of consequences. This study evaluated the effects of treatment initiation on substance use, school attendance, employment, and involvement in criminal activity at 12 months post-admission for 419 adolescents (aged 12 to 18) enrolled in chemical dependency recovery programs in a large managed care health plan. Instrumental variables estimation methods were used to account for unobserved selection into treatment by jointly modeling the likelihood of participation in treatment and the odds of attaining a certain outcome or level of an outcome. Treatment initiation significantly increased the likelihood of attending school, promoted abstinence, and decreased the probability of adolescent employment, but it did not significantly affect participation in criminal activity at the 12-month follow-up. These findings highlight the need to address selection in a non-experimental study and demonstrate the importance of considering multiple outcomes when assessing the effectiveness of adolescent treatment.

  17. An investigation of scale effects in family substance abuse treatment programs

    Directory of Open Access Journals (Sweden)

    Lee A James

    2010-07-01

    Full Text Available Abstract This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families was too small to be economical. Although the sample size (just nine programs was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

  18. Type II (noninsulin-dependent) diabetes: new treatment options.

    Science.gov (United States)

    Bodzin, B J

    1997-01-01

    Type II diabetes (noninsulin-dependent diabetes mellitus [NIDDM]) is a common primary and secondary diagnosis in home care patients. This article describes the pathophysiology of NIDDM, the new drugs that have been released for treatment, and the nursing implications inherent in using these new medications.

  19. Treatment of adrenocorticotropin-dependent cushing's syndrome: A consensus statement

    NARCIS (Netherlands)

    B.M.K. Biller; A. Grossman (Ashley Barry); P.M. Stewart; S. Melmed (Shlomo); X. Bertagna; J. Bertherat (Jerome); M. Buchfelder; A. Colao (Annamaria); A.R. Hermus (Ad); L.J. Hofland (Leo); A. Klibanski; A. Lacroix; J.R. Lindsay; J. Newell-Price; L.K. Nieman; S. Petersenn; N. Sonino; G.K. Stalla (Günter); B. Swearingen; M.L. Vance; J.A.H. Wass (John); M. Boscaro

    2008-01-01

    textabstractObjective: Our objective was to evaluate the published literature and reach a consensus on the treatment of patients with ACTH-dependent Cushing's syndrome, because there is no recent consensus on the management of this rare disorder. Participants: Thirty-two leading endocrinologists,

  20. Treatment of adrenocorticotropin-dependent Cushing's syndrome: a consensus statement.

    NARCIS (Netherlands)

    Grossman, A.B.; Stewart, P.M.; Melmed, S.; Bertagna, X.; Bertherat, J.; Buchfelder, M.; Colao, A.; Hermus, A.R.M.M.; Hofland, L.J.; Klibanski, A.; Lacroix, A.; Lindsay, J.R.; Newell-Price, J.; Nieman, L.K.; Petersenn, S.; Sonino, N.; Stalla, G.K.; Swearingen, B.; Vance, M.L.; Wass, J.A.; Boscaro, M.

    2008-01-01

    OBJECTIVE: Our objective was to evaluate the published literature and reach a consensus on the treatment of patients with ACTH-dependent Cushing's syndrome, because there is no recent consensus on the management of this rare disorder. PARTICIPANTS: Thirty-two leading endocrinologists, clinicians,

  1. Nalmefene: a new approach to the treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Paille F

    2014-08-01

    Full Text Available François Paille, Hervé Martini Department of Addiction Treatment, University Hospital, Vandœuvre-lès-Nancy, France Abstract: Reduction of alcohol consumption is not yet a widely accepted treatment objective for alcohol-dependent patients, as abstinence is often considered to be the only possible objective in this situation. However, various studies have demonstrated the value of proposing these two options to such patients. Firstly, reduction of alcohol consumption very significantly reduces the risk of alcohol-related damage, and also modifies the patient's and the doctor's perception of the disease, resulting in improved access to care and better patient adherence with the proposed treatment objective and consequently better clinical results. Recent studies have shown that some medicinal products can help patients reduce their alcohol consumption. One such product, nalmefene, has been granted European marketing authorization and is now being released onto the market in various countries. The ESENSE 1 and 2 studies in alcohol-dependent patients showed that, in combination with BRENDA, a psychosocial intervention focusing on reinforcement of motivation and treatment adherence, nalmefene significantly reduced the number of heavy drinking days and mean daily total alcohol consumption versus placebo. This reduction was more marked in the marketing authorization target population, ie, patients with a high or very high drinking risk level according to World Health Organization criteria. Another original feature of this molecule is that it can be used as needed if the patient perceives a risk of drinking, which is a more flexible approach and more likely to ensure the patient's active involvement in the treatment of his/her disease. This molecule opens up interesting and original therapeutic prospects in the treatment of alcohol dependence. Keywords: alcohol dependence, reduction, consumption, damage reduction, drug therapy, nalmefene

  2. 78 FR 44575 - Sickle Cell Disease Treatment Demonstration Program

    Science.gov (United States)

    2013-07-24

    ... HUMAN SERVICES Health Resources and Services Administration Sickle Cell Disease Treatment Demonstration... Treatment Demonstration Program (U1E) Awards to Three Currently Funded Grantees. SUMMARY: HRSA currently has nine programs that are funded through competitive grant awards under the Sickle Cell Disease Treatment...

  3. Conditioned learning in alcohol dependence: implications for cue exposure treatment.

    Science.gov (United States)

    Drummond, D C; Cooper, T; Glautier, S P

    1990-06-01

    A review of the literature pertinent to cue exposure treatment in alcohol dependence is presented. Psychological models of relapse, based on conditioning and social learning theories, are critically evaluated. In particular, attention is drawn to the potential implications for cue exposure research and treatment of an interaction between Pavlovian and operant conditioning, problems with the application of the concepts of arousal and craving and the importance of a systems model to understand physiological responses. It is concluded that no study has so far demonstrated a link between conditioned responses to alcohol-related cues and relapse, an assumption on which cue exposure treatment is based. Further, the evidence for the effectiveness of cue exposure as a treatment is lacking. Promising research directions are identified.

  4. The application of machine learning techniques as an adjunct to clinical decision making in alcohol dependence treatment.

    Science.gov (United States)

    Connor, J P; Symons, M; Feeney, G F X; Young, R McD; Wiles, J

    2007-01-01

    With few exceptions, research in the addictive sciences has relied on linear statistics and methodologies. Addiction involves a complex array of nonlinear behaviors. This study applies two machine learning techniques, Bayesian and decision tree classifiers, in the assessment of outcome of an alcohol dependence treatment program. These nonlinear approaches are compared to a standard linear analysis. Seventy-three alcohol-dependent subjects undertaking a 12-week cognitive-behavioral therapy (CBT) program and 66 subjects undertaking an identical program but also prescribed the relapse prevention agent Acamprosate were employed in this study. Demographic, alcohol use, dependence severity, craving, health-related quality of life, and psychological measures at baseline were used to predict abstinence at 12 weeks. Decision trees had a 77% predictive accuracy across both data sets, Bayesian networks 73%, and discriminant analysis 42%. Combined with clinical experience, machine learning approaches offer promise in understanding the complex relationships that underlie treatment outcome for abstinence-based alcohol treatment programs.

  5. "Patients, not criminals"? An assessment of Thailand's compulsory drug dependence treatment system.

    Science.gov (United States)

    Pearshouse, Richard

    2009-05-01

    Since the enactment of a new law on addiction treatment in 2002, Thailand has sharply increased the number of people in compulsory drug treatment programs. This article provides an overview of the system, particularly the custodial programs. It also provides some preliminary observations on the implementation of the legislation on its own terms--namely, that people who are dependent on drugs should be "treated as patients and not criminals." While diverting people with drug dependence from the criminal justice system is important, this stated approach is undermined in a number of ways by the law's implementation. This article is based on a longer report released by the Canadian HIV/AIDS Legal Network in 2009.

  6. Pregabalin in the treatment of alcohol and benzodiazepines dependence.

    Science.gov (United States)

    Oulis, Panagiotis; Konstantakopoulos, George

    2010-01-01

    We review all available studies on the use of the newer anticonvulsant drug pregabalin (PGB) in the treatment of both alcohol dependence (AD) and benzodiazepine dependence (BD). In AD, the available evidence includes one open-label and one double-blind randomized studies, whereas in BD, only a few case reports and one open-label study are as yet available. In both conditions, PGB was found efficacious with significant improvement in withdrawal symptoms at the dosage ranges of 150-450 mg/day (AD) and 225-900 mg/day (BD). Moreover, its side effects were mild and transient. Despite the limited quality of the studies design, their findings suggest that PGB might constitute a novel efficacious and safe option in the treatment of both AD and BD.

  7. An Ontology-Driven Dependable Water Treatment Plant CPS

    Directory of Open Access Journals (Sweden)

    SANISLAV Teodora

    2013-05-01

    Full Text Available The paper introduces an ontology-drivenCyber-Physical System with dependability features tocontrol, monitor and diagnose a water treatment plant,with emphasis on the ontology, as a new approach forthe existing industrial control systems used in thisfield. The proposed dependability ontology is based ona fault forecasting technique, a qualitative evaluationof the water treatment plant Cyber-Physical Systembehaviour - Failure Modes and Effects Analysis. Theontology has two important parts: one is the ontologyof faults including several categories of system faultsand the other is the ontology of failures includingseveral categories of system failures. The dependabilityontology plays a central role in the Cyber-PhysicalSystem architecture and drives various aspects of thissystem, especially the ones related to system diagnosis.

  8. In silico models of alcohol dependence and treatment

    Directory of Open Access Journals (Sweden)

    Boris eKovatchev

    2012-02-01

    Full Text Available In this paper we view alcohol dependence and the response to treatment as a recurrent bio-behavioral process developing in time and propose formal models of this process combining behavior and biology in silico. The behavioral components of alcohol dependence and treatment are formally described by a stochastic process of human behavior, which serves as an event generator challenging the metabolic system. The biological component is driven by the biochemistry of alcohol intoxication described by deterministic models of ethanol pharmacodynamics and pharmacokintetics to enable simulation of drinking addiction in humans. Derived from the known physiology of ethanol and the literature of both ethanol intoxication and ethanol absorption, the different models are distilled into a minimal model (as simple as the complexity of the data allows that can represent any specific patient. We use these modeling and simulation techniques to explain responses to placebo and ondansetron treatment observed in clinical studies. Specifically, the response to placebo was explained by a reduction of the probability of environmental reinforcement, while the effect of ondansetron was explained by a gradual decline in the degree of ethanol-induced neuromodulation. Further, we use in silico experiments to study critical transitions in blood alcohol levels after specific average number of drinks per day, and propose the existence of two critical thresholds in the human - one at 5 and another at 11 drinks/day - at which the system shifts from stable to critical and to super critical state indicating a state of alcohol addiction. The advantages of such a model-based investigation are that 1 the process of instigation of alcohol dependence and its treatment can be deconstructed into meaningful steps, which allow for individualized treatment tailoring, and 2 physiology and behavior can be quantified in different (animal or human studies and then the results can be integrated

  9. Arguments in favour of compulsory treatment of opioid dependence.

    Science.gov (United States)

    Wu, Zunyou

    2013-02-01

    Twelve agencies of the United Nations, including the World Health Organization, have issued a joint statement that calls on Member States to replace the compulsory detention of people who use opioids in treatment centres with voluntary, evidence-informed and rights-based health and social services. The arguments in favour of this position fall into three broad categories: Compulsory treatment centres infringe on an individual's liberty, they put human beings at risk of harm, and evidence of their effectiveness against opioid dependence has not been generated. The United Nations statement underscores that although countries apply different criteria for sending individuals to compulsory treatment centres, detention often takes place without due process, legal safeguards or judicial review. This clearly violates internationally recognized human rights standards. Furthermore, people who are committed to these centres are often exposed to physical and sexual violence, forced labour and sub-standard living conditions. They are often denied health care, despite their heightened vulnerability to HIV infection and tuberculosis. Finally, there is no evidence, according to the statement, that these centres offer an environment that is conducive to recovery from opioid dependence or to the rehabilitation of commercial sex workers or of children who have suffered sexual exploitation, abuse or lack of care and protection. The author of this paper sets forth several arguments that counter the position taken by the United Nations and argues in favour of compulsory treatment within a broader harm reduction strategy aimed at protecting society as well as the individual concerned.

  10. Maintenance Check-ups Following Treatment for Cannabis Dependence.

    Science.gov (United States)

    Walker, Denise D; Stephens, Robert S; Towe, Sheri; Banes, Kelsey; Roffman, Roger

    2015-09-01

    Substance use disorders, including cannabis use disorders and associated negative consequences, are best considered chronic and in need of continuing care. In contrast, most treatment efficacy studies evaluate a fixed number of intervention sessions at a single point in time. The present study evaluated the efficacy of posttreatment maintenance check-ups (MCUs) in maintaining and improving outcomes following nine sessions of motivational enhancement treatment/cognitive behavioral treatment (MET/CBT). Adults dependent on cannabis (n=74) were randomly assigned to the MCU or a no check-up (NCU) condition and followed up at 3- and 9-months. MCU sessions occurred 1 and 4months following the completion of the base treatment. Additional MET/CBT sessions were available to participants throughout the follow-up period. The MCUs specifically encouraged treatment re-entry for those showing ongoing signs of disorder. Participants in the MCU condition reported significantly greater abstinent rates at both follow-ups and were using on fewer days at the 3-month but not the 9-month follow-up. Contrary to hypotheses, MCU participants did not attend more additional treatment and differences in rates of cannabis use emerged prior to the first MCU session. Future research with longer follow-up periods and longer monitoring of outcomes is needed to fully evaluate the utility of MCUs or other forms of continuing care.

  11. Psychobiology and the treatment of drug dependence: the biobehavioral interface.

    Science.gov (United States)

    Meyer, R E

    1986-01-01

    In the past 15 years there has been an explosion of data on the multivariate nature of drug dependence. The complex relationship between addictive disorders and psychopathology has been better clarified. Certain Axis I and II diagnoses in DSM-III appear to occur more commonly in alcohol- and drug-dependent patients than in the general population, suggesting that they may serve as risk factors for the development of addictive disorders. Psychopathological symptoms also result during periods of chronic intoxication and may persist as secondary psychiatric disorders even in the absence of continued substance use. Behavioral research in human and animal models has begun to yield insights into the nature of dependence disorders and the importance of brain mechanisms of reinforcement to the addiction process. Inevitably, neural scientists are beginning to delineate the commonalities and differences in drug reinforcement across drug class. The research has begun to suggest pharmacological approaches to the treatment of drug dependence and withdrawal. This paper provides an overview of research on the psychobiology of drug dependence with implications for the clinician.

  12. Barriers to Quitting Smoking Among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome.

    Science.gov (United States)

    Martin, Rosemarie A; Cassidy, Rachel N; Murphy, Cara M; Rohsenow, Damaris J

    2016-05-01

    For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n=184 and 340). Both components (general barriers, weight concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; weight concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD.

  13. Treatment utilization and barriers to treatment: Results of a survey of dependent methamphetamine users

    Directory of Open Access Journals (Sweden)

    Lee Nicole K

    2011-02-01

    Full Text Available Abstract Background Australia has one of the highest rates of methamphetamine use in the world; however, treatment access for methamphetamine is comparatively low. This descriptive study aimed to identify patterns of treatment utilization and perceived barriers to accessing treatment among dependent methamphetamine users in the hope that such information will enable services to more appropriately respond to this group. Methods One hundred and twenty-six methamphetamine users who had a current or past history of methamphetamine dependence were interviewed about their experiences of, and perceived barriers to, treatment. Results Treatment utilization among methamphetamine users was reportedly low. One of the main reasons cited for not accessing treatment was that methamphetamine users did not perceive their drug use to be a problem (despite apparent levels of dependence. Self-detoxification with the use of other licit and illicit drugs was high among this group. Participants identified a lack of confidence in the ability of treatment services to address methamphetamine dependence and the 'opiate-centric' nature of treatment services as significant blocks to treatment entry. Suggestions for improvement by participants included operating specialist services for methamphetamine users, placing an emphasis on responsiveness and routinely involving case management services for this group. Discussion and Conclusions To improve service delivery, treatment services should reorient their services to better address the needs of methamphetamine users by making small changes such as specific opening times for methamphetamine users or using a dedicated space for methamphetamine treatment. Alternative options such as online treatments and specialist methamphetamine clinics should be considered for methamphetamine users.

  14. An example of activity based costing of treatment programs.

    Science.gov (United States)

    Alemi, Farrokh; Sullivan, Thomas

    2007-01-01

    We introduce a new tool that can be used for estimating number, length of time, and nature of services patient receive in drug treatment programs. While the field has made significant progress in standardizing the collection of expenditure data, little progress has been made on creating a standard measure for estimating program activities and census. We report on a method of estimating program activities.

  15. Consenso sobre o tratamento da dependência de nicotina Consensus on the treatment of nicotine dependence

    Directory of Open Access Journals (Sweden)

    Ana Cecilia P R Marques

    2001-12-01

    Full Text Available Têm sido atribuídas à dependência de nicotina 20% das mortes nos EUA. Estudos têm mostrado que 30% a 50% das pessoas que começam a fumar escalam para um uso problemático. Nos últimos 20 anos, a educação e a persuasão não foram suficientes para promover uma mudança política, cultural e social relacionada ao comportamento de fumar. As intervenções para interromper o uso de tabaco ainda não estão integradas às rotinas dos serviços de saúde no mundo. A falta de estratégias de integração, de tempo disponível para acoplar ações assistenciais mais específicas e mesmo a percepção dos profissionais de saúde de que os tratamentos para a dependência de nicotina são pouco efetivos são algumas das barreiras apontadas. Assim, elaborar um consenso sobre a dependência de nicotina teve como objetivos: • levantar dados epidemiológicos relevantes relacionados ao uso do tabaco no mundo e no Brasil; • revisar as ações gerais e centrais da nicotina; • elaborar um protocolo de triagem mínimo para serviços de atenção primária à saúde; • recomendar diretrizes básicas de avaliação, diagnóstico e tratamento para todos os níveis de atenção à saúde em relação à dependência de nicotina; • fornecer sugestões para a abordagem de grupos especiais de pacientes: adolescentes, gestantes, idosos, pacientes em regime de internação, obesos e pacientes com comorbidades psiquiátricas, cardiovasculares e respiratórias.Twenty percent of mortality rates in the US have been attributed to nicotine dependence. Thirty to fifty percent of nicotine dependent patients will reach a stage of problematic use in a short-term follow-up. Over the last 20 years, educational programs and persuasive techniques aimed to the general population were not able to have a significant impact on political, cultural and social beliefs to change smoking behavior. Treatment programs to stop smoking are not yet integrated in health services

  16. Benzodiazepine dependence and its treatment with low dose flumazenil.

    Science.gov (United States)

    Hood, Sean David; Norman, Amanda; Hince, Dana Adelle; Melichar, Jan Krzysztof; Hulse, Gary Kenneth

    2014-02-01

    Globally benzodiazepines remain one of the most prescribed medication groups, especially in the primary care setting. With such high levels of prescribing it is not surprising that benzodiazepine dependence is common, cutting across all socioeconomic levels. Despite recognition of the potential for the development of iatrogenic dependence and the lack of any effective treatment, benzodiazepines continue to be widely prescribed in general practice. Conventional dependence management, benzodiazepine tapering, is commonly a protracted process over several weeks or months. It is often associated with significant withdrawal symptoms and craving leading to patient drop out and return to use. Accordingly, there is a worldwide need to find effective pharmacotherapeutic interventions for benzodiazepine dependence. One drug of increasing interest is the GABAA benzodiazepine receptor antagonist/partial agonist, flumazenil. Multiple bolus intravenous infusions of low dose flumazenil used either with or without benzodiazepine tapering can reduce withdrawal sequelae, and/or longer term symptoms in the months following withdrawal. Preliminary data suggest that continuous intravenous or subcutaneous flumazenil infusion for 4 days significantly reduces acute benzodiazepine withdrawal sequelae. The subcutaneous infusion was shown to be tissue compatible so the development of a longer acting (i.e. several weeks) depot flumazenil formulation has been explored. This could be capable of managing both acute and longer term benzodiazepine withdrawal sequelae. Preliminary in vitro water bath and in vivo biocompatibility data in sheep show that such an implant is feasible and so is likely to be used in clinical trials in the near future.

  17. Prevention and treatment in prison law: women prisoners drug dependence in Spain

    Directory of Open Access Journals (Sweden)

    Francisco José del Pozo Serrano

    2015-05-01

    Full Text Available The penitentiary drug dependence treatment for women has been traditionally generic (applied for most masculine penitentiary and with few differentiating empiric studies in an spanish level.Based on a regulatory framework, this research focuses on the study of the main elements of risk and protection implied in the relation between the drug dependant female prisoners and the treatment programs, as well as the recovery processes, in order to propose specific actions.The research has a multimethod approach, inserted within the Project I+D+I named “Mujeres reclusas drogodependientes y su reinserción social. Estudio socioeducativo y propuestas de acción” [EDU2009-13408], with a national sample of second and third degree (Central Government and Community of Catalonia, corresponding to an estimate of 15% of the female prisoners nationally. 538 valid questionnaires, 61 semi-structured interviews has been obtained, in which informatic analytical methods, specific programs for quantitative data (SPSS, V. 15 y 20, and analytical content methods for qualitative data has been applied. The analysis has been developed before and after the internment, including four profiles of female prisioners (AA: Active addicted (8'20%, EX: ex addicted (EX: 67'21%, NA: non addicted (NA: 14.75% and PMM (9.84% addicted within methadone maintenance programs .Among the main results found, it is relevant to mention the elements of risk related to the absence of participation of ex addicted women in relapse prevention programs. In fact, this is a relevant issue since 70% of the women are ex addicted. There is a large number of women not receiving any treatment in prision and not participating in any program due to lack of information, mistrust and overlap with other activities. Aditionally, theres is a perception of gender discrimination towards the access and permanece of women in the programs, compared with men.  Also, within the main elements of protection, it has been

  18. Smoking cessation treatment in community-based substance abuse rehabilitation programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Flammino, Frank; Nunes, Edward V; Jiang, Huiping; Kourniotis, Eva; Lima, Jennifer; Brady, Ron; Burgess, Cynthia; Arfken, Cynthia; Pihlgren, Eric; Giordano, Louis; Starosta, Aron; Robinson, James; Rotrosen, John

    2008-07-01

    Nicotine dependence is highly prevalent among drug- and alcohol-dependent patients. A multisite clinical trial of smoking cessation (SC) treatment was performed at outpatient community-based substance abuse rehabilitation programs affiliated with the National Drug Abuse Treatment, Clinical Trials Network. Cigarette smokers (N=225) from five methadone maintenance programs and two drug and alcohol dependence treatment programs were randomly assigned in a 2:1 ratio to receive either (1) SC treatment as an adjunct to substance abuse treatment-as-usual (TAU) or (2) substance abuse TAU. Smoking cessation treatment consisted of 1 week of group counseling before the target quit date and 8 weeks of group counseling plus transdermal nicotine patch treatment (21 mg/day for Weeks 1-6 and 14 mg/day for Weeks 7 and 8) after the target quit date. Smoking abstinence rates in SC, 10%-11% during treatment and 5%-6% at the 13- and 26-week follow-up visits, were significantly better than those in TAU during treatment (p< .01). In addition, SC was associated with significantly greater reductions as compared with TAU in cigarettes smoked per day (75% reduction, p< .001), exhaled carbon monoxide levels (p< .001), cigarette craving (p< .05), and nicotine withdrawal (p< .05). Smoking cessation did not differ from TAU on rates of retention in substance abuse treatment, abstinence from primary substance of abuse, and craving for primary substance of abuse. Compliance with SC treatment, moderate at best, was positively associated with smoking abstinence rates. Smoking cessation treatment resulted in significant reductions in daily smoking and modest smoking abstinence rates without having an adverse impact on substance abuse rehabilitation when given concurrently with outpatient substance abuse treatment. Substance abuse treatment programs should not hesitate to implement SC for established patients.

  19. Lapse and relapse following inpatient treatment of opiate dependence.

    LENUS (Irish Health Repository)

    Smyth, B P

    2010-06-01

    We conducted a prospective follow-up study of consecutive opiate dependent patients admitted to a residential addiction treatment service for detoxification. We measured the rate of relapse following discharge, and sought to identify factors that were associated with early relapse (i.e., a return to daily opiate use). Follow-up interviews were conducted with 109 patients, of whom, 99 (91%) reported a relapse. The initial relapse occurred within one week in 64 (59%) cases. Multivariate survival analysis revealed that earlier relapse was significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and a failure to enter aftercare. Unexpectedly, those who were in a relationship with an opiate user had significantly delayed relapse. Those who completed the entire six-week inpatient treatment programme also had a significantly delayed relapse. In order to reduce relapse and the associated increased risk of fatal overdose, services providing residential opiate detoxification should prepare people for admission, strive to retain them in treatment for the full admission period and actively support their entry into planned aftercare in order to improve outcome.

  20. The Australian Treatment Outcome Study (ATOS): what have we learnt about treatment for heroin dependence?

    Science.gov (United States)

    Darke, Shane; Ross, Joanne; Teesson, Maree

    2007-01-01

    Opioids make the single largest contribution to illicit drug-related mortality and morbidity worldwide In this paper we reflect upon what has been learnt regarding treatment outcome and the natural history of heroin use from the Australian Treatment Outcome Study (ATOS). We focus on what we knew prior to ATOS, what ATOS revealed that is novel, and the implications for research, practice and policy. ATOS provided strong evidence for sustained improvement attributable to treatment across the three years of the study. It is argued that treatment for heroin dependence is money well spent, and leads to clear and sustained benefits to both heroin users and society.

  1. Outcome of heroin-dependent adolescents presenting for opiate substitution treatment.

    LENUS (Irish Health Repository)

    Smyth, Bobby P

    2012-01-01

    Because the outcome of methadone and buprenorphine substitution treatment in adolescents is unclear, we completed a retrospective cohort study of 100 consecutive heroin-dependent adolescents who sought these treatments over an 8-year recruitment period. The participants\\' average age was 16.6 years, and 54 were female. Half of the patient group remained in treatment for over 1 year. Among those still in treatment at 12 months, 39% demonstrated abstinence from heroin. The final route of departure from the treatment program was via planned detox for 22%, dropout for 32%, and imprisonment for 8%. The remaining 39% were transferred elsewhere for ongoing opiate substitution treatment after a median period of 23 months of treatment. Males were more likely to exit via imprisonment (p < .05), but other outcomes were not predicted by gender. There were no deaths during treatment among these 100 patients who had a cumulative period of 129 person years at risk. Our findings suggest that this treatment delivers reductions in heroin use and that one fifth of patients will exit treatment following detox completion within a 1- to 2-year time frame.

  2. Transportation and retention in outpatient drug abuse treatment programs.

    Science.gov (United States)

    Friedmann, P D; Lemon, S C; Stein, M D

    2001-09-01

    To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

  3. Alcohol abuse and related disorders treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Yu. P. Sivolap

    2014-01-01

    Full Text Available Alcohol abuse and alcoholism are the leading causes of worse health and increased mortality rates. Excessive alcohol consumption is the third leading cause of the global burden of diseases and a leading factor for lower lifespan and higher mortality. Alcohol abuse decreases working capacity and efficiency and requires the increased cost of the treatment of alcohol-induced disorders, which entails serious economic losses. The unfavorable medical and social consequences of excessive alcohol use determine the importance of effective treatment for alcoholism. The goals of rational pharmacotherapy of alcohol dependence are to enhance GABA neurotransmission, to suppress glutamate neurotransmission, to act on serotonin neurotransmission, to correct water-electrolyte balance, and to compensate for thiamine deficiency. Alcoholism treatment consists of two steps: 1 the prevention and treatment of alcohol withdrawal syndrome and its complications (withdrawal convulsions and delirium alcoholicum; 2 antirecurrent (maintenance therapy. Benzodiazepines are the drugs of choice in alleviating alcohol withdrawal and preventing its convulsive attacks and delirium alcoholicum. Diazepam and chlordiazepoxide are most commonly used for this purpose; the safer drugs oxazepam and lorazepam are given to the elderly and patients with severe liver lesions. Anticonvulsants having normothymic properties, such as carbamazepine, valproic acid, topiramate, and lamotrigine, are a definite alternative to benzodiazepines. The traditional Russian clinical practice (clearance detoxification has not a scientific base or significant impact on alcohol withdrawal-related states in addicts. Relapse prevention and maintenance therapy for alcohol dependence are performed using disulfiram, acamprosate, and naltrexone; since 2013 the European Union member countries have been using, besides these agents, nalmefene that is being registered in Russia. Memantine and a number of other

  4. Practical Programming with Higher-Order Encodings and Dependent Types

    DEFF Research Database (Denmark)

    Poswolsky, Adam; Schürmann, Carsten

    2008-01-01

    utilizing HOAS free the programmer from concerns of handling explicit contexts and substitutions, our system permits programming over such encodings without making these constructs explicit, leading to concise and elegant programs. To this end our system distinguishes bindings of variables intended...

  5. Children Facing Divorce: A Treatment Program

    Science.gov (United States)

    Magid, Kenneth M.

    1977-01-01

    The children facing divorce program began last year and was built on the talents of an interdisciplinary staff. Included are experts in client-centered counseling, sociometry and psychodrama, Gestalt and TA, behavior modification, and various eclectic approaches to family therapy. (Author)

  6. [Fluoxetine (FX) efficacy in the treatment of cocaine dependence methadone maintenance patients. Interaction with plasma levels].

    Science.gov (United States)

    Baño, M D; Agujetas, M; López, M L; Tena, T; Rodríguez, A; Lora-Tamayo, C; Guillén, J L

    1999-01-01

    The objective of this study was to assess the efficacy of fluoxetine (FX) treatment in cocaine dependent methadone (MTD) maintenance patients, to assess decrease or interruption of cocaine use and pharmacokinetic interaction between fluoxetine an methadone plasma levels. The sample was composed of 11 patients with DSM IV criteria for opioid and cocaine dependence. We added Fluoxetine (20 mg per day) during 9 weeks in Majadahonda Drug Program. All patients were in methadone program a mean of 7.5 months. We made a psychiatry interview and the baseline severity of the mood disorder was assessed with the Clinical Global Impression ICG for therapeutic improvement. Cocaine use and fluoxetine treatment was measured in urine analysis and pharmacokinetic interaction between FX-MTD were measured with plasma levels of methadone. Fluoxetine was well tolerated combined with methadone. FX-MTD interaction didn't occur, resulting in no increased of MTD plasma level to dose before and after fluoxetine treatment. After fluoxetine treatment decreased cocaine use, changed cocaine tract from injected to smoked and improvement depressive symptoms.

  7. Buprenorphine: clinical pharmacokinetics in the treatment of opioid dependence.

    Science.gov (United States)

    Elkader, Alexander; Sproule, Beth

    2005-01-01

    Buprenorphine is a semi-synthetic opioid derived from thebaine, a naturally occurring alkaloid of the opium poppy, Papaver somniferum. The pharmacology of buprenorphine is unique in that it is a partial agonist at the opioid mu receptor. Buprenorphine undergoes extensive first-pass metabolism and therefore has very low oral bioavailability; however, its bioavailability sublingually is extensive enough to make this a feasible route of administration for the treatment of opioid dependence. The mean time to maximum plasma concentration following sublingual administration is variable, ranging from 40 minutes to 3.5 hours. Buprenorphine has a large volume of distribution and is highly protein bound (96%). It is extensively metabolised by N-dealkylation to norbuprenorphine primarily through cytochrome P450 (CYP) 3A4. The terminal elimination half-life of buprenorphine is long and there is considerable variation in reported values (mean values ranging from 3 to 44 hours). Most of a dose of buprenorphine is eliminated in the faeces, with approximately 10-30% excreted in urine. Naloxone has been added to a sublingual formulation of buprenorphine to reduce the abuse liability of the product. The presence of naloxone does not appear to influence the pharmacokinetics of buprenorphine. Buprenorphine crosses the placenta during pregnancy and also crosses into breast milk. Buprenorphine dosage does not need to be significantly adjusted in patients with renal impairment; however, since CYP3A activity may be decreased in patients with severe chronic liver disease, it is possible that the metabolism of buprenorphine will be altered in these patients. Although there is limited evidence in the literature to date, drugs that are known to inhibit or induce CYP3A4 have the potential to diminish or enhance buprenorphine N-dealkylation. It appears that the interaction between buprenorphine and benzodiazepines is more likely to be a pharmacodynamic (additive or synergistic) than a

  8. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    Directory of Open Access Journals (Sweden)

    Saeed Imani

    2015-11-01

    Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

  9. The canadian eating disorder program survey - exploring intensive treatment programs for youth with eating disorders.

    Science.gov (United States)

    Norris, Mark; Strike, Melanie; Pinhas, Leora; Gomez, Rebecca; Elliott, April; Ferguson, Patricia; Gusella, Joanne

    2013-11-01

    To explore and describe philosophies and characteristics of intensive eating disorder (ED) treatment programs based in tertiary care institutions across Canada. A ninety-item survey examining ED services for adolescents was developed, piloted, and completed by 11 programs across Canada. Information pertaining to program characteristics and components, governance, staffing, referrals, assessments, therapeutic modalities in place, nutritional practices, and treatment protocols were collected. The results highlight the diversity of programming available but also the lack of a unified approach to intensive eating disorder treatment in youth. This report provides important baseline data that offers a framework that programs can use to come together to establish assessment and treatment protocols as well as a process for outcome evaluation. Continued collaboration will be essential moving forward to ensure Canadian youth, regardless of geographic location, receive the necessary treatment required to attain and sustain recovery.

  10. Nuclear Waste Treatment Program: Annual report for FY 1986

    Energy Technology Data Exchange (ETDEWEB)

    Burkholder, H.C.; Brouns, R.A. (comps.); Powell, J.A. (ed.)

    1987-09-01

    To support DOE's attainment of its goals, Nuclear Waste Treatment Program (NWTP) is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting. This annual report describes progress during FY 1986 toward meeting these two objectives. 29 refs., 59 figs., 25 tabs.

  11. Characteristics of drug-abusing women with children in residential treatment: a preliminary evaluation of program retention and treatment completion.

    Science.gov (United States)

    Simons, Lori

    2008-01-01

    An ex post facto study was conducted to investigate treatment outcomes for 80 women and 168 children admitted into a residential substance-abuse treatment program. The results indicated childhood emotional neglect is a barrier for remaining in and completing treatment for African-American women with comorbid psychological disorders but not for those with crack cocaine dependent disorders. African-American women with comorbid psychological disorders were also three times more likely to dropout of treatment. In addition, there were relatively few differences for between drug-exposed and nonexposed children. However, the results indicated that children of substance-abusing women who completed treatment were more likely to have behavioral problems, to receive early intervention services, and to have mothers as legal guardians by the end of treatment. Implications for gender-specific interventions for African-American women and their children in residential treatment are discussed.

  12. Use of Gestalt Therapy Within a Drug Treatment Program.

    Science.gov (United States)

    Sideroff, Stephen I.

    1979-01-01

    Presents a Gestalt therapeutic approach that has shown promise within a drug treatment program. The major issues discussed include the acquisition of self-support, taking responsibility, dealing with anxiety, contact, and the expression of pent-up feelings. (Author)

  13. Relevance of Ericksonian psychotherapy to the treatment of chemical dependency.

    Science.gov (United States)

    McGarty, R

    1985-01-01

    Dr. Milton Erickson is credited with having developed many unique and effective approaches to the problem of resistance in therapy. Clinicians treating patients with alcohol and other drug abuse problems often face significant resistance from clients. This article focuses on a number of ideas associated with Dr. Erickson's work and their relevance to the treatment of chemical dependency with a particular focus on the issue of resistance. One note of caution is in order in reference to the paradoxical interventions alluded to in the paper. These interventions are not appropriate or acceptable for all substance abusers. A therapist should have significant experience and support from co-therapist and supervisors before attempting such interventions.

  14. Adolescent Perpetrator Treatment Programs: Assessment Issues.

    Science.gov (United States)

    Abbey, Joan M.

    The value of early identification of sexually aberrant behaviors and intervention with sexually deviant minors is obvious from a community safety perspective. Early intervention also appears to have value from the offender's perspective. A research review revealed several common themes with implications for both assessment and treatment. Most…

  15. METHOTREXATE IN THE TREATMENT OF GLUCOCORTICOID-DEPENDENT ASTHMA

    Institute of Scientific and Technical Information of China (English)

    王国杨; 朱利文; 姚婉贞; 赵呜武

    2001-01-01

    To study how low-dose of methotrexate affects steroid use, asthma symptom scores and pulmonary function in glucocorticoid-dependent asthmatic patients.Methods 13 patients with severe, steroid-dependent asthma were enrolled in the prospective study, who received weekly oral methotrexate 20 mg for 12 months. Of these 13 patients, 12 finished 12 monthcourseResults The mean prednisone dose reduced from 20.63mg/d to 7.71mg/d (P<0.001) in the 12 patients treated with long-term methotrexate: Eight patients discontinued the regular use of prednisone, 10 patients reduced predaisone dosage by more than 50%. Measurement of forced vital capacity(FVC) and forced expiratory volume in one second (FEV1) showed that there was no deterioration due to methotrexate treatment and steroid reduction. Mean daily symptom scores for cough, wheezing, shortness of breath, and chest tightness remained unchanged.Conclusion Our study provides evidence supporting the long-term efficacy and safety of methotrexate in patients with severe bronchial asthma.

  16. Program for quantum wave-packet dynamics with time-dependent potentials

    CERN Document Server

    Dion, C M; Rahali, G

    2014-01-01

    We present a program to simulate the dynamics of a wave packet interacting with a time-dependent potential. The time-dependent Schr\\"odinger equation is solved on a one-, two-, or three-dimensional spatial grid using the split operator method. The program can be compiled for execution either on a single processor or on a distributed-memory parallel computer.

  17. Neuro-Linguistic Programming Treatment for Anxiety: Magic or Myth?

    Science.gov (United States)

    Krugman, Martin; And Others

    1985-01-01

    Compared neuro-linguistic programing treatment for anxiety with self-control desensitization of equal duration and a waiting-list control group in treating public speaking anxiety. Results indicated that neither treatment was more effective in reducing anxiety than merely waiting for one hour. (Author/MCF)

  18. Attrition and family participation in obesity treatment programs: clinicians' perceptions.

    Science.gov (United States)

    Skelton, Joseph A; Irby, Megan B; Beech, Bettina M; Rhodes, Scott D

    2012-01-01

    The majority of participants drop out of pediatric obesity treatment programs; however, clinicians have little knowledge of how to address this problem. The objective of this study was to explore obesity treatment clinicians' perceptions of contributors to attrition, as well as methods to maintain family participation. Semistructured interviews were conducted with 29 pediatric obesity clinicians representing primary care (PC), community based (CB), and tertiary care (TC) treatment programs in North Carolina. Interviews were recorded, transcribed verbatim, and coded with a multistage inductive approach. Grounded theory was used to analyze responses. Eleven themes emerged from analysis, including: the influence of program elements, family characteristics, and the variety of approaches used to address retention. Only TC programs reported attempts to address attrition. Patients' past experiences with obesity treatment, desire for immediate outcomes, and relationships with clinicians were perceived as important factors related to attrition. Other important themes were: families' understanding of obesity treatment, importance of realistic expectations, and families' value of treatment. Important differences and similarities among programs were identified. All clinicians reported families came to treatment through physician referral, not self referral. Clinicians perceive attrition to be a significant problem in pediatric obesity treatment. As a result of clinical interviews, several potential avenues to address attrition were identified, including: the need for clinicians to develop relationships with families, assist in building appropriate expectations, and address families' value of treatment. Findings of this study can inform larger investigations of attrition, and guide exploration of family impressions of and experiences in treatment. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults

    Directory of Open Access Journals (Sweden)

    Samet Jeffrey

    2011-10-01

    Full Text Available Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance dependence. Methods Cross-sectional secondary data analysis of self-reported baseline data from alcohol and/or drug-dependent adults enrolled in a randomized clinical trial of a disease management program for substance dependence in primary care. The main independent variable was chronic medical disease status, categorized using the Katz Comorbidity Score as none, single condition of lower severity, or higher severity (multiple conditions or single higher severity condition, based on comorbidity scores determined from self-report. Asthma was also examined in secondary analyses. The primary outcome was any self-reported addiction treatment utilization (excluding detoxification in the 3 months prior to study entry, including receipt of any addiction-focused counseling or addiction medication from any healthcare provider. Logistic regression models were adjusted for sociodemographics, type of substance dependence, recruitment site, current smoking, and recent anxiety severity. Results Of 563 subjects, 184 (33% reported any chronic disease (20% low severity; 13% higher severity and 111 (20% reported asthma; 157 (28% reported any addiction treatment utilization in the past 3 months. In multivariate regression analyses, no significant effect was detected for chronic disease on addiction treatment utilization (adjusted odds ratio [AOR] 0.88 lower severity vs. none, 95% confidence interval (CI: 0.60, 1.28; AOR 1.29 higher severity vs. none, 95% CI: 0.89, 1.88 nor for

  20. Smoking cessation treatment among patients in community-based substance abuse rehabilitation programs: exploring predictors of outcome as clues toward treatment improvement.

    Science.gov (United States)

    Reid, Malcolm S; Jiang, Huiping; Fallon, Bryan; Sonne, Susan; Rinaldi, Paul; Turrigiano, Eva; Arfken, Cynthia; Robinson, James; Rotrosen, John; Nunes, Edward V

    2011-09-01

    Predictors of smoking cessation (SC) treatment outcome were explored in a multisite clinical trial of SC treatment at community-based, outpatient, substance abuse rehabilitation programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. To explore baseline demographic and clinical predictors of abstinence during treatment. Cigarette smokers from five methadone maintenance programs and two drug and alcohol dependence treatment programs were randomly assigned to SC treatment as an adjunct to substance abuse treatment as usual or to substance abuse treatment as usual. SC treatment consisted of group counseling (weeks 1-8) plus transdermal nicotine patch treatment (21 mg/day, weeks 1-6; 14 mg/day, weeks 7-8). Demographic and clinical predictors of smoking abstinence were evaluated among those patients assigned to the active SC condition (N = 153) using logistic regression. Abstinence during treatment was positively associated with younger age, Hispanic or Caucasian (as opposed to African American) ethnicity/race, employment or student status, fewer cigarettes per day at baseline, lower severity of the primary substance problem at baseline, and higher methadone doses (among the subsample in methadone treatment). During future efforts to improve SC treatments among drug- and alcohol-dependent patients, consideration should be given to adequate treatment to reduce the severity of the primary drug or alcohol problem, tailoring treatments for patients with greater severity of smoking and of the primary substance problem, and culturally sensitive interventions. Analysis of predictors of outcome may be a useful tool for treatment development.

  1. Implementation of smoking cessation treatment in VHA substance use disorder residential treatment programs.

    Science.gov (United States)

    Gifford, Elizabeth; Tavakoli, Sara; Wisdom, Jennifer; Hamlett-Berry, Kim

    2015-03-01

    Although the prevalence of tobacco use among individuals with substance use disorders remains high, smoking cessation (SC) has not been a focus of addiction treatment programs. Veterans Health Administration (VHA) policy requires tobacco use screening and the availability of evidence-based SC treatment in specialty care settings, including substance use disorder programs. As part of a larger quality improvement effort, this qualitative study examined how SC treatment is delivered in VHA substance use disorder residential treatment programs (SRTPs) and the barriers and opportunities for growth that exist within these settings. Twenty-five staff were interviewed across a sample of 15 SRTPs. Participants were asked to describe their knowledge and attitudes about SC treatment as well as organizational barriers and facilitators related to implementation of SC treatment in their programs. Content analysis was used to extract responses within and across programs. Participants endorsed SC as a general goal and reported that SRTPs responded to patients who requested help. However, many programs did not emphasize SC as an important part of recovery from substance use disorders and did not document, reevaluate, or consistently address tobacco use. The results identified critical gaps in the provision of SC treatment in VHA SRTPs. These findings suggest actionable opportunities to improve SC treatment in SRTPs, including providing training opportunities, developing or enforcing policies that support SC, implementing systems to track and report tobacco-related diagnoses and treatment, and obtaining leadership support for building a culture that encourages SC.

  2. Time-dependent theoretical treatments of the dynamics of electrons and nuclei in molecular systems

    Science.gov (United States)

    Deumens, E.; Diz, A.; Longo, R.; Öhrn, Y.

    1994-07-01

    An overview is presented of methods for time-dependent treatments of molecules as systems of electrons and nuclei. The theoretical details of these methods are reviewed and contrasted in the light of a recently developed time-dependent method called electron-nuclear dynamics. Electron-nuclear dynamics (END) is a formulation of the complete dynamics of electrons and nuclei of a molecular system that eliminates the necessity of constructing potential-energy surfaces. Because of its general formulation, it encompasses many aspects found in other formulations and can serve as a didactic device for clarifying many of the principles and approximations relevant in time-dependent treatments of molecular systems. The END equations are derived from the time-dependent variational principle applied to a chosen family of efficiently parametrized approximate state vectors. A detailed analysis of the END equations is given for the case of a single-determinantal state for the electrons and a classical treatment of the nuclei. The approach leads to a simple formulation of the fully nonlinear time-dependent Hartree-Fock theory including nuclear dynamics. The nonlinear END equations with the ab initio Coulomb Hamiltonian have been implemented at this level of theory in a computer program, ENDyne, and have been shown feasible for the study of small molecular systems. Implementation of the Austin Model 1 semiempirical Hamiltonian is discussed as a route to large molecular systems. The linearized END equations at this level of theory are shown to lead to the random-phase approximation for the coupled system of electrons and nuclei. The qualitative features of the general nonlinear solution are analyzed using the results of the linearized equations as a first approximation. Some specific applications of END are presented, and the comparison with experiment and other theoretical approaches is discussed.

  3. Psychological changes in alcohol-dependent patients during a residential rehabilitation program

    Directory of Open Access Journals (Sweden)

    Giorgi I

    2015-12-01

    Full Text Available Ines Giorgi,1 Marcella Ottonello,2,3 Giovanni Vittadini,4 Giorgio Bertolotti5 1Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, 2Department of Physical & Rehabilitation Medicine, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Genoa, 3Department of Medicine, PhD Program in Advanced Sciences and Technologies in Rehabilitation Medicine and Sport, Università di Tor Vergata, Rome, 4Alcohol Rehabilitation Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, 5Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Tradate, Italy Background: Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive–affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse.Materials and methods: The sample included 560 subjects (mean age 46.91±10.2 years who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment – Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome

  4. Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

    Science.gov (United States)

    McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

    2008-01-01

    Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

  5. Treatment programs in the National Drug Abuse Treatment Clinical Trials Network.

    Science.gov (United States)

    McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W; Nunes, Edward V; Miller, Michael; Forman, Robert; Magruder, Kathryn M; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

    2008-01-01

    Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed Organizational Surveys (n=106 of 112; 95% response rate) and Treatment Unit Surveys (n=348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to National Survey of Substance Abuse Treatment Services (N-SSATS), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services provided. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice.

  6. Demographic Trends of Adults in New York City Opioid Treatment Programs--An Aging Population.

    Science.gov (United States)

    Han, Benjamin; Polydorou, Soteri; Ferris, Rosie; Blaum, Caroline S; Ross, Stephen; McNeely, Jennifer

    2015-01-01

    The population of adults accessing opioid treatment is growing older, but exact estimates vary widely, and little is known about the characteristics of the aging treatment population. Further, there has been little research regarding the epidemiology, healt h status, and functional impairments in this population. To determine the utilization of opioid treatment services by older adults in New York City. This study used administrative data from New York State licensed drug treatment programs to examine overall age trends and characteristics of older adults in opioid treatment programs in New York City from 1996 to 2012. We found significant increases in utilization of opioid treatment programs by older adults in New York City. By 2012, those aged 50-59 made up the largest age group in opioid treatment programs. Among older adults there were notable shifts in demographic background including gender and ethnicity, and an increase in self-reported impairments. More research is needed to fully understand the specific characteristics and needs of older adults with opioid dependence.

  7. Assessment of motivation for treatment in alcohol dependent patients who sought treatment at a specialized medical service

    Directory of Open Access Journals (Sweden)

    Oliveira Júnior Hercílio Pereira de

    2003-01-01

    Full Text Available INTRODUCTION: Motivation is deemed a critical component for interventions intended to change behaviors related to the use of alcohol and other drugs. The classification of patients in 'stages of change' can be a useful tool for the organization and improvement of treating programs. METHODS: This study assessed the stages of change using the scales URICA and SOCRATES in patients who attended two different treating programs for alcohol dependence in a specialized medical service. We performed an analysis of the association between stages of change and demographic aspects. After three months of treatment, patients were reassessed to evaluate their outcome. RESULTS: In the assessments using URICA, there was an association between stages of change and monthly income and age. There was no evidence that patients move across the stages of change. Using the scale SOCRATES, we found an association between stages of change and monthly income. In the reassessment, there was a significant movement across the stages of change. CONCLUSION: Patients who attend two different treating programs may have different motivation profiles. There was no movement congruent with the stage of change model, suggesting that patients may need more than 3 months to obtain significant changes in their motivation.

  8. Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change.

    Science.gov (United States)

    Becan, Jennifer E; Knight, Danica K; Crawley, Rachel D; Joe, George W; Flynn, Patrick M

    2015-03-01

    Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (time 1) and 35 days after admission (time 2). The design consisted of a comparison sample (n=281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n=238). Repeated measures ANCOVAs were conducted using each time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation.

  9. Effectiveness of the Treatment Readiness and Induction Program for Increasing Adolescent Motivation for Change

    Science.gov (United States)

    Becan, Jennifer E.; Knight, Danica K.; Crawley, Rachel D.; Joe, George W.; Flynn, Patrick M.

    2014-01-01

    Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (Time 1) and 35 days after admission (Time 2). The design consisted of a comparison sample (n = 281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n = 238). Repeated measures ANCOVAs were conducted using each Time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation. PMID:25456094

  10. Prazosin for Treatment With PTSD And Comorbid Alcohol Dependence

    Science.gov (United States)

    2010-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD and alcohol dependence . The objective of this study is to evaluate the efficacy of prazosis (16mg

  11. Treatment refusal/attrition among adults randomly assigned to programs at a drug treatment campus: The New Jersey Substance Abuse Treatment Campus, Seacaucus, NJ.

    Science.gov (United States)

    Condelli, W S; Koch, M A; Fletcher, B

    2000-06-01

    The New Jersey Substance Abuse Treatment Campus was funded to assess the feasibility of establishing a new model for delivering substance abuse treatment services and to serve as a research laboratory for conducting comparative evaluations of those services. The 350-bed campus was designed to improve treatment effectiveness by providing special services needed by underserved populations, and reduce treatment costs by serving large numbers of clients, centralizing services, and sharing facilities. First-time clients who met preliminary eligibility requirements during phone screening were randomly assigned to therapeutic community and chemical dependency programs. We used data collected on 1,573 adults who were ultimately accepted for admission to analyze treatment refusals and attrition during the 25 days after admission. Only 6.4% of the clients refused admission when informed of their treatment assignment. Planned duration of the residential phase of treatment, gender, and language spoken (English/Spanish) interacted with one another and differentially predicted treatment refusal/attrition. These findings may be useful for understanding treatment refusal and attrition in substance abuse treatment programs.

  12. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  13. Sexual Dysfunction in Heroin Dependents: A Comparison between Methadone and Buprenorphine Maintenance Treatment.

    Directory of Open Access Journals (Sweden)

    Anne Yee

    Full Text Available Methadone has long been regarded as an effective treatment for opioid dependence. However, many patients discontinue maintenance therapy because of its side effects, with one of the most common being sexual dysfunction. Buprenorphine is a proven alternative to methadone. This study aimed to investigate sexual dysfunction in opioid-dependent men on buprenorphine maintenance treatment (BMT and methadone maintenance treatment (MMT. The secondary aim was to investigate the correlation between sexual dysfunction and the quality of life in these patients.Two hundred thirty-eight men participated in this cross-sectional study. Four questionnaires were used, the Mini International Neuropsychiatric Interview, Opiate Treatment Index, Malay version of the International Index of Erectile Function 15 (Mal-IIEF-15, and World Health Organization Quality of Life-BREF Scale. Multivariate analysis of covariance was used to examine the relationship between MMT and BMT and the Mal-IIEF 15 scores while controlling for all the possible confounders.The study population consisted of 171 patients (71.8% on MMT and 67 (28.2% on BMT. Patients in the MMT group who had a sexual partner scored significantly lower in the sexual desire domain (p < 0.012 and overall satisfaction (p = 0.043 domain compared with their counterparts in the BMT group. Similarly, patients in the MMT group without a sexual partner scored significantly lower in the orgasmic function domain (p = 0.008 compared with those in the BMT group without a partner. Intercourse satisfaction (p = 0.026 and overall satisfaction (p = 0.039 were significantly associated with the social relationships domain after adjusting for significantly correlated sociodemographic variables.Sexual functioning is critical for improving the quality of life in patients in an opioid rehabilitation program. Our study showed that buprenorphine causes less sexual dysfunction than methadone. Thus, clinicians may consider the former when

  14. Using a latent variable approach to inform gender and racial/ethnic differences in cocaine dependence: a National Drug Abuse Treatment Clinical Trials Network study.

    Science.gov (United States)

    Wu, Li-Tzy; Pan, Jeng-Jong; Blazer, Dan G; Tai, Betty; Stitzer, Maxine L; Woody, George E

    2010-06-01

    This study applies a latent variable approach to examine gender and racial/ethnic differences in cocaine dependence, to determine the presence of differential item functioning (DIF) or item-response bias to diagnostic questions of cocaine dependence, and to explore the effects of DIF on the predictor analysis of cocaine dependence. The analysis sample included 682 cocaine users enrolled in two national multisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN). Participants were recruited from 14 community-based substance abuse treatment programs associated with the CTN, including 6 methadone and 8 outpatient nonmethadone programs. Factor and multiple indicators-multiple causes (MIMIC) procedures evaluated the latent continuum of cocaine dependence and its correlates. MIMIC analysis showed that men exhibited lower odds of cocaine dependence than women (regression coefficient, beta = -0.34), controlling for the effects of DIF, years of cocaine use, addiction treatment history, comorbid drug dependence diagnoses, and treatment setting. There were no racial/ethnic differences in cocaine dependence; however, DIF by race/ethnicity was noted. Within the context of multiple community-based addiction treatment settings, women were more likely than men to exhibit cocaine dependence. Addiction treatment research needs to further evaluate gender-related differences in drug dependence in treatment entry and to investigate how these differences may affect study participation, retention, and treatment response to better serve this population.

  15. Participation Rates in the Aid to Families with Dependent Children Program: Trends for 1967 through 1984.

    Science.gov (United States)

    Ruggles, Patricia; Michel, Richard C.

    This report examines participation rates in the Aid to Families with Dependent Children (AFDC) program. TRIM2, a microsimulation model that simulated the eligibility and benefit rules of the AFDC program on a state-by-state basis, showed that there had been a dramatic decline after 1981 in the rate at which AFDC families were applying for and…

  16. Dropout of a multidisciplinary treatment program for women with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Tatiana Rehder Gonçalves

    2010-03-01

    Full Text Available Objective: To evaluate the dropout of a multidisciplinary treatment program in fibromyalgia (FM. Methods: An observational study conducted during the period of April 2000 to December 2005, including 133 women with fibromyalgia, participating in a multidisciplinary treatment program. Those who had left the treatment for two weeks or more were classified as inactive and contacted by telephone to record the reasons for their noncompliance, which were divided into four groups: 1 Family; 2 Occupations; 3 Medical; 4 Other Reasons. Results: When collecting data, 92 (69.4% women were considered inactive. There was no significant difference between noncompliance before and after six months of treatment. Of the total number of inactive women, 54 (40.8% participants left for medical reasons, 30 (22.6% for other reasons, 26 (19.4% for family reasons and 23 (17.2% due to occupation. There was no statistical difference between the motives of dropout according to the length of stay in the program (p> 0.05. Conclusion: We conclude that the multidisciplinary program for women with fibromyalgia had high levels of noncompliance, half of them occurred in the first six months. Among the main reasons reported for dropout, the medical reasons were more frequent.

  17. A Model Adolescent Substance-Abuse Treatment Program.

    Science.gov (United States)

    Copans, Stuart

    1993-01-01

    Describes two adolescent substance abuse treatment programs in New England psychiatric center: Osgood Three, which is no longer in existence, and Tyler Three, which replaced it and is struggling to grow. Considers transition from Osgood Three to Tyler Three, process of change, and learning what can be preserved from past and what must be…

  18. Pharmacologic approaches to the treatment of cocaine dependence.

    OpenAIRE

    Taylor, W. A.; Gold, M. S.

    1990-01-01

    When pharmacologic agents are considered in the treatment of cocaine addiction, the objective of such treatment--sustained abstinence--must be considered. Medication and medical approaches have been disappointing in the treatment of cocaine overdose. The central neurobiologic mechanism(s) involved in cocaine toxicity are poorly understood. Without a cocaine antagonist, pharmacologic approaches have been less than promising in preventing relapse. Various psychoactive medications have been trie...

  19. [Optimization of acupuncture treatment programs for facial paralysis].

    Science.gov (United States)

    Luo, He-Ping; Lin, Tian-dong; Cai, Min; Huang, Xian-xun; Wang, Bang-bo; Gao, Wei-keng

    2010-02-01

    To optimize the acupuncture treatment programs for facial paralysis. Sixty-three patients of facial paralysis were randomly divided and treated according to the table of L9 (3)4 in orthogonal test. They were treated with different combined programs of 4 factors and 3 levels, including factor A (acupuncture op portunity), B (acupoints prescription), C (quantity of stimulus) and D (time of electroacupuncture). The change of facial nerve function score was observed to choose the best acupuncture treatment program for facial paralysis from factor A (acupuncture opportunity), B (acupoints prescription), C (quantity of stimulus), D (time of electroacupuncture) and their 3 levels in each factor. B (acupoints prescription) and D (time of electroacupuncture) were significant factors (P facial paralysis.

  20. Neuro-linguistic programming and application in treatment of phobias.

    Science.gov (United States)

    Karunaratne, Mahishika

    2010-11-01

    Phobias are a prevalent and often debilitating mental health problem all over the world. This article aims to explore what is known about the use of Neuro-linguistic Programming (NLP) as a treatment for this condition. Whilst there is abundant experiential evidence from NLP practitioners attesting to the efficacy of this method as a treatment for phobias, experimental research in this area is somewhat limited. This paper reviews evidence available in literature produced in the UK and US and reveals that NLP is a successful treatment for phobias as well as being particularly efficient due to the relatively brief time period it takes to effect an improvement.

  1. Laboratory measures of methylphenidate effects in cocaine-dependent patients receiving treatment.

    Science.gov (United States)

    Roache, J D; Grabowski, J; Schmitz, J M; Creson, D L; Rhoades, H M

    2000-02-01

    Two experiments examined the effects of methylphenidate in male and female patients enrolled in an outpatient treatment program for primary cocaine dependence. The first study was a component of a double-blind efficacy trial wherein 57 patients were first tested in a human laboratory for their initial responsiveness to medication. Patients were randomly assigned to receive either placebo or methylphenidate treatment and received their first dose in the human laboratory environment before continuing in outpatient treatment. Methylphenidate was given as a 20-mg sustained-release dose (twice daily) plus an additional 5-mg immediate-release dose combined with the morning dose. Methylphenidate increased heart rate and subjective ratings; however, the subjective effects were primarily of a "dysphoric" nature, and significant effects were limited to increases in anxiety, depression, and anger on the Profile of Mood States; shaky/jittery ratings on a visual analog scale; and dysphoria on the lysergic acid diethylamide (LSD) scale of the Addiction Research Center Inventory. Methylphenidate did not increase cocaine craving nor ratings suggesting abuse potential (i.e., Morphine-Benzedrine Group or drug-liking scores, etc.). None of the drug effects observed in the human laboratory was of clinical concern, and no subject was precluded from continuing in the outpatient study. After outpatient treatment completion, 12 patients were brought back into a second double-blind human laboratory study in which three doses (15, 30, and 60 mg) of immediate-release methylphenidate were administered in an ascending series preceded and followed by placebo. Methylphenidate produced dose-related increases in heart rate, subjective ratings of shaky/jittery, and LSD/dysphoria without significantly altering cocaine craving or stimulant euphoria ratings. These results suggest that stimulant substitution-type approaches to the treatment of cocaine dependence are not necessarily contraindicated

  2. Role of personality traits in cocaine craving throughout an outpatient psychosocial treatment program

    Directory of Open Access Journals (Sweden)

    Flávia Ismael

    2014-03-01

    Full Text Available Objective: Cocaine dependence is a major international public health concern. Its chronically relapsing nature is possibly related to craving intensity, which can be influenced by diverse biological and psychological aspects. This study aimed to evaluate the role of different personality traits in craving measured throughout a psychosocial treatment program. Method: The sample comprised 66 cocaine-dependent outpatients who were enrolled in an individual and manualized cognitive-behavioral therapy program. The influence of personality traits on craving intensity, frequency, and duration was analyzed using a generalized estimating equations model with an autoregressive correlation structure. Results: Craving varied during treatment. The personality traits of novelty seeking, reward dependence, and harm avoidance interacted with craving intensity, and the personality trait of persistence interacted with craving duration throughout the treatment period. Furthermore, there were significant interactions between drug use and craving intensity, and between different routes of administration and craving intensity. Participants who used cocaine/crack while in treatment and concurrent users of crack (i.e., freebase cocaine and powder cocaine also had a higher craving intensity. Conclusion: The extent of craving variation can depend on certain personality styles. This study shows that craving is influenced by personality traits, and this may presumably change clinical expression involved in disease.

  3. SELECTION OF CHEMICAL TREATMENT PROGRAM FOR OILY WASTEWATER

    Directory of Open Access Journals (Sweden)

    Miguel Díaz

    2017-04-01

    Full Text Available When selecting a chemical treatment program for wastewater to achieve an effective flocculation and coagulation is crucial to understand how individual colloids interact. The coagulation process requires a rapid mixing while flocculation process needs a slow mixing. The behavior of colloids in water is strongly influenced by the electrokinetic charge, where each colloidal particle carries its own charge, which in its nature is usually negative. Polymers, which are long chains of high molecular weight and high charge, when added to water begin to form longer chains, allowing removing numerous particles of suspended matter. A study of physico-chemical treatment by addition of coagulant and flocculant was carried out in order to determine a chemical program for oily wastewater coming from the gravity separation process in a crude oil refinery. The tests were carried out in a Jar Test equipment, where commercial products: aluminum polychloride (PAC, aluminum sulfate and Sintec D50 were evaluated with five different flocculants. The selected chemical program was evaluated with fluids at three temperatures to know its sensitivity to this parameter and the mixing energy in the coagulation and flocculation. The chemical program and operational characteristics for physico-chemical treatment with PAC were determined, obtaining a removal of more than 93% for suspended matter and 96% for total hydrocarbons for the selected coagulant / flocculant combination.

  4. Incorporating Nondrug Social & Recreational Activities in Outpatient Chemical Dependency Treatment

    Science.gov (United States)

    Siporin, Sheldon; Baron, Lisa

    2012-01-01

    "Contingency Management programs (CMP) and non-drug social and recreational activities (NDSRA) are interventions premised on behavior theory that rely on external sources of reinforcement alternative to drug-based forms to decrease drug use. CMP usually employs vouchers as reinforcement for negative toxicologies. Despite research support, CMP…

  5. Baclofen in the short-term maintenance treatment of benzodiazepine dependence

    Directory of Open Access Journals (Sweden)

    Lekhansh Shukla

    2014-01-01

    Full Text Available Benzodiazepine (BZD dependence is a significant public health problem. Apart from the long-term tapering doses of BZD, no others drugs are available for the maintenance treatment of BZD dependence. Baclofen has been used in alcohol and other drug dependence as long-term anti-craving agent. Since alcohol and BZD act through the GABA receptor, we attempted to study the effect of Baclofen as maintenance treatment in a series of five cases with BZD dependence.

  6. Baclofen in the short-term maintenance treatment of benzodiazepine dependence.

    Science.gov (United States)

    Shukla, Lekhansh; Kandasamy, Arun; Kesavan, Muralidharan; Benegal, Vivek

    2014-11-01

    Benzodiazepine (BZD) dependence is a significant public health problem. Apart from the long-term tapering doses of BZD, no others drugs are available for the maintenance treatment of BZD dependence. Baclofen has been used in alcohol and other drug dependence as long-term anti-craving agent. Since alcohol and BZD act through the GABA receptor, we attempted to study the effect of Baclofen as maintenance treatment in a series of five cases with BZD dependence.

  7. Antenatal treatment in two Dutch families with pyridoxine-dependent seizures.

    NARCIS (Netherlands)

    Bok, L.A.; Been, J.V.; Struys, E.A.; Jakobs, C.; Rijper, E.A.; Willemsen, M.A.A.P.

    2010-01-01

    Incidental reports suggest that antenatal treatment of pyridoxine dependent seizures (PDS) may improve neurodevelopmental outcome of affected patients. Two families with PDS are reported, both with two affected siblings. Antenatal treatment with pyridoxine was instituted during the second pregnancy

  8. Antenatal treatment in two Dutch families with pyridoxine-dependent seizures.

    NARCIS (Netherlands)

    Bok, L.A.; Been, J.V.; Struys, E.A.; Jakobs, C.; Rijper, E.A.; Willemsen, M.A.A.P.

    2010-01-01

    Incidental reports suggest that antenatal treatment of pyridoxine dependent seizures (PDS) may improve neurodevelopmental outcome of affected patients. Two families with PDS are reported, both with two affected siblings. Antenatal treatment with pyridoxine was instituted during the second pregnancy

  9. Adding voucher-based incentives to community reinforcement approach improves outcomes during treatment for cocaine dependence.

    Science.gov (United States)

    García-Fernández, Gloria; Secades-Villa, Roberto; García-Rodríguez, Olaya; Sánchez-Hervás, Emilio; Fernández-Hermida, José R; Higgins, Stephen T

    2011-01-01

    This study compares the efficacy of the Community Reinforcement Approach (CRA) with and without an incentive program for cocaine-dependent patients in Spain. A total of 58 patients were randomly assigned to the CRA or CRA plus vouchers condition. In the CRA plus vouchers group, mean percentage of cocaine-negative samples was 97.07%, versus 79.76% in the no-voucher group. Those treated in the CRA plus vouchers condition also achieved greater improvements in psychosocial functioning than those treated in the CRA condition. The present results show that treatment outcome is better if incentives are delivered contingent upon the submission of cocaine-free urine specimens. 

  10. The role of topiramate and other anticonvulsants in the treatment of alcohol dependence: a clinical review.

    Science.gov (United States)

    De Sousa, Avinash

    2010-03-01

    Alcohol dependence is a major health problem worldwide. Various pharmacological agents have been used in the management of alcohol dependence. This review looks at the role of topiramate and other anticonvulsants in the management of alcohol dependence. Topiramate is the most widely used anticonvulsant in the treatment of alcohol dependence. The literature on topiramate is reviewed and critically analyzed, along with its proposed mechanism of action in alcohol dependence. A review of data available on other anticonvulsants like carbamazepine, oxcarbazepine, sodium valproate, gabapentin and levetiracetam are presented and their potential in the treatment of alcohol dependence is considered, together with future research directions.

  11. Psychiatric Disorders in Smokers Seeking Treatment for Tobacco Dependence: Relations with Tobacco Dependence and Cessation

    Science.gov (United States)

    Piper, Megan E.; Smith, Stevens S.; Schlam, Tanya R.; Fleming, Michael F.; Bittrich, Amy A.; Brown, Jennifer L.; Leitzke, Cathlyn J.; Zehner, Mark E.; Fiore, Michael C.; Baker, Timothy B.

    2010-01-01

    Objective: The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Method: Data were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with…

  12. Dependent-Chance Programming Models for Capital Budgeting in Fuzzy Environments

    Institute of Scientific and Technical Information of China (English)

    LIANG Rui; GAO Jinwu

    2008-01-01

    Capital budgeting is concerned with maximizing the total net profit subject to budget constraints by selecting an appropriate combination of projects. This paper presents chance maximizing models for capital budgeting with fuzzy input data and multiple conflicting objectives. When the decision maker sets a prospec-tive profit level and wants to maximize the chances of the total profit achieving the prospective profit level, a fuzzy dependent-chance programming model, a fuzzy multi-objective dependent-chance programming model, and a fuzzy goal dependent-chance programming model are used to formulate the fuzzy capital budgeting problem. A fuzzy simulation based genetic algorithm is used to solve these models. Numerical examples are provided to illustrate the effectiveness of the simulation-based genetic algorithm and the po-tential applications of these models.

  13. Nuclear waste treatment program. Annual report for FY 1985

    Energy Technology Data Exchange (ETDEWEB)

    Powell, J.A. (ed.)

    1986-04-01

    Two of the US Department of Energy's (DOE) nuclear waste management-related goals are: (1) to ensure that waste management is not an obstacle to the further deployment of light-water reactors (LWR) and the closure of the nuclear fuel cycle and (2) to fulfill its institutional responsibility for providing safe storage and disposal of existing and future nuclear wastes. As part of its approach to achieving these goals, the Office of Terminal Waste Disposal and Remedial Action of DOE established what is now called the Nuclear Waste Treatment Program (NWTP) at the Pacific Northwest Laboratory (PNL) during the second half of FY 1982. To support DOE's attainment of its goals, the NWTP is to provide (1) documented technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and (2) problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting assistance, as required, to treat existing wastes. This annual report describes progress during FY 1985 toward meeting these two objectives. The detailed presentation is organized according to the task structure of the program.

  14. Surface treatment and history-dependent corrosion in lead alloys

    Energy Technology Data Exchange (ETDEWEB)

    Li Ning [Los Alamos National Laboratory, Los Alamos, NM (United States)]. E-mail: ningli@lanl.gov; Zhang Jinsuo [Los Alamos National Laboratory, Los Alamos, NM (United States); Sencer, Bulent H. [Los Alamos National Laboratory, Los Alamos, NM (United States); Koury, Daniel [University of Nevada, Las Vegas, NV (United States)

    2006-06-23

    In oxygen-controlled lead and lead-bismuth eutectic (LBE), steel corrosion may be strongly history dependent. This is due to the competition between liquid metal dissolution corrosion and oxidation as a 'self-healing' protection barrier. Such effects can be observed from corrosion testing of a variety of surface-treated materials, such as cold working, shot peening, pre-oxidation, etc. Shot peening of austenitic steels produces surface-layer microstructural damages and grain compression, which could contribute to increased Cr migration to the surface and enhance the protection through an impervious oxide. Pre-oxidation under conditions different from operating ones may form more protective oxides, reduce oxygen and metal ion migration through the oxides, and achieve better protection for longer durations. Corrosion and oxidation modeling and analysis reveal the potential for significantly reducing long-term corrosion rates by initial and early-stage conditioning of steels for Pb/LBE services.

  15. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Science.gov (United States)

    Matthews, Alicia K.; Li, Chien-Ching; Kuhns, Lisa M.; Tasker, Timothy B.; Cesario, John A.

    2013-01-01

    Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT) people's response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N = 198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association's “Freedom from Smoking Program” (ALA-FFS) and were tailored to LGBT smokers' needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5) were mostly White (70.4%) and male (60.5%) and had at least a college degree (58.4%). Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions). Higher educational attainment and use of nicotine replacement therapy (NRT) were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45), use of NRT (OR = 4.24), and lower nicotine dependency (OR = 0.73) were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake. PMID:23840237

  16. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Directory of Open Access Journals (Sweden)

    Alicia K. Matthews

    2013-01-01

    Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.

  17. [The treatment of cannabis dependence: Clinical work, psychotherapy and evidence].

    Science.gov (United States)

    Capece, José; Pavlovsky, Federico

    2016-11-01

    Identifying compulsive consumption of marijuana in association with another mental disorder (attentional defcit disorder, bipolar disorder, depression or psychosis) presents the challenge of clarifying validated therapeutic strategies, especially within the teen population, in which it shows the highest prevalence. The ever-increasing prevalence and the need for regional treatments, demand that we approach this health matter as a public health issue. The ideological con?icts related to the necessary decriminalization of consumption and the current debate on the medical use of marijuana often confuse the urgent need to establish effective therapeutic strategies for the population affected by this mental disorder. Family therapy and community reinforcement are one of the most effcient interventions, other than the traditional individual and group therapies. Contingent, motivational and cognitive-behavioral tailored interventions appear to be most effcient and recommendable. Aerobic exercise and the use of mobile technology also show effectiveness. The administration of medications such as gabepentin, the aminoacid n-acetyl cysteine (NAC) and the cannabinoid cannabidiol (CBD) appear to be very promising. Usual medications, such as valproic acid, quetiapine and bupropion, increase craving, therefore intensifying the need for consumption and thus yielding overall negative results.

  18. Visual exploration of program structure, dependencies and metrics with SolidSX

    NARCIS (Netherlands)

    Reniers, Dennie; Voinea, Lucian; Telea, Alexandru

    2011-01-01

    We present SolidSX, an visual analysis tool for code structure, dependencies, and metrics. Our tool facilitates the understanding of large program code bases by simplifying the entire pipeline from data acquisition up to visualization and interactive querying. Secondly, SolidSX is an easy to use,

  19. State policy influence on the early diffusion of buprenorphine in community treatment programs

    Directory of Open Access Journals (Sweden)

    Abraham Amanda J

    2008-06-01

    Full Text Available Abstract Background Buprenorphine was approved for use in the treatment of opioid dependence in 2002, but its diffusion into everyday clinical practice in community-based treatment programs has been slow. This study examines the net impact of efforts by state agencies, including provision of Medicaid coverage, on program-level adoption of buprenorphine as of 2006. Methods Interviews were conducted with key informants in 49 of the 50 state agencies with oversight responsibility for addiction treatment services. Information from these interviews was integrated with organizational data from the 2006 National Survey of Substance Abuse Treatment Services. A multivariate logistic regression model was estimated to identify the effects of state efforts to promote the use of this medication, net of a host of organizational characteristics. Results The availability of Medicaid coverage for buprenorphine was a significant predictor of its adoption by treatment organizations. Conclusion Inclusion of buprenorphine on state Medicaid formularies appears to be a key element in ensuring that patients have access to this state-of-the-art treatment option. Other potential barriers to the diffusion of buprenorphine require identification, and the value of additional state-level policies to promote its use should be evaluated.

  20. Time-dependent enhancement of hippocampus-dependent memory after treatment with memantine: Implications for enhanced hippocampal adult neurogenesis.

    Science.gov (United States)

    Ishikawa, Rie; Kim, Ryang; Namba, Takashi; Kohsaka, Shinichi; Uchino, Shigeo; Kida, Satoshi

    2014-07-01

    Adult hippocampal neurogenesis has been suggested to play modulatory roles in learning and memory. Importantly, previous studies have shown that newborn neurons in the adult hippocampus are integrated into the dentate gyrus circuit and are recruited more efficiently into the hippocampal memory trace of mice when they become 3 weeks old. Interestingly, a single high-dose treatment with the N-methyl-d-aspartate receptor antagonist memantine (MEM) has been shown to increase hippocampal neurogenesis dramatically by promoting cell proliferation. In the present study, to understand the impact of increased adult neurogenesis on memory performance, we examined the effects of a single treatment of MEM on hippocampus-dependent memory in mice. Interestingly, mice treated with MEM showed an improvement of hippocampus-dependent spatial and social recognition memories when they were trained and tested at 3-6 weeks, but not at 3 days or 4 months, after treatment with MEM. Importantly, we observed a significant positive correlation between the scores for spatial memory (probe trial in the Morris water maze task) and the number of young mature neurons (3 weeks old) in MEM-treated mice, but not saline-treated mice. We also observed that the young mature neurons generated by treatment with MEM were recruited into the trace of spatial memory similarly to those generated through endogenous neurogenesis. Taken together, our observations suggest that treatment with MEM temporally improves hippocampus-dependent memory formation and that the newborn neurons increased by treatment with MEM contribute to this improvement when they become 3 weeks old. © 2014 Wiley Periodicals, Inc.

  1. Nuclear waste treatment program: Annual report for FY 1987

    Energy Technology Data Exchange (ETDEWEB)

    Brouns, R.A.; Powell, J.A. (comps.)

    1988-09-01

    Two of the US Department of Energy's (DOE) nuclear waste management-related goals are to ensure that waste management is not an obstacle to the further development of light-water reactors and the closure of the nuclear fuel cycle and to fulfill its institutional responsibility for providing safe storage and disposal of existing and future nuclear wastes. As part of its approach to achieving these goals, the Office of Remedial Action and Waste Technology of DOE established what is now called the Nuclear Waste Treatment Program (NWTP) at the Pacific Northwest Laboratory during the second half of FY 1982. To support DOE's attainment of its goals, the NWTP is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting assistance, as required to treat existing wastes. This annual report describes progress during FY 1987 towards meeting these two objectives. 24 refs., 59 figs., 24 tabs.

  2. Codeine misuse and dependence in South Africa: Perspectives of addiction treatment providers

    Directory of Open Access Journals (Sweden)

    Charles D H Parry

    2017-05-01

    Full Text Available Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. Method. Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions. Results. While many participants had received training in pharmacological management of individuals with opioid dependence, only two had received specific training on codeine management. Between half and two-thirds of the treatment settings they worked in provided detoxification, pharmacotherapy, psychosocial treatment and aftercare. Very few treatment settings offered long-term treatment for codeine misuse and dependence. Participants indicated that over half of their codeine patients entered treatment for intentional misuse for intoxication, and dependence resulting from excessive or long-term use. The main barriers to patients entering treatment were seen as denial of having a problem, not being ready for change, mental health problems, stigma, and affordability of treatment. Participants identified a need for further training in how to manage withdrawal and detoxification, treatment modalities including motivational interviewing, and relapse prevention. Conclusions. Gaps in training among treatment providers need to centre on how to manage withdrawal from codeine use and detoxification, motivational interviewing and relapse prevention. Interventions are needed to address barriers to entering treatment, including user denial.

  3. Tratamento farmacológico da dependência do álcool The pharmacologic treatment of the alcohol dependence

    Directory of Open Access Journals (Sweden)

    Luís André Castro

    2004-05-01

    Full Text Available As intervenções farmacológicas podem ter um papel crucial na redução do craving, consumo de álcool e manutenção da abstinência. Este artigo revisa a farmacoterapia para a dependência de álcool com ênfase na naltrexona, dissulfiram e acamprosato. O antagonista opióide naltrexona diminui taxas de recaída, reduz dias de consumo e prolonga períodos de abstinência. Acamprosato restaura a atividade normal dos sistemas glutamato e GABA. Dissulfiram tem demonstrado ser mais efetivo para pacientes que acreditam em sua eficácia e permaneçam aderentes ao tratamento. Ondansetron tem-se mostrado promissor na dependência de álcool de início precoce, mas necessita estudos mais extensivos. Topiramato (até 300 mg/dia foi mais eficaz do que placebo no tratamento da dependência de álcool.The pharmacological intervention can play a crucial role in the reduction of craving and drinking and the maintenance of abstinence. This article reviews pharmacotherapy for alcohol dependence with an emphasis on the naltrexone, dissulfiram and acamprosate. The opioid antagonist naltrexone lowers relapse rate, reduces drinking days and prolongs periods of abstinence. Acamprosate restores the normal activity of glutamate and GABA systems. Disulfiram has been shown to be most effective for patients who believe in its efficacy and remain compliant with the treatment. Ondansetron, has shown promise in the early-onset alcohol dependence but needs more extensive study. Topiramate (up to 300 mg per day was more efficacious than placebo in the treatment of alcohol dependence.

  4. Bench to Bedside: Understanding Symptom Response to Acupuncture Treatment and Designing a Successful Acupuncture Treatment Program

    Science.gov (United States)

    2016-10-01

    social support and healthy behaviors in a veteran sample. Statistics of CAM use within military populations ranges from 23% to 81.5% depending on...reliable surveys. Methods: Results: Statistically significant (to p<=0.05) improvements were found in subjects perceived social support3 post program...Interestingly these affective changes were not due to the addition of new social contacts as we found no statistically significant changes in social

  5. [Family Health Program and children palliative care: listening the relatives of technology dependent children].

    Science.gov (United States)

    Rabello, Cláudia Azevedo Ferreira Guimarães; Rodrigues, Paulo Henrique de Almeida

    2010-03-01

    This study discusses the creation of a new children palliative care program based on the Family Health Program, considering the level of care at home and yielding to family requests. The study focused on eighteen members of nine families of technology dependent children (TDC) who were hospital patients at Instituto Fernandes Figueira (IFF): four who are being assisted by its palliative care program Programa de Assistência Domiciliar Interdisciplinar (PADI); three who were inpatients waiting for inclusion in the Program, and finally two inpatients already included in PADI. PADI was chosen because it is the only child palliative care program in Brazil. The results are positive in regards to the connection established between the families and the health care team, the reception of the children, the explanation to the family concerning the disease, and the functional dynamics between the PADI and IFF. As negative points, difficulties arose as a result of the implementation of the program, from its continuity to the worsening or illness of the entire family. In conclusion, although the PADI is the IFF's way of discharging patients, the domiciliary cares taken by the Family Health Program, well articulated with the healthcare system, would be ideal for being the adequate assistance for such.

  6. Readiness for Change and Treatment Outcome among Individuals with Alcohol Dependency.

    Science.gov (United States)

    Hewes, Robert L.; Janikowski, Timothy P.

    1998-01-01

    Uses the Addiction Severity Index and Stage of Change Readiness and Treatment Eagerness Scale to evaluate individuals with primary alcohol-abuse problems involved in treatment programs. Results indicate that participants showed significant improvement in problems related to alcohol use. No significant differences were found between participants…

  7. Effects of Program and Patient Characteristics on Retention of Drug Treatment Patients.

    Science.gov (United States)

    Hser, Yih-Ing; Joshi, Vandana; Maglione, Margaret; Chou, Chih Ping; Anglin, M. Douglas

    2001-01-01

    Studied the effects of program and patient characteristics on patient retention in residential, out-patient, and methadone maintenance drug treatment programs. Data for 26,047 patients in 87 programs show that threshold retention rates were generally low for all 3 program types, although program practice and service provision played important…

  8. Treatment of Methamphetamine Dependence with Electroconvulsive Therapy (ECT in Iran: A Critical Note.

    Directory of Open Access Journals (Sweden)

    Babak Roshanaei-Moghaddam

    2014-09-01

    Full Text Available This comment article reviews the literature to explore whether the use of ECT for the treatment of methamphetamine dependence can be justified by scientific rationale and/or evidence.This article reviews the literature on the use of ECT in addictive disorders. It describes a patient with methamphetamine dependence treated with ECT. It then offers a historical review of the moral and ethical difficulties encountered in the treatment of addictive disorders. It proposes a dynamic understanding as to why clinicians might deploy such brutal actions in the face of hopeless and emotionally intense encounters.We found no scientific evidence or justification for ECT as a treatment of methamphetamine dependence or as the first line treatment for methamphetamine-induced psychiatric comorbidities.the current available evidence does not support using ECT for the treatment of addictive disorders, and hence is unethical, unacceptable and inhumane and warrants immediate social and political attention.

  9. [Patterns and personality disorders in persons with cocaine dependence in treatment].

    Science.gov (United States)

    López Durán, Ana; Becoña Iglesias, Elisardo

    2006-08-01

    The aim of the present study is to determine patterns and personality disorder in subjects under cocaine dependence treatment using MCMI-II, and their relationship with sociodemographic variables and consumption characteristics. We assess 102 subjects under cocaine dependence treatment in Drug Abuse Centers in Galicia (Spain). The results indicate that the most prevalent basic scales of personality are the passive-aggressive, antisocial, narcisism and histrionic. Borderline and paranoid scales are the most prevalent with regard to the pathological personality scales. These results coincide with other international and national studies. We conclude pointing out the necessity to carry out studies with wider cocaine dependence samples in treatment, and the specific inclusion criteria should be established in the study. We also indicate the importance of carrying out a previous assessment of all demanding treatment subjects to design the objectives of the mentioned treatment.

  10. An Introduction to Programming and Proving with Dependent Types in Coq

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    Adam Chlipala

    2010-01-01

    Full Text Available Computer proof assistants vary along many dimensions. Among the mature implementations, the Coq system is distinguished by two key features. First, we have support for programming with dependent types in the tradition of type theory, based on dependent function types and inductive type families. Second, we have a domain-specific language for coding correct-by-construction proof automation. Though the Coq user community has grown quite large, neither of the aspects I highlight is widely used. In this tutorial, I aim to provide a pragmatic introduction to both, showing how they can bring significant improvements in productivity.

  11. Optimization of conventional water treatment plant using dynamic programming.

    Science.gov (United States)

    Mostafa, Khezri Seyed; Bahareh, Ghafari; Elahe, Dadvar; Pegah, Dadras

    2015-12-01

    In this research, the mathematical models, indicating the capability of various units, such as rapid mixing, coagulation and flocculation, sedimentation, and the rapid sand filtration are used. Moreover, cost functions were used for the formulation of conventional water and wastewater treatment plant by applying Clark's formula (Clark, 1982). Also, by applying dynamic programming algorithm, it is easy to design a conventional treatment system with minimal cost. The application of the model for a case reduced the annual cost. This reduction was approximately in the range of 4.5-9.5% considering variable limitations. Sensitivity analysis and prediction of system's feedbacks were performed for different alterations in proportion from parameters optimized amounts. The results indicated (1) that the objective function is more sensitive to design flow rate (Q), (2) the variations in the alum dosage (A), and (3) the sand filter head loss (H). Increasing the inflow by 20%, the total annual cost would increase to about 12.6%, while 20% reduction in inflow leads to 15.2% decrease in the total annual cost. Similarly, 20% increase in alum dosage causes 7.1% increase in the total annual cost, while 20% decrease results in 7.9% decrease in the total annual cost. Furthermore, the pressure decrease causes 2.95 and 3.39% increase and decrease in total annual cost of treatment plants.

  12. Receipt of Prescribed Controlled Substances by Adolescents and Young Adults Prior to Presenting for Opiate Dependence Treatment

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    Steven C. Matson

    2013-01-01

    Full Text Available Purpose. The objective of this study was to document the number of controlled substance prescriptions filled by adolescents and young adult patients in the 2 years prior to presentation for opiate dependence treatment. Methods. Opiate-dependent youth ( presenting to our Medication-Assisted Treatment for Addiction program from January 1, 2008 to June 30, 2010 were identified via electronic medical record. Subjects were further classified based on their opiate use as dependent to heroin-only, prescription (Rx opiate-only, or combined heroin + Rx opiate only. The Ohio Automated Rx Reporting System (OARRS was used to identify each subject's controlled substance prescription history. Negative binomial regression was used to examine the relationships between patient characteristics and the total number of prescriptions filled. Results. Twenty-five percent of subjects had filled ≥6 prescriptions, and 15% had filled ≥11 prescriptions. The mean number of prescriptions filled was 5 (range: 0–59. Thirteen percent had filled ≥6 opiate/narcotic prescriptions, and 8% had filled ≥11 prescriptions. Conclusions. A subset of opiate-dependent youth had filled multiple opiate/narcotic prescriptions providing some evidence that physician-provided prescriptions may be a source of opiate abuse or diversion for a minority of opiate-dependent adolescents and young adults.

  13. LSVT LOUD and LSVT BIG: Behavioral Treatment Programs for Speech and Body Movement in Parkinson Disease

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    Cynthia Fox

    2012-01-01

    Full Text Available Recent advances in neuroscience have suggested that exercise-based behavioral treatments may improve function and possibly slow progression of motor symptoms in individuals with Parkinson disease (PD. The LSVT (Lee Silverman Voice Treatment Programs for individuals with PD have been developed and researched over the past 20 years beginning with a focus on the speech motor system (LSVT LOUD and more recently have been extended to address limb motor systems (LSVT BIG. The unique aspects of the LSVT Programs include the combination of (a an exclusive target on increasing amplitude (loudness in the speech motor system; bigger movements in the limb motor system, (b a focus on sensory recalibration to help patients recognize that movements with increased amplitude are within normal limits, even if they feel “too loud” or “too big,” and (c training self-cueing and attention to action to facilitate long-term maintenance of treatment outcomes. In addition, the intensive mode of delivery is consistent with principles that drive activity-dependent neuroplasticity and motor learning. The purpose of this paper is to provide an integrative discussion of the LSVT Programs including the rationale for their fundamentals, a summary of efficacy data, and a discussion of limitations and future directions for research.

  14. Mu opioid receptor (OPRM1 as a predictor of treatment outcome in opiate-dependent individuals of Arab descent

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    Tay GK

    2012-09-01

    Full Text Available Laith N AL-Eitan,1 Saied A Jaradat,2 Steve YS Su,3 Guan K Tay,1 Gary K Hulse4,51Centre for Forensic Science, 2Princess Haya Biotechnology Center, Jordan University of Science and Technology, Irbid, Jordan; 3School of Mathematics and Statistics, 4School of Psychiatry and Clinical Neurosciences, 5Unit for Research and Education in Alcohol and Drugs, Queen Elizabeth II Medical Centre, The University of Western Australia, Crawley, WA, AustraliaBackground: A number of research studies on the genetics of opiate dependence have focused on the µ-opioid receptor (OPRM1, which is a primary target for opiates. This study aims to identify genetic polymorphisms within the OPRM1 gene involved in response to the biopsychosocial treatment in opiate-dependent individuals of Arab descent.Methods: Unrelated Jordanian Nationals of Arab descent (N = 183 with opiate dependence were selected for this study. These individuals, all males, met the DSM-IV criteria for opiate dependence and were undergoing a voluntary 8-week treatment program at a Jordanian Drug Rehabilitation Centre. All individuals were genotyped for 22 single nucleotide polymorphisms (SNPs within the OPRM1 gene using the Sequenom MassARRAY® system (iPLEX GOLD. Statistical analyses were carried out using the R package.Results: Patients receiving biopsychosocial treatment showed that there was a significant difference in their OPRM1 SNPs’ genotyping distribution between good, moderate, and poor responders to the treatment at two sites (rs6912029 [G-172T], and rs12205732 [G-1510A], P < 0.05, Fisher’s exact test.Conclusion: This study is the first report of an association between the OPRM1 G-172T and G-1510A polymorphisms and treatment response for opiate dependence. Specifically, this study demonstrated that the OPRM1 GG-172 and GG-1510 genotypes were more frequent among patients who were nonresponders to the biopsychosocial treatment. However, further pharmacogenetic studies in a larger cohort of

  15. Changes in brain activation in breast cancer patients depend on cognitive domain and treatment type

    Science.gov (United States)

    Menning, Sanne; de Ruiter, Michiel B.; Veltman, Dick J.; Boogerd, Willem; Oldenburg, Hester S. A.; Reneman, Liesbeth

    2017-01-01

    Background Cognitive problems in breast cancer patients are common after systemic treatment, particularly chemotherapy. An increasing number of fMRI studies show altered brain activation in breast cancer patients after treatment, suggestive of neurotoxicity. Previous prospective fMRI studies administered a single cognitive task. The current study employed two task paradigms to evaluate whether treatment-induced changes depend on the probed cognitive domain. Methods Participants were breast cancer patients scheduled to receive systemic treatment (anthracycline-based chemotherapy +/- endocrine treatment, n = 28), or no systemic treatment (n = 24) and no-cancer controls (n = 31). Assessment took place before adjuvant treatment and six months after chemotherapy, or at similar intervals. Blood oxygen level dependent (BOLD) activation and performance were measured during an executive functioning task and an episodic memory task. Group-by-time interactions were analyzed using a flexible factorial design. Results Task performance did not differ between patient groups and did not change over time. Breast cancer patients who received systemic treatment, however, showed increased parietal activation compared to baseline with increasing executive functioning task load compared to breast cancer patients who did not receive systemic treatment. This hyperactivation was accompanied by worse physical functioning, higher levels of fatigue and more cognitive complaints. In contrast, in breast cancer patients who did not receive systemic treatment, parietal activation normalized over time compared to the other two groups. Conclusions Parietal hyperactivation after systemic treatment in the context of stable levels of executive task performance is compatible with a compensatory processing account of hyperactivation or maintain adequate performance levels. This over-recruitment of brain regions depends on the probed cognitive domain and may represent a response to decreased neural

  16. Measuring Dimensions of Spirituality in Chemical Dependence Treatment and Recovery: Research and Practice

    Science.gov (United States)

    Shorkey, Clayton; Uebel, Michael; Windsor, Liliane C.

    2008-01-01

    Spirituality and religiousness have long been associated with physical and mental health. The scientific treatment of religiosity as a multi-dimensional phenomenon is well established, especially in relation to chemical dependence treatment. Indeed, over 100 instruments are available for measuring various dimensions of religiosity. The more recent…

  17. Agonist substitution--a treatment alternative for high-dose benzodiazepine-dependent patients?

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    Liebrenz, Michael; Boesch, Lukas; Stohler, Rudolf; Caflisch, Carlo

    2010-11-01

    There is vast evidence for the superiority of agonist treatments (methadone, buprenorphine) over a withdrawal approach in opioid-dependent populations. Little research, however, has been conducted on the same approach for the treatment of high-dose benzodiazepine (BZD) dependence. Even large-scale reviews and meta-analyses discussing treatment strategies for benzodiazepine-dependent patients focus solely upon approaches that aim at achieving abstinence, namely on complete BZD withdrawal. While the types of interventions differ (e.g. gradual benzodiazepine taper with a long or a short half-life benzodiazepine, switching to non-benzodiazepine anxiolytics or prescribing adjunctive medications such as antidepressants or anticonvulsants on an in- or out-patient basis), the common aim of treatment still is total abstinence from benzodiazepines. However, the majority of patients suffering from high-dose BZD dependence do not succeed with long-term abstinence, irrespective of the procedure, and clinicians have been using BZD 'substitution' treatment in such cases for decades. Therefore, we suggest the evaluation of a substitution approach in this group, consisting of maintenance treatment with a slow-onset, long-acting BZD. Advantages of such a procedure may be improved health, less craving, fewer withdrawal complications, reduced anxiety, increased treatment retention, improvements in social functioning and less illegal activity. Cognitive impairments, the most problematic side effects of substitution treatment with benzodiazepines, could possibly be minimized by using an optimal agonist.

  18. Predicting Rapid Relapse Following Treatment for Chemical Dependence: A Matched-Subjects Design.

    Science.gov (United States)

    Svanum, Soren; McAdoo, William George

    1989-01-01

    Persons who underwent residential treatment for chemical dependency were identified as three-month treatment failures (N=52) or successes (N=52). Subjects were matched on Minnesota Multiphasic Personality Inventory (MMPI) scores. Found posttreatment depression, anxiety, and sleep problems strongly related to failure among psychiatric MMPI group;…

  19. 19 CFR 181.71 - Denial of preferential tariff treatment dependent on origin verification and determination.

    Science.gov (United States)

    2010-04-01

    ... FREE TRADE AGREEMENT Origin Verifications and Determinations § 181.71 Denial of preferential tariff... 19 Customs Duties 2 2010-04-01 2010-04-01 false Denial of preferential tariff treatment dependent...) of this part, Customs shall deny preferential tariff treatment on an imported good, or shall deny...

  20. Impact of rehabilitation programs on dependency and functional performance of patients with major lower limb amputations

    Science.gov (United States)

    AlSofyani, Mohammad A.; AlHarthi, Abdulaziz S.; Farahat, Fayssal M.; Abuznadah, Wesam T.

    2016-01-01

    Objectives: To determine pattern and impact of physical rehabilitation on dependency and functional performance of patients. Methods: This retrospective chart review was carried out between July and August 2012 at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Data were collected using demographic, clinical, and dependency assessment checklists. Results: Patients who underwent major lower limb amputations between January 2007 and April 2012 (n=121) were included in the study. There were 84 (69.4%) male and 37 (30.6%) female patients with a mean ± standard deviation of 63.3±17.4 years old. Diabetes mellitus was the most frequent cause in 63.6% of patients. Only one-third of the amputees (32.2%) have records of completion of their rehabilitation programs, although 20.7% of them completed the <50% of the scheduled rehabilitation sessions, 17.2% attended between 50% and 80%, and the remaining 62.1% attended more than 80% of the scheduled sessions. Muscle power scores in each side of the upper and lower limbs were significantly better following rehabilitation (p<0.0001). Basic functions of mobility and transfer have also significantly improved (p<0.05). Conclusions: Overall dependency and functional performance were significantly better following implementation of the physical rehabilitation programs. A multidisciplinary team approach is mandatory to improve compliance of patients toward the rehabilitation programs. PMID:27652362

  1. Lifetime substance use and HIV sexual risk behaviors predict treatment response to contingency management among homeless, substance-dependent MSM.

    Science.gov (United States)

    Reback, Cathy J; Peck, James A; Fletcher, Jesse B; Nuno, Miriam; Dierst-Davies, Rhodri

    2012-01-01

    Homeless, substance-dependent men who have sex with men (MSM) continue to suffer health disparities, including high rates of HIV. One-hundred and thirty one homeless, substance-dependent MSM were randomized into a contingency management (CM) intervention to increase substance abstinence and health-promoting behaviors. Participants were recruited from a community-based, health education/risk reduction HIV prevention program and the research activities were also conducted at the community site. Secondary analyses were conducted to identify and characterize treatment responders (defined as participants in a contingency management intervention who scored at or above the median on three primary outcomes). Treatment responders were more likely to be Caucasian/White (p interventions continues to be a public health priority, especially in the effort to implement effective interventions for use in community settings. The identification of both treatment responders and nonresponders is important for intervention development tailored to specific populations, both in service programs and research studies, to optimize outcomes among highly impacted populations.

  2. Clinical trial of treatment programs for purulent vaginal discharge in lactating dairy cattle in New Zealand.

    Science.gov (United States)

    McDougall, Scott; de Boer, Melvin; Compton, Chris; Leblanc, Stephen J

    2013-05-01

    Studies of treatment of postpartum endometritis in dairy cows indicate that prostaglandin (PGF2α) might result in similar outcomes as intrauterine antibiotics, but the effect might depend on the presence of a CL. The objective was to compare reproductive performance in cows with purulent vaginal discharge treated on the basis of having or not having a CL (CL-dependent treatment; CLdep), versus treatment of all affected cows with an intrauterine antibiotic alone. Cows (N = 756) from 36 seasonal calving dairy herds in New Zealand were enrolled on the basis of having a vaginal discharge score (VDS) ≥2 (mucus with flecks of pus or more purulent) after examination with the Metricheck device (Simcro, Hamilton, New Zealand) and ≥14 days after calving. The presence of a CL was assessed by transrectal palpation. Cows were randomly assigned within farm to be treated with an intrauterine antibiotic (0.5 g cephapirin) irrespective of CL status, or treated with PGF2α if a CL was present and cephapirin if a CL was not present (CLdep). The VDS was reassessed 14 days later. Cows were bred using standard practices and pregnancy was tested to define the date of conception. The proportion of cows clinically cured (i.e., with a VDS ≤1 at reexamination) did not differ between treatment groups (0.82 ± 0.03 vs. 0.80 ± 0.03) for the group of cows treated with an intrauterine antibiotic irrespective of CL status and the CLdep groups, respectively (P = 0.66). The proportions of cows submitted for AI by 21 days into the breeding program, pregnant to first breeding, pregnant by 42 days into the breeding program, and at the end of the breeding program, and the interval from the start of the mating program to pregnancy did not differ among treatment groups. Cows that had positive VDS (i.e., >1) at Day 14 after treatment had lower proportions of conception and pregnancy than those with lower (antibiotic.

  3. Predictors of attrition with buprenorphine/naloxone treatment in opioid dependent youth☆

    Science.gov (United States)

    Warden, Diane; Subramaniam, Geetha A.; Carmody, Thomas; Woody, George E.; Minhajuddin, Abu; Poole, Sabrina A.; Potter, Jennifer; Fishman, Marc; Bogenschutz, Michael; Patkar, Ashwin; Trivedi, Madhukar H.

    2012-01-01

    Background In opioid dependent youth there is substantial attrition from medication-assisted treatment. If youth at risk for attrition can be identified at treatment entry or early in treatment, they can be targeted for interventions to help retain them in treatment. Methods Opioid dependent adolescents and young adults (n=152), aged 15–21, were randomized to 12 weeks (BUP, n=74) or 2 weeks of detoxification (DETOX, n=78) with buprenorphine/naloxone (Bup/Nal), both in combination with 12 weeks of psychosocial treatment. Baseline and early treatment related predictors of treatment attrition were identified in each group using bivariate and multivariate logistic regression. Results In the DETOX group 36% left between weeks 2 and 4, at the end of the dose taper, while in the BUP group only 8% left by week 4. In the BUP group, early adherence to Bup/Nal, early opioid negative urines, use of any medications in the month prior to treatment entry, and lifetime non-heroin opioid use were associated with retention while prior 30-day hallucinogen use was associated with attrition. In the DETOX group, only use of sleep medications was associated with retention although not an independent predictor. A broad range of other pre-treatment characteristics was unrelated to attrition. Conclusions Prompt attention to those with early non-adherence to medication or an early opioid positive urine, markers available in the first 2 weeks of treatment, may improve treatment retention. Extended Bup/ Nal treatment appeared effective in improving treatment retention for youth with opioid dependence across a wide range of demographics, and pre-treatment clinical characteristics. PMID:22626890

  4. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

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    Jinhee Lee

    2015-01-01

    Full Text Available Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

  5. Gastrostomy Tube Weaning and Treatment of Severe Selective Eating in Childhood: Experience in Israel Using an Intensive Three Week Program.

    Science.gov (United States)

    Shalem, Tzippora; Fradkin, Akiva; Dunitz-Scheer, Marguerite; Sadeh-Kon, Tal; Goz-Gulik, Tali; Fishler, Yael; Weiss, Batia

    2016-06-01

    Children dependent on gastrostomy tube feeding and those with extremely selective eating comprise the most challenging groups of early childhood eating disorders. We established, for the first time in Israel, a 3 week intensive weaning and treatment program for these patients based on the "Graz model." To investigate the Graz model for tube weaning and for treating severe selective eating disorders in one center in Israel. Pre-program assessment of patients' suitability to participate was performed 3 months prior to the study, and a treatment goal was set for each patient. The program included a multidisciplinary outpatient or inpatient 3 week treatment course. The major outcome measures were achievement of the target goal of complete or partial tube weaning for those with tube dependency, and expansion of the child's nutritional diversity for those with selective eating. Thirty-four children, 28 with tube dependency and 6 with selective eating, participated in four programs conducted over 24 months. Their mean age was 4.3 ± 0.37 years. Of all patients, 29 (85%) achieved the target goal (24 who were tube-dependent and 5 selective eaters). One patient was excluded due to aspiration pneumonia. After 6 months follow-up, 24 of 26 available patients (92%) maintained their target or improved. This intensive 3 week program was highly effective in weaning children with gastrostomy tube dependency and ameliorating severe selective eating. Preliminary evaluation of the family is necessary for completion of the program and achieving the child's personal goal, as are an experienced multidisciplinary team and the appropriate hospital setup, i.e., inpatient or outpatient.

  6. Healthcare utilization of patients accessing an African national treatment program

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    Wood Robin

    2007-06-01

    Full Text Available Abstract Background The roll-out of antiretroviral therapy (ART in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. Methods This paper describes healthcare utilization from program entry by treatment-naïve patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count Results 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO, excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. Conclusion Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.

  7. Impulsivity is associated with treatment non-completion in cocaine- and methamphetamine-dependent patients but differs in nature as a function of stimulant-dependence diagnosis.

    Science.gov (United States)

    Winhusen, Theresa; Lewis, Daniel; Adinoff, Bryon; Brigham, Gregory; Kropp, Frankie; Donovan, Dennis M; Seamans, Cindy L; Hodgkins, Candace C; Dicenzo, Jessica C; Botero, Christopher L; Jones, Davina R; Somoza, Eugene

    2013-01-01

    Greater impulsivity, assessed by the Barratt Impulsiveness Scale-11 (BIS-11) and Stroop interference scores, has been associated with treatment completion in cocaine-dependent patients. This study evaluated the relationships among impulsivity, stimulant-dependence diagnosis, and treatment completion. Six sites evaluating 12-step facilitation for stimulant abusers obtained the BIS-11 and Stroop from 182 methamphetamine- and/or cocaine-dependent participants. Methamphetamine-dependent, relative to cocaine-dependent, participants evidenced significantly greater BIS-11 non-planning and total scores. There was a trend for poorer response inhibition, measured by the Stroop, in cocaine-dependent, relative to methamphetamine-dependent, participants. Accounting for other factors related to treatment completion, BIS-11 motor score, assessing the tendency to act without thinking, predicted treatment completion for both cocaine-dependent and methamphetamine-dependent patients. These results suggest that methamphetamine-dependent and cocaine-dependent patients may have different impulsivity profiles but that the BIS-11 may be useful in identifying both methamphetamine-dependent and cocaine-dependent patients who are at risk for treatment non-completion.

  8. Heroin-assisted treatment as a response to the public health problem of opiate dependence.

    Science.gov (United States)

    Fischer, Benedikt; Rehm, Jürgen; Kirst, Maritt; Casas, Miguel; Hall, Wayne; Krausz, Michael; Metrebian, Nicky; Reggers, Jean; Uchtenhagen, Ambros; van den Brink, Wim; van Ree, Jan M

    2002-09-01

    Injection drug use (involving the injection of illicit opiates) poses serious public health problems in many countries. Research has indicated that injection drug users are at higher risk for morbidity in the form of HIV/AIDS and Hepatitis B and C, and drug-related mortality, as well as increased criminal activity. Methadone maintenance treatment is the most prominent form of pharmacotherapy treatment for illicit opiate dependence in several countries, and its application varies internationally with respect to treatment regulations and delivery modes. In order to effectively treat those patients who have previously been resistant to methadone maintenance treatment, several countries have been studying and/or considering heroin-assisted treatment as a complementary form of opiate pharmacotherapy treatment. This paper provides an overview of the prevalence of injection drug use and the opiate dependence problem internationally, the current opiate dependence treatment landscape in several countries, and the status of ongoing or planned heroin-assisted treatment trials in Australia, Canada and certain European countries.

  9. Valoración de los usuarios de un programa de reducción de daños integrado en un ambulatorio de drogodependencias Users´ perception of a harm reduction program in an outpatient drug dependency treatment center

    Directory of Open Access Journals (Sweden)

    Constanza Daigre

    2010-12-01

    coffee», a methadone maintenance program, a room for supervised drug consumption, a place for personal hygiene, and medical and psychosocial follow-up. The particularity of this program lies in its integration within an outpatient drug treatment center forming part of a general hospital. Methods: We performed a descriptive study using qualitative methods. Theoretical sampling was conducted. Twelve in-depth interviews and one focus group composed of eight users were carried out. Information analysis was based on grounded theory. Literal transcriptions were coded and subsequently sorted into broad categories. Three researchers participated in this process and finally a fourth researcher triangulated the results. Results: Five dimensions were identified in the users´ discourse: accessibility, service, relationship, localization, and identity. Each consisted of several topics that were evaluated based on the participants´ experiences and expectations. The dimension of identity emerged as a distinctive element in patient-program bonding. Conclusions: The users´ overall evaluation of the program was positive. Facilitators and barriers influencing patient-program bonding were identified and participants suggested ways to remove barriers. The coexistence among users of the harm reduction program and patients treated conventionally provoked ambivalence but the team's management was deemed helpful in easing the difficulties arising from this situation.

  10. From Errors Treatment to Exceptions Treatment Regarding the Execution Control over Visual Basic Programs

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    Cristina Raluca POPESCU

    2008-01-01

    Full Text Available In order to comply with the quality standards and with the best practices, the execution of the professional programs must be rigorously controlled so that to avoid occurrence of unpredictable situations that might generate anomalies and could lead to computer blockage, forced termination of the execution and data loss. In traditional programming languages, including Visual Basic 6, the concept of error is extremely evolved. It is considered as error any situation in which the program fails to execute correctly, regardless if such anomaly is generated by a software or hardware cause. Nowadays the modern platforms, including VB.NET have introduced a new concept: exception. Unfortunately, perhaps by mistake, exception is assimilated by many IT specialists as an exceptional (extraordinary situation or a rare situation.We agree with the opinion of those IT specialists asserting that error is strictly dependant on the programmer, when he/she fails in correctly generating the application’s structures, whilst exception is a situation not fitting in the usual natural execution or as desired by the programmer or user, without meaning that it occurs more often or more rarely.Designing robust programs implies for such not to terminate abnormally or block, not even upon receiving improper parameters. Two aspects are referred to: the behavior regarding low level errors (caused by the operation system, memory allocation, reading/writing in files or hardware malfunctions and the reaction to the user’s errors, such as providing incorrect input data or incorrect use of operations in respect with their sequences. Notwithstanding what platform is used in designing the programs and regardless the controversy between the specialists, in order for the execution to be terminated under the program’s control, the commands that might generate anomalies and interruptions should be strictly monitored. Implicitly, the execution control

  11. The predictive validity of the Drinking-Related Cognitions Scale in alcohol-dependent patients under abstinence-oriented treatment

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    Sawayama Toru

    2012-05-01

    Full Text Available Abstract Background Cognitive factors associated with drinking behavior such as positive alcohol expectancies, self-efficacy, perception of impaired control over drinking and perception of drinking problems are considered to have a significant influence on treatment effects and outcome in alcohol-dependent patients. However, the development of a rating scale on lack of perception or denial of drinking problems and impaired control over drinking has not been substantial, even though these are important factors in patients under abstinence-oriented treatment as well as participants in self-help groups such as Alcoholics Anonymous (AA. The Drinking-Related Cognitions Scale (DRCS is a new self-reported rating scale developed to briefly measure cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment, including positive alcohol expectancies, abstinence self-efficacy, perception of impaired control over drinking, and perception of drinking problems. Here, we conducted a prospective cohort study to explore the predictive validity of DRCS. Methods Participants in this study were 175 middle-aged and elderly Japanese male patients who met the DSM-IV Diagnostic Criteria for Alcohol Dependence. DRCS scores were recorded before and after the inpatient abstinence-oriented treatment program, and treatment outcome was evaluated one year after discharge. Results Of the 175 participants, 30 were not available for follow-up; thus the number of subjects for analysis in this study was 145. When the total DRCS score and subscale scores were compared before and after inpatient treatment, a significant increase was seen for both scores. Both the total DRCS score and each subscale score were significantly related to total abstinence, percentage of abstinent days, and the first drinking occasion during the one-year post-treatment period. Therefore, good treatment outcome was significantly predicted by low

  12. Day treatment for cocaine dependence: incremental utility over outpatient counseling and voucher incentives.

    Science.gov (United States)

    Marlowe, Douglas B; Kirby, Kimberly C; Festinger, David S; Merikle, Elizabeth P; Tran, Giao Q; Platt, Jerome J

    2003-03-01

    Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling (n=39) or day treatment (n=40). Participants in both conditions received equivalent individual cognitive-behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.

  13. Long term outcomes of pharmacological treatments for opioid dependence: does methadone still lead the pack?

    Science.gov (United States)

    Garcia-Portilla, Maria Paz; Bobes-Bascaran, Maria Teresa; Bascaran, Maria Teresa; Saiz, Pilar Alejandra; Bobes, Julio

    2014-02-01

    The aim of this review was to update and summarize the scientific knowledge on the long term outcomes of the different pharmacological treatment options for opioid dependence currently available and to provide a critical discussion on the different treatment options based on these results. We performed a literature search using the PubMed databases and the reference lists of the identified articles. Data from research show that the three pharmacological options reviewed are effective treatments for opioid dependence with positive long term outcomes. However, each one has its specific target population and setting. While methadone and buprenorphine are first line options, heroin-assisted treatment is a second line option for those patients refractory to treatment with methadone with concomitant severe physical, mental, social and/or functional problems. Buprenorphine seems to be the best option for use in primary care offices. The field of opioid dependence treatment is poised to undergo a process of reinforcement and transformation. Further efforts from researchers, clinicians and authorities should be made to turn new pharmacological options into clinical reality and to overcome the structural and functional obstacles that maintenance programmes face in combatting opioid dependence.

  14. Overdose prevention in injecting opioid users: The role of substance abuse treatment and training programs

    Directory of Open Access Journals (Sweden)

    Ana Sarasa-Renedo

    2014-03-01

    Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.

  15. [Pharmacological treatment in alcohol-, drug- and benzodiazepine-dependent patients - the significance of trazodone].

    Science.gov (United States)

    Funk, Sándor

    2013-06-01

    Currently detoxification of drug and alcohol dependent patients is pharmacologically unresolved, and long-term treatment following the acute phase is also not very successful including a high number of relapses. We would need medications that on the short term cease: the severe vegetative symptoms, the pain, the extremely distressing psychosyndrome characterised by restlessness, anxiety or acute depressive symptoms, and the craving. The optimal would be if there was one medication capable of simultaneously alleviating or diminishing all the above symptoms without causing dependency and preventing relapse in the long-term. Dependency is almost all cases accompanied by primary and/or secondary mood disorder or sleep disorder which should also be treated. It should be considered, however, that following withdrawal of the agent benzodiazepine dependency often develops. The serotonin antagonist and reuptake inhibitor (SARI) trazodone is effective in the treatment of depression accompanied by sleeping disorder and it has also shown efficacy in alcohol and benzodiazepine-dependency. Its administration may improve the efficacy of detoxification and treatment of following conditions, may decrease medication load and the risk of the development of benzodiazepine dependency. In our clinical practice we frequently use this agent to treat our patients simultaneously suffering from depression and addiction problems, gaining experience comparing it to other pharmacotherapies (benzodiazepines or other antidepressants). The medication is not approved for alcohol and drug dependence, however, treatment t of comorbid conditions is not against to the official recommendations. Our aim was, in addition to reviewing the literature, to share our experience which, although cannot be considered an evidence based study, we deemed worthy of publishing. We cannot, at this point, put forward a protocol addressing all related scientific problems and problems of off-label treatment, and we could

  16. Time dependent pre-treatment EPID dosimetry for standard and FFF VMAT.

    Science.gov (United States)

    Podesta, Mark; Nijsten, Sebastiaan M J J G; Persoon, Lucas C G G; Scheib, Stefan G; Baltes, Christof; Verhaegen, Frank

    2014-08-21

    Methods to calibrate Megavoltage electronic portal imaging devices (EPIDs) for dosimetry have been previously documented for dynamic treatments such as intensity modulated radiotherapy (IMRT) using flattened beams and typically using integrated fields. While these methods verify the accumulated field shape and dose, the dose rate and differential fields remain unverified. The aim of this work is to provide an accurate calibration model for time dependent pre-treatment dose verification using amorphous silicon (a-Si) EPIDs in volumetric modulated arc therapy (VMAT) for both flattened and flattening filter free (FFF) beams. A general calibration model was created using a Varian TrueBeam accelerator, equipped with an aS1000 EPID, for each photon spectrum 6 MV, 10 MV, 6 MV-FFF, 10 MV-FFF. As planned VMAT treatments use control points (CPs) for optimization, measured images are separated into corresponding time intervals for direct comparison with predictions. The accuracy of the calibration model was determined for a range of treatment conditions. Measured and predicted CP dose images were compared using a time dependent gamma evaluation using criteria (3%, 3 mm, 0.5 sec). Time dependent pre-treatment dose verification is possible without an additional measurement device or phantom, using the on-board EPID. Sufficient data is present in trajectory log files and EPID frame headers to reliably synchronize and resample portal images. For the VMAT plans tested, significantly more deviation is observed when analysed in a time dependent manner for FFF and non-FFF plans than when analysed using only the integrated field. We show EPID-based pre-treatment dose verification can be performed on a CP basis for VMAT plans. This model can measure pre-treatment doses for both flattened and unflattened beams in a time dependent manner which highlights deviations that are missed in integrated field verifications.

  17. Time dependent pre-treatment EPID dosimetry for standard and FFF VMAT

    Science.gov (United States)

    Podesta, Mark; Nijsten, Sebastiaan M. J. J. G.; Persoon, Lucas C. G. G.; Scheib, Stefan G.; Baltes, Christof; Verhaegen, Frank

    2014-08-01

    Methods to calibrate Megavoltage electronic portal imaging devices (EPIDs) for dosimetry have been previously documented for dynamic treatments such as intensity modulated radiotherapy (IMRT) using flattened beams and typically using integrated fields. While these methods verify the accumulated field shape and dose, the dose rate and differential fields remain unverified. The aim of this work is to provide an accurate calibration model for time dependent pre-treatment dose verification using amorphous silicon (a-Si) EPIDs in volumetric modulated arc therapy (VMAT) for both flattened and flattening filter free (FFF) beams. A general calibration model was created using a Varian TrueBeam accelerator, equipped with an aS1000 EPID, for each photon spectrum 6 MV, 10 MV, 6 MV-FFF, 10 MV-FFF. As planned VMAT treatments use control points (CPs) for optimization, measured images are separated into corresponding time intervals for direct comparison with predictions. The accuracy of the calibration model was determined for a range of treatment conditions. Measured and predicted CP dose images were compared using a time dependent gamma evaluation using criteria (3%, 3 mm, 0.5 sec). Time dependent pre-treatment dose verification is possible without an additional measurement device or phantom, using the on-board EPID. Sufficient data is present in trajectory log files and EPID frame headers to reliably synchronize and resample portal images. For the VMAT plans tested, significantly more deviation is observed when analysed in a time dependent manner for FFF and non-FFF plans than when analysed using only the integrated field. We show EPID-based pre-treatment dose verification can be performed on a CP basis for VMAT plans. This model can measure pre-treatment doses for both flattened and unflattened beams in a time dependent manner which highlights deviations that are missed in integrated field verifications.

  18. Treatment of drug dependence with Brazilian herbal medicines Tratamento da dependência de drogas com plantas medicinais brasileiras

    Directory of Open Access Journals (Sweden)

    Elisaldo A. Carlini

    2006-12-01

    Full Text Available The topic "Herbal Medicines in the Treatment of Addictions" in a country must be preceded by answers to four questions: 1. Does the country in question possess a biodiversity rich enough to allow the discovery of useful medicines? 2. Do local people have tradition and culture to look for and use resources from Nature to alleviate and cure diseases, including drug dependence? 3. Is drug dependence (or addiction present in the country in question? 4. Do people of that country recognize and diagnose such problem as a serious one? Alcohol is, by far, the most serious health problem when drug abuse is considered, reaching all of Brazilian society, including the Indians. On the contrary, other drugs may be considered as minor problems and they are not the main focus of this manuscript. The people living in Brazilian hinterland don’t have access to public health systems. Consequently, these people seek assistance from "curandeiros" and "raizeiros"; the Indians are assisted by the shaman. These "folk doctors" do not know the academic medicine and therapeutics, and resort to the local plants to treat different ailments of their patients. Furthermore, alcohol abuse and dependence are not recognized by them, according to the rules and criteria of academic medicine. We have conducted a survey in many Brazilian books, Thesis concerning phytotherapy, and several databank. The results of such searches were very disappointing. No published papers from Brazilian authors concerning the use of plants for the treatment of addictions were found in the databases and there were only three very short notes in the masterly book written by Shultes and Raffauf (1990. From the Brazilian books on folk medicine employing medicinal plants, ten mentions were disclosed: most of them dealing with treatment of alcohol problems and two to counteract "Ayahuasca" dependence.O tema "Plantas medicinais no tratamento de dependência" em um país deve ser precedido pela resposta a

  19. [Risk/protective factors and prevention programs for drug dependence in Peru].

    Science.gov (United States)

    Cabanillas-Rojas, William

    2012-03-01

    Risk/ protective factors (RPF) are main elements for the analysis, understanding and formulation of answers for the prevention of drug dependences. The objective of this article is to present a literature review about the RPF and their implications in the design of preventive programs. It will focus on individual (genetic aspects, early experiences and psicosocial skills), family (parental control and monitoring, permissiveness, parenting styles), peer (group pressure and social norms) and communitarian (disorganization) RPF. On the other hand, the need of incorporating a multifactor conceptual framework for the preventive approach to drug dependences, articulating the intervention spaces (school, family and community), assuming and evolving perspective allowing the implementations of sustained actions is evidenced. On top, the implications for future research and public policy formulation are discussed.

  20. Sex differences in cocaine-dependent individuals’ response to disulfiram treatment

    Science.gov (United States)

    Nich, Charla; McCance-Katz, Elinore F.; Petrakis, Ismene L.; Cubells, Joseph F.; Rounsaville, Bruce J.; Carroll, Kathleen M.

    2013-01-01

    The objective of this study is to evaluate differential response to disulfiram treatment of cocaine dependence by sex. Sex by treatment interactions from two pooled randomized clinical trials involving 191 cocaine-dependent subjects (36% female) were evaluated. Primary outcomes were days of abstinence and percentage of drug-free urine specimens. Significant sex by treatment interactions were found, where men treated with disulfiram had better outcomes than those who were not. Women had an intermediate outcome regardless of whether they received disulfiram. Sex differences in response to disulfiram treatment have important clinical and theoretical implications. Reasons for this apparent sex-based response are not clear, but possible mechanisms worthy of greater study include differences in alcohol use by sex as well as differences in dopamine-mediated responses to cocaine and disulfiram. PMID:15236812

  1. A controlled trial of flumazenil and gabapentin for initial treatment of methylamphetamine dependence.

    Science.gov (United States)

    Urschel, Harold C; Hanselka, Larry L; Baron, Michael

    2011-02-01

    Drug use has been associated with craving, which may be described as a powerful and sometimes overwhelming urge to use the drug. Patients seeking treatment for methylamphetamine dependence must cope with drug cravings as they engage in psychosocial treatments. Changes in brain GABA(A) receptors during substance use and withdrawal provide a neurobiological basis for craving and associated anxiety. Flumazenil (a benzodiazepine antagonist) plus gabapentin (an antiepileptic) were compared with placebo in a randomized, double-blind study to assess the effects on craving during initial treatment for methylamphetamine dependence. Evaluation was conducted over a 30-day period. Craving and drug use were found to be highly correlated. Craving was reduced significantly in the flumazenil plus gabapentin group compared with placebo following the initial treatment period and throughout the 30 days. Decreased methylamphetamine use was also observed, as measured by urine drug screens and self-reports.

  2. Nuclear Waste Treatment Program annual report for FY 1988

    Energy Technology Data Exchange (ETDEWEB)

    Brouns, R.A.; Powell, J.A. (comps.)

    1989-11-01

    Much emphasis continues to be on the transfer of remote design technology for components integral to the West Valley Demonstration Project's (WVDP) vitrification process. In addition to preparing equipment specifications and drawings, Pacific Northwest Laboratory (PNL) staff also participated in numerous design coordination meetings and reviews of drawings prepared by other WVDP contractors. Nearly 200 jumper drawings for the vitrification cell were prepared by this program in FY 1988. The remote jumpers connect vessels in the cell to each other for the transfer of solutions and provide for the flow of materials, instrumentation signals, and power from outside the cell. Analysis required in preparing the jumper designs involved balance, thermal stress, seismic, set-down stress, and displacement calculations. Design efforts were begun on the canister decontamination and swipe station and on the remote maintenance station. Equipment selection and layouts of the vitrification off-gas treatment system, including a reamer to remotely clean the melter off-gas line, were finalized. Also finalized were the designs for the high-efficiency particulate air (HEPA) filter assemblies for heating, cooling and air conditioning of the vitrification cell.

  3. An intronic variant in OPRD1 predicts treatment outcome for opioid dependence in African-Americans.

    Science.gov (United States)

    Crist, Richard C; Clarke, Toni-Kim; Ang, Alfonso; Ambrose-Lanci, Lisa M; Lohoff, Falk W; Saxon, Andrew J; Ling, Walter; Hillhouse, Maureen P; Bruce, R Douglas; Woody, George; Berrettini, Wade H

    2013-09-01

    Although buprenorphine and methadone are both effective treatments for opioid dependence, their efficacy can vary significantly among patients. Genetic differences may explain some of the variability in treatment outcome. Understanding the interactions between genetic background and pharmacotherapy may result in more informed treatment decisions. This study is a pharmacogenetic analysis of the effects of genetic variants in OPRD1, the gene encoding the δ-opioid receptor, on the prevalence of opioid-positive urine tests in African-Americans (n=77) or European-Americans (n=566) undergoing treatment for opioid dependence. Patients were randomly assigned to treatment with either methadone or buprenorphine/naloxone (Suboxone) over a 24-week open-label clinical trial, in which illicit opioid use was measured by weekly urinalysis. In African-Americans, the intronic SNP rs678849 predicted treatment outcome for both medications. Methadone patients with the CC genotype were less likely to have opioid-positive urine tests than those in the combined CT and TT genotypes group (relative risk (RR)=0.52, 95% confidence interval (CI)=0.44-0.60, p=0.001). In the buprenorphine treatment group, however, individuals with the CC genotype were more likely to have positive opioid drug screens than individuals in the combined CT and TT genotypes group (RR=2.17, 95% CI=1.95-2.68, p=0.008). These findings indicate that the genotype at rs678849 predicts African-American patient response to two common treatments for opioid dependence, suggesting that matching patients to treatment type based on the genotype at this locus may improve overall treatment efficacy. This observation requires confirmation in an independent population.

  4. Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network (CTN)

    Science.gov (United States)

    Knudsen, Hannah K.; Abraham, Amanda J.; Roman, Paul M.; Studts, Jamie L.

    2011-01-01

    Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network (CTN). During face-to-face interviews conducted in 2005–2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two-thirds of these programs had at least one nurse on staff. In programs with nurses, the average rate of voluntary turnover was 15.0%. Turnover was significantly lower in hospital-based programs and programs offering adolescent treatment, but higher in facilities offering residential treatment. The majority of administrators indicated that filling vacant nurse positions was difficult and took more than two months to complete. These findings suggest that nurse turnover is a significant issue facing many substance abuse treatment facilities. Efforts to improve retention of the addiction treatment workforce should be expanded to include nursing professionals. PMID:21177062

  5. [Occlusion treatment for amblyopia. Age dependence and dose-response relationship].

    Science.gov (United States)

    Fronius, M

    2016-04-01

    Based on clinical experience and studies on animal models the age of 6-7 years was regarded as the limit for treatment of amblyopia, although functional improvement was also occasionally reported in older patients. New technical developments as well as insights from clinical studies and the neurosciences have attracted considerable attention to this topic. Various aspects of the age dependence of amblyopia treatment are discussed in this article, e. g. prescription, electronic monitoring of occlusion dosage, calculation of indicators for age-dependent plasticity of the visual system, and novel, alternative treatment approaches. Besides a discussion of the recent literature, results of studies by our "Child Vision Research Unit" in Frankfurt are presented: results of a questionnaire about prescription habits concerning age limits of patching, electronic recording of occlusion in patients beyond the conventional treatment age, calculation of dose-response function and efficiency of patching and their age dependence. The results of the questionnaire illustrate the uncertainty about age limits of prescription with significant deviations from the guideline of the German Ophthalmological Society (DOG). Electronic recording of occlusion allowed the quantification of declining dose-response function and treatment efficiency between 5 and 16 years of age. Reports about successful treatment with conventional and novel methods in adults are at variance with the notion of a rigid adult visual system lacking plasticity. Electronic recording of patching allowed new insights into the age-dependent susceptibility of the visual system and contributes to a more evidence-based treatment of amblyopia. Alternative approaches for adults challenge established notions about age limits of amblyopia therapy. Further studies comparing different treatment options are urgently needed.

  6. Mechanism-based medication development for the treatment of nicotine dependence

    OpenAIRE

    Xi, Zheng-Xiong; Spiller, Krista; Gardner, Eliot L.

    2009-01-01

    Tobacco use is a global problem with serious health consequences. Though some treatment options exist, there remains a great need for new effective pharmacotherapies to aid smokers in maintaining long-term abstinence. In the present article, we first discuss the neural mechanisms underlying nicotine reward, and then review various mechanism-based pharmacological agents for the treatment of nicotine dependence. An oversimplified hypothesis of addiction to tobacco is that nicotine is the major ...

  7. Psychological Treatment as Part of Dropout Prevention: An Israeli Program

    Science.gov (United States)

    Schwartz, Hava; Hain, Rebecca

    2014-01-01

    This article reports on the integration of psychotherapy in a comprehensive dropout prevention program developed at the Dean of Students' office of Ben-Gurion University of the Negev in Israel. The program's psychologists conducted psychotherapy with a subset of dropout prevention program participants who had reacted with emotional turmoil to the…

  8. [The effectiveness of psychosocial treatment approaches for alcohol dependence--a review].

    Science.gov (United States)

    Bottlender, M; Köhler, J; Soyka, M

    2006-01-01

    Treatment approaches which are used in the context of inpatient alcoholism treatment are frequently neither theoretically justified nor empirically examined. In view of the enormous method variety the necessity exists for the development of treatment guidelines in order to offer indicators of promising treatment achievement for practitioners and pension funds. In a first step, it must be examined which treatments are effective, which are ineffective and which are possibly even counter-productive. This article aims to give a comprehensive review of randomized-controlled studies/meta-analysis on the efficacy of different treatment approaches. This article reporting the literature review is part of a larger programme to develop clinical practice guidelines for rehabilitation which is supported in form, content and finance by the German Pension Institute for Salaried Employees (Bundesversicherungsanstalt für Angestellte, BfA). Summing up, treatment is effective compared to no treatment. Cognitive behavioural therapy included in a multimodal treatment program is effective. There are a number of treatment protocols for which controlled research has consistently found positive results like social skills training, community reinforcement approaches, behaviour contracting, motivation-enhancing treatment, and family/marital therapy. There is also a number of commonly used treatment approaches that brought neither a positive result or were counter productive like relapse prevention, non-behavioural marital therapy, and insight psychotherapy, confrontational counseling, education, relaxation training, and milieu therapy. Support for matching to a specific treatment is weak, but interventions against alcohol problems should be differentiated according to the severity of the alcohol problem. Since treatment evaluation is mainly accomplished in the US and supplying structures with respect to the US and Germany are substantially different, a generalized transmission of US

  9. Clinical effectiveness of baclofen for the treatment of alcohol dependence: a review

    Directory of Open Access Journals (Sweden)

    Brennan JL

    2013-07-01

    Full Text Available Jessica L Brennan,2 Jonathan G Leung,1 Jane P Gagliardi,3 Sarah K Rivelli,3 Andrew J Muzyk4 1Department of Hospital Pharmacy Services, Mayo Clinic, Rochester, MN, 2Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 4Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA Abstract: Baclofen, an agonist at the B subunit of gaba-aminobutyric acid receptor, possesses pharmacologic properties that may confer utility for the treatment of alcohol dependence. Research suggests that not only can it be useful in promoting maintenance of alcohol abstinence but also it may play a key role in decreasing alcohol cravings and anxiety often associated with alcohol dependence. To assess the benefit of baclofen for alcohol dependence, a review of the literature was conducted to identify published data investigating this off-label treatment. Four randomized controlled trials to date have been published and were included in this review. Although primary outcomes differ between studies, patients randomized to baclofen experience higher rates of abstinence from alcohol than those taking placebo in two of the trials. Secondary analyses indicate that baclofen is safe in patients with alcohol dependence, including those with moderate to severe liver cirrhosis, and may provide beneficial anxiolytic effects. Despite some positive data, the largest available randomized controlled trial failed to find any differences between baclofen and placebo. In all studies, individuals with severe medical comorbidities, seizure disorders, and psychiatric disorders were excluded from trials, which may limit external validity. In summary, there may be beneficial effects from using baclofen for the treatment of alcohol dependence; however, limited conclusions can be drawn from the small number of studies

  10. The appropriateness of the treatment setting for the inpatient post-acute treatment of alcohol dependence disorders in Switzerland

    Directory of Open Access Journals (Sweden)

    Odenwald Michael

    2009-07-01

    Full Text Available Abstract Background In Switzerland, a total of 1'000 patients a year are treated for alcohol-dependence in specialized institutions. Though the current literature suggests favoring outpatient treatment, whether outpatient or inpatient treatment is more efficient cannot be answered generally. For Germany, "AWMF"-treatment guidelines were formulated in order to treat patients with substance use disorders in the appropriate treatment settings. The aim of the present study was to test the hypothesis that the majority of patients treated in the largest specialized institution for alcohol abuse treatment in Switzerland were treated in the appropriate setting. Methods All completed treatments conducted in the Forel-Hospital – the largest clinic of its kind in Switzerland – between the 1st of January 2004 and the 20th of December 2006 were included in the investigation (n = 915. Patient and treatment characteristics were gathered using the information from the PSYREC and act-info questionnaire. The AWMF criteria were operationalized on the basis of the questionnaire. Results Applying the AWMF criteria resulted in the emergence of three groups: 73.7% of the study sample could clearly be assigned to the inpatient treatment group, and for 7.5% there was evidence supporting the allocation to an outpatient treatment setting. In 18.8% of the cases, however, the AWMF criteria did not allow an assignment to either of the treatment settings. Of the total sample, 18.5% of all patients apparently did not profit from the inpatient treatment setting, whereas for the vast majority (81.5%, a therapeutic progress was documented. In those patients who, according to the AWMF guidelines, did not need an inpatient setting, a larger proportion improved than in the group of the patients who needed an inpatient treatment in a specialized hospital. Furthermore, the logistic regression analyses revealed that the less severe the clinical state of a patient upon admittance

  11. Characterization of two Runx1-dependent nociceptor differentiation programs necessary for inflammatory versus neuropathic pain

    Directory of Open Access Journals (Sweden)

    Arber Silvia

    2010-07-01

    Full Text Available Abstract Background The cellular and molecular programs that control specific types of pain are poorly understood. We reported previously that the runt domain transcription factor Runx1 is initially expressed in most nociceptors and controls sensory neuron phenotypes necessary for inflammatory and neuropathic pain. Results Here we show that expression of Runx1-dependent ion channels and receptors is distributed into two nociceptor populations that are distinguished by persistent or transient Runx1 expression. Conditional mutation of Runx1 at perinatal stages leads to preferential impairment of Runx1-persistent nociceptors and a selective defect in inflammatory pain. Conversely, constitutive Runx1 expression in Runx1-transient nociceptors leads to an impairment of Runx1-transient nociceptors and a selective deficit in neuropathic pain. Notably, the subdivision of Runx1-persistent and Runx1-transient nociceptors does not follow the classical nociceptor subdivision into IB4+ nonpeptidergic and IB4- peptidergic populations. Conclusion Altogether, we have uncovered two distinct Runx1-dependent nociceptor differentiation programs that are permissive for inflammatory versus neuropathic pain. These studies lend support to a transcription factor-based distinction of neuronal classes necessary for inflammatory versus neuropathic pain.

  12. Design considerations for a study to evaluate the impact of smoking cessation treatment on stimulant use outcomes in stimulant-dependent individuals.

    Science.gov (United States)

    Winhusen, Theresa; Stitzer, Maxine; Woody, George; Brigham, Gregory; Kropp, Frankie; Ghitza, Udi; Lindblad, Robert; Adinoff, Bryon; Green, Cindy; Sharma, Gaurav; Somoza, Eugene

    2012-01-01

    Cigarette smoking is prevalent in cocaine/methamphetamine-dependent patients and associated with significant morbidity and mortality, yet, the provision of smoking cessation treatment in conjunction with substance use disorder (SUD) treatment is not standard practice. This is due, in part, to clinician concern that combining smoking cessation treatment with SUD treatment could lead to poorer SUD outcomes. The NIDA Clinical Trials Network is conducting a 10-week, two-group, randomized trial to evaluate the impact of providing smoking cessation treatment (SCT) with SUD treatment as usual (TAU), compared to TAU alone, in smokers who are in outpatient treatment for cocaine or methamphetamine dependence. Approximately 528 participants, recruited from 12 community treatment programs, will be randomized into the trial. The present paper describes key design decisions made during protocol development. The trial is designed to evaluate the relationship between cigarette smoking and stimulant use, which prior research suggests is linked, and should contribute to our understanding of how best to address the co-occurring problems of nicotine dependence and cocaine/methamphetamine-dependence. Unique aspects of the trial include the primary question of interest, which concerns the impact of providing SCT on SUD outcomes rather than on smoking outcomes, and the intensity of the SCT chosen, which includes bupropion, nicotine replacement, and two psychosocial interventions.

  13. A Preliminary Investigation of Acceptance and Commitment Therapy as a Treatment for Marijuana Dependence in Adults

    Science.gov (United States)

    Twohig, Michael P.; Shoenberger, Deacon; Hayes, Steven C.

    2007-01-01

    In this investigation, 3 adults who met criteria for marijuana dependence were treated using an abbreviated version of acceptance and commitment therapy (ACT). The treatment was delivered in eight weekly 90-min individual sessions. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design.…

  14. Creatinine Ratios in Dogs with Pituitary-Dependent Hypercortisolism during Trilostane Treatment

    NARCIS (Netherlands)

    Galac, S.; Buijtels, J.J.C.W.M.; Kooistra, H.S.

    2009-01-01

    J Vet Intern Med. 2009 Nov-Dec;23(6):1214-9. Epub 2009 Aug 26. Urinary Corticoid : Creatinine Ratios in Dogs with Pituitary-Dependent Hypercortisolism during Trilostane Treatment. Galac S, Buijtels JJ, Kooistra HS. Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine,

  15. Identification of patients at high risk of noncompliance in substance dependence treatment

    NARCIS (Netherlands)

    de Weert-van Oene, G. H.; Burger, H.; Grobbee, D. E.; Schrijvers, A. J. P.

    2007-01-01

    Noncompliance in substance dependence treatment seriously threatens its effectiveness. Pretreatment identification of those at the highest risk allows targeting of specific compliance enhancing interventions to those who may benefit most from it. In a cohort of 292 patients entering a 30-day treatme

  16. The Use of Gestalt Interventions in the Treatment of the Resistant Alcohol-Dependent Client.

    Science.gov (United States)

    Ramey, Luellen

    1998-01-01

    Reviews ethical and practical dilemmas associated with clients who have hidden alcohol dependencies, and proposes an approach rooted in Gestalt counseling theory which confronts these issues and is compatible with a current emerging alcohol-treatment model. Suggests specific activities for addressing client resistance to revealing a hidden alcohol…

  17. Programming of left hand exploits task set but that of right hand depends on recent history.

    Science.gov (United States)

    Tang, Rixin; Zhu, Hong

    2017-07-01

    There are many differences between the left hand and the right hand. But it is not clear if there is a difference in programming between left hand and right hand when the hands perform the same movement. In current study, we carried out two experiments to investigate whether the programming of two hands was equivalent or they exploited different strategies. In the first experiment, participants were required to use one hand to grasp an object with visual feedback or to point to the center of one object without visual feedback on alternate trials, or to grasp an object without visual feedback and to point the center of one object with visual feedback on alternating trials. They then performed the tasks with the other hand. The result was that previous pointing task affected current grasping when it was performed by the left hand, but not the right hand. In experiment 2, we studied if the programming of the left (or right) hand would be affected by the pointing task performed on the previous trial not only by the same hand, but also by the right (or left) hand. Participants pointed and grasped the objects alternately with two hands. The result was similar with Experiment 1, i.e., left-hand grasping was affected by right-hand pointing, whereas right-hand grasping was immune from the interference from left hand. Taken together, the results suggest that when open- and closed-loop trials are interleaved, motor programming of grasping with the right hand was affected by the nature of the online feedback on the previous trial only if it was a grasping trial, suggesting that the trial-to-trial transfer depends on sensorimotor memory and not on task set. In contrast, motor programming of grasping with the left hand can use information about the nature of the online feedback on the previous trial to specify the parameters of the movement, even when the type of movement that occurred was quite different (i.e., pointing) and was performed with the right hand. This suggests that

  18. Crisis intervention program: an alternative to inpatient psychiatric treatment for children.

    Science.gov (United States)

    Blumberg, Samuel H

    2002-03-01

    This study evaluated the impact of a Crisis Intervention program as an alternative to use of psychiatric treatment beds for young children. A multidisciplinary community-based intervention was utilized, including family therapy, psychiatric intervention, and school consultations. The impact of the service was evaluated in relation to the use of psychiatric treatment beds by the population of children eligible for Medicaid or uninsured. In comparison to an historical control group, the program resulted in a 23% reduction in the use of psychiatric treatment beds. A cost-minimization analysis indicated that in addition to the program reducing the use of psychiatric treatment beds, the cost of treatment was also slightly reduced.

  19. Tratamento farmacológico do tabagismo Pharmacological treatment of tobacco dependence

    Directory of Open Access Journals (Sweden)

    Guilherme Rubino de A. Focchi

    2005-10-01

    Full Text Available A cada ano, o tabagismo mata 5 milhões de pessoas em todo o mundo; este número tende a crescer nos próximos anos. A farmacoterapia tem grande importância no tratamento da dependência de nicotina. Este artigo faz uma revisão crítica dos principais tratamentos medicamentosos usados atualmente para o tratamento deste transtorno: a terapia de reposição de nicotina, a bupropiona e a nortriptilina.Each year, nicotine dependence kills five million people around the world and the morbidity and mortality due to tobacco use tends to increase in the following years. Pharmacotherapy has great importance in the treatment of nicotine dependence. This paper presents a critical review of the main pharmacotherapies presently available for the treatment of this disorder: nicotine replacement, bupropion and nortriptyline.

  20. A Preliminary Study of Sexual Dysfunction in Male Opioid-Dependants under Methadone Maintenance Treatment

    Directory of Open Access Journals (Sweden)

    Masoudeh Babakhanian

    2011-08-01

    Full Text Available Introduction: Sexual dysfunction is one of the prevalent problems of opiate-dependent patients. The current preliminarily study examines sexual dysfunction in a group of opiate-dependent patients before and after 6 months of MMT. Methods: The current study is a cross-sectional study. The numbers of 30 opiate-dependent patients were selected of Cheraghiyan clinic in Damghan, Iran. Demographics questionnaire and the International Index of Erectile Function were administered before and after treatment. Results: Erectile function showed an increase and intercourse satisfactions completely improved. Sexual desire and overall satisfaction increased, showing slight improvement while orgasmic function increased showing no improvement. Discussion: The findings revealed the prevalence of sexual dysfunction and improvement of some component in patients after treatment. Future studies are needed to explore the roles of other factors.

  1. VIRTUAL REALITY CUE EXPOSURE THERAPY FOR THE TREATMENT OF TOBACCO DEPENDENCE.

    Science.gov (United States)

    Culbertson, Christopher S; Shulenberger, Stephanie; De La Garza, Richard; Newton, Thomas F; Brody, Arthur L

    2012-01-01

    Researchers and clinicians have recently begun using Virtual Reality (VR) to create immersive and interactive cue exposure paradigms. The current study aimed to assess the effectiveness of individual cue exposure therapy (CET), using smoking-related VR cues (smoking-VR) as a smoking cessation treatment compared to a placebo-VR (neutral cue) treatment. The sample consisted of healthy treatment-seeking cigarette smokers, who underwent bi-weekly cognitive behavioral group therapy (CBT) plus either smoking-VR CET or placebo-VR CET (random assignment). Smoking-VR CET participants had a higher quit rate than placebo-VR CET participants (P = 0.015). Smoking-VR CET treated participants also reported smoking significantly fewer cigarettes per day at the end of treatment than placebo-VR CET treated participants (P = 0.034). These data indicate that smoking-related VR CET may prove useful in enhancing the efficacy of CBT treatment for tobacco dependence.

  2. Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial.

    Science.gov (United States)

    Kunøe, Nikolaj; Lobmaier, Philipp; Vederhus, John Kåre; Hjerkinn, Bjørg; Hegstad, Solfrid; Gossop, Michael; Kristensen, Øistein; Waal, Helge

    2009-06-01

    Naltrexone has considerable potential in helping to prevent relapse in heroin dependency. A longer-lasting formulation for naltrexone treatment is desirable to further reduce non-adherence and relapse during treatment of opiate dependence. To evaluate the safety and effectiveness of a 6-month naltrexone implant in reducing opioid use after in-patient treatment. A group of 56 abstinence-oriented patients who completed in-patient treatment for opioid dependence were randomly and openly assigned to receive either a 6-month naltrexone implant or their usual aftercare. Drug use and other outcomes were assessed at 6-month follow-up. Patients receiving naltrexone had on average 45 days less heroin use and 60 days less opioid use than controls in the 180-day period (both P<0.05). Blood tests showed naltrexone levels above 1 ng/ml for the duration of 6 months. Two patients died, neither of whom had received an implant. Naltrexone implant treatment safely and significantly reduces opioid use in a motivated population of patients.

  3. Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months.

    Science.gov (United States)

    Zawertailo, Laurie A; Baliunas, Dolly; Ivanova, Anna; Selby, Peter L

    2015-08-01

    Individuals with concurrent tobacco dependence and other addictions often report symptoms of low mood and depression and as such may have more difficulty quitting smoking. We hypothesized that current symptoms of depression would be a significant predictor of quit success among a group of smokers receiving individualized treatment for tobacco dependence within addiction treatment settings. Individuals in treatment for other addictions were enrolled in a smoking cessation program involving brief behavioral counseling and individualized dosing of nicotine replacement therapy. The baseline assessment included the Patient Health Questionnaire (PHQ9) for depression. Smoking cessation outcomes were measured at 3 and 6 months post-enrollment. Bivariate associations between cessation outcomes and PHQ9 score were analyzed. Of the 1,196 subjects enrolled to date, 1,171 (98%) completed the PHQ9. Moderate to severe depression (score >9) was reported by 28% of the sample, and another 29% reported mild depression (score between 5 and 9). Contrary to the extant literature and other findings by our own group, there was no association between current depression and cessation outcome at either 3 months (n = 1,171) (17.0% in those with PHQ9 > 9 vs. 19.8% in those with PHQ9 addictions treatment setting. These data indicate that patients in an addictions treatment setting can successfully quit smoking regardless of current depressive symptoms. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. CYP2A6 Polymorphisms May Strengthen Individualized Treatment for Nicotine Dependence

    Directory of Open Access Journals (Sweden)

    Yawo Mawuli Akrodou

    2015-01-01

    Full Text Available Each CYP2A6 gene variant metabolizes nicotine differently depending on its enzymatic activities. The normal nicotine metabolizer CYP2A6*1A is associated with high scores of nicotine dependence (5–10 on the Fagerström Test for Nicotine Dependence (FTND scale because it encodes for enzymes that catalyze nicotine 100%. Slow nicotine metabolizers (i.e., CYP2A6*1H, CYP2A6*4A, CYP2A6*9, and CYP2A6*12A are associated with underrated nicotine metabolizing activity (50%–75%, linking them to low scores for nicotine dependence (0–4 on the FTND scale. In a clinical trial involving the use of bupropion, people who were carriers of slow nicotine metabolizers were found to have a tendency to maintain abstinence 1.7 times longer than people with normal nicotine metabolizers. An overview of CYP2A6 polymorphism enzymatic activities in nicotine dependence etiology and treatment revealed that slow nicotine metabolizers may strengthen the individualized treatment of nicotine dependence.

  5. Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility

    Directory of Open Access Journals (Sweden)

    Witkiewitz K

    2012-02-01

    Full Text Available Katie Witkiewitz, Kimber Saville, Kacie HamreusDepartment of Psychology, Washington State University Vancouver, Vancouver, WA, USAAbstract: Acamprosate, or N-acetyl homotaurine, is an N-methyl-D-aspartate receptor modulator approved by the Food and Drug Administration (FDA as a pharmacological treatment for alcohol dependence. The exact mechanism of action of acamprosate is still under investigation, but the drug appears to work by promoting a balance between the excitatory and inhibitory neurotransmitters, glutamate and gamma-aminobutyric acid, respectively, and it may help individuals with alcohol dependence by reducing withdrawal-associated distress. Acamprosate has low bioavailability, but also has an excellent tolerability and safety profile. In comparison with naltrexone and disulfiram, which are the other FDA-approved treatments for alcohol dependence, acamprosate is unique in that it is not metabolized by the liver and is also not impacted by alcohol use, so can be administered to patients with hepatitis or liver disease (a common comorbid condition among individuals with alcohol dependence and to patients who continue drinking alcohol. Acamprosate has demonstrated its efficacy in more than 25 placebo-controlled, double-blind trials for individuals with alcohol dependence, and has generally been found to be more efficacious than placebo in significantly reducing the risk of returning to any drinking and increasing the cumulative duration of abstinence. However, acamprosate appears to be no more efficacious than placebo in reducing heavy drinking days. Numerous trials have found that acamprosate is not significantly more efficacious than naltrexone or disulfiram, and the efficacy of acamprosate does not appear to be improved by combining acamprosate with other active medications (eg, naltrexone or with psychosocial treatment (eg, cognitive-behavioral therapy. In this review, we present the data on acamprosate, including its pharmacology

  6. Expanding treatment capacity for opioid dependence with office-based treatment with buprenorphine: National surveys of physicians.

    Science.gov (United States)

    Arfken, Cynthia L; Johanson, Chris-Ellyn; di Menza, Salvatore; Schuster, Charles Roberts

    2010-09-01

    Office-based treatment of opioid dependence with buprenorphine has the potential to expand treatment capacity in the United States. However, nationally, little is known about the number, characteristics, and experiences of physicians certified to prescribe buprenorphine. Moreover, little is known about the impact of easing federal regulations on the number of patients a physician is allowed to treat concurrently. To address these questions, surveys of national samples of physicians certified to prescribe buprenorphine (2004-2008) were analyzed (N = 6,892). There has been a continual increase in the number of physicians certified to prescribe buprenorphine, increase in the mean number of patients treated by physicians, and decrease in patients turned away, coinciding temporally with easing of federal regulations. In addition, most physicians prescribed buprenorphine outside of traditional treatment settings. The U.S. experiment in expanding Schedule III-V medications for opioid dependence to physicians outside of formal substance abuse treatment facilities appears to have resulted in expanded capacity. Copyright 2010 Elsevier Inc. All rights reserved.

  7. Developing Treatment for Adolescents Who Stutter: A Phase I Trial of the Camperdown Program

    Science.gov (United States)

    Hearne, Anna; Packman, Ann; Onslow, Mark; O'Brian, Sue

    2008-01-01

    Purpose: To investigate in detail how adolescents who stutter perform during treatment, with the aim of informing treatment development for this age group. Method: The Camperdown Program was conducted with 3 adolescents who stutter. Their performance during treatment was recorded in detail, and outcome measures were collected before treatment and…

  8. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Science.gov (United States)

    2010-07-01

    ... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section 17.81... dependence or abuse disabilities. (a) Contracts for treatment services authorized under § 17.80(a) may be... Department of Veterans Affairs sponsored residents to adjust to and maintain freedom from dependence on...

  9. Pericyazine in the treatment of cannabis dependence in general practice: a naturalistic pilot trial

    Directory of Open Access Journals (Sweden)

    Morley KC

    2012-05-01

    Full Text Available Kirsten C Morley,1 Paul S Haber,1,2 Madeleine L Morgan,3 Fares Samara3,41Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia; 2Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; 3Drug and Alcohol Services, North Coast Area Health Service, Kempsey and Port Macquarie, NSW, Australia; 4Durri Aboriginal Medical Service, Kempsey, NSW, AustraliaAbstract: Cannabis is one of the most widely used illicit drugs worldwide. However, while the rates of cannabis dependence and treatment increase, there remains no medications approved for this use. Due to its sedative effects and low abuse liability, the typical antipsychotic pericyazine has been utilized in some parts of Australia for the treatment of cannabis dependence. We aimed to provide documentation of preliminary outcomes and acceptability of pericyazine treatment in a small sample. A naturalistic case series study was conducted in which 21 patients were enrolled for a 4-week course of pericyazine (up to 8 × 2.5 mg tablets daily and weekly medical review. Levels of cannabis use were reported and side effects with electrocardiography and blood tests were monitored. Measures of dependence severity, depression, anxiety, and insomnia were taken at baseline and follow-up utilizing validated psychometric tools. Significant reductions in cannabis use, depression, anxiety, and insomnia severity occurred across time. Pericyazine appeared to be well tolerated and easily administered in the community clinics. The results provide some preliminary evidence that low-dose short-term pericyazine may be an acceptable mode of treatment in this population. Given the open-label nature of the design, we cannot conclude that pharmacotherapy was uniquely responsible for the treatment effect. Nonetheless, low-dose pericyazine may be a potentially effective approach to the treatment of cannabis dependence, and further evaluation via a randomized placebo

  10. Novelty seeking as a predictor of treatment retention for heroin dependent cocaine users.

    Science.gov (United States)

    Helmus, T C; Downey, K K; Arfken, C L; Henderson, M J; Schuster, C R

    2001-02-01

    This study examined the relationship between novelty seeking between treatment retention and among heroin dependent cocaine users. Participants were treated with buprenorphine maintenance and contingency management. The Tridimensional Personality Questionnaire's (TPQ) Novelty Seeking scale was administered to 68 participants prior to buprenorphine induction. Demographics, mood and anxiety disorders, antisocial personality disorder, and substance use were also assessed. Variables with significant relationships with overall retention were entered into a logistic regression analysis. In addition, using a survival analysis, all variables with significant relationships with time to drop-out were entered into a multivariate proportional hazards regression with time dependent covariates. Results demonstrated that although high novelty seekers, in comparison to low novelty seekers, were more likely to drop-out by the end of treatment, they had higher retention rates during the early phases of treatment. It is suggested that buprenorphine and contingency management were viewed by participants as novel treatment components and thus facilitated high novelty seekers' success early in treatment. If replicated, results suggest that inclusion of novel treatment components might facilitate retention among this at-risk group.

  11. Increasing dependency of older people in nursing homes is associated with need for dental treatments

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    Zenthöfer A

    2014-12-01

    Full Text Available Andreas Zenthöfer, Peter Rammelsberg, Tomas Cabrera, Alexander Jochen Hassel Department of Prosthodontics, Dental School, University of Heidelberg, Heidelberg, Germany Abstract: To determine relationships between the need for dental treatments of institutionalized elderly people and cognitive impairment and the general level of care needed. Two hundred and sixty-eight residents of long-term care facilities in Germany were included in this study. Age, sex, diseases, number of frequently taken drugs, and location of the long-term care facility of the participants were recorded. For each participant, the need for care was assessed by use of the Barthel index (BI. Cognitive impairment was evaluated by use of the mini-mental state examination (MMSE. To assess dental treatment needs, the revised oral assessment guide (ROAG was applied for different oral health conditions, which were rated “healthy” or “treatment needed”. Spearman correlations were performed to evaluate associations between BI and MMSE and dental treatment needs. Statistical analysis revealed significant associations of BI (P<0.001 and MMSE (P=0.015 with the ROAG score. Increasing dependency and decreasing cognitive ability worsen oral health and increase the need for dental treatment. Keywords: elderly, dependency, Barthel index, treatment needs, oral health

  12. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Bruno José Barcellos Fontanella

    2005-12-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  13. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Fontanella Bruno José Barcellos

    2005-01-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  14. Caries Risk Assessment/Treatment Programs in U.S. Dental Schools.

    Science.gov (United States)

    Yorty, Jack S.; Brown, K. Birgitta

    1999-01-01

    A survey of 42 U.S. dental schools was conducted to identify the number and characteristics of caries risk- assessment/treatment programs. Findings address lectures about caries risk, use of variable recall programs, categorization of risk level, early detection and treatment of lesions, and restoration of radiographically visible lesions. (DB)

  15. Baclofen as relapse prevention in the treatment of gamma-hydroxybutyrate dependence: a case series.

    Science.gov (United States)

    Kamal, Rama M; Loonen, Anton J M; Dijkstra, Boukje A G; De Jong, Cornelis A J

    2015-06-01

    In the last decade, gamma-hydroxybutyrate (GHB) abuse and dependence have increased. It has been reported that GHB dependence has a high rate of relapse, serious complications of intoxication, and a potentially life-threatening withdrawal syndrome. Nevertheless, in clinical practice, there is no known medical treatment to support GHB relapse prevention. We describe a case series of patients who were supported through an off-label treatment with baclofen to avoid a relapse into GHB abuse, for a period of 12 weeks. Nine of 11 patients did not relapse while taking a dose ranging from 30 to 60 mg per day, one patient relapsed after 5 weeks, and one stopped after 7 weeks. Baclofen was well tolerated; patients reported mild side effects such as fatigue, nausea, dry mouth, excessive sweating, and depressive feelings. Although systematic evidence is still lacking, our practice-based experience suggests that treatment with baclofen to assist abstinence might be effective in patients with GHB dependence. Further systematic controlled studies are necessary to establish the exact efficacy and safety of baclofen as relapse prevention for GHB-dependent patients.

  16. The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS).

    Science.gov (United States)

    Ajami, Sima; Mellat-Karkevandi, Zahra

    2015-11-01

    Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS). This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient, complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services, being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness.

  17. The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2015-01-01

    Full Text Available Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS. This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient, complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services, being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness.

  18. [Treatment processes of pre-alcoholism and alcohol dependence targeted towards drinking reduction].

    Science.gov (United States)

    Yoshimura, Atsushi; Maesato, Hitoshi; Hisatomi, Nobuko; Higuchi, Susumu

    2013-02-01

    Since the 1990s, we have suggested the concept of pre-alcoholism which encompasses patients who have drunk a great deal of alcohol leading to alcohol related problems such as health issues, domestic violence, drunken driving and black-outs. Pre-alcoholism excludes alcohol-dependent patients who have experienced continuous drinking or withdrawal symptoms. We have treated many outpatients with pre-alcoholism for several years. Our regimen demands that the patients must be abstinent for half a year at the beginning of their treatment. After half a year they can choose whether they will continue to be abstinent or they will resume drinking with the aim of reducing their total alcohol consumption. The study clarified the character of pre-alcoholism by investigation of the patients' background and re-diagnosis of the patients based on the International Classification of Diseases, 10th Revision (ICD-10). A remarkable ratio of pre-alcoholic patients was diagnosed with alcohol dependence under ICD-10. We classified pre-alcoholic patients into two groups, one diagnosed as having ICD-10-classed alcohol dependence and the other which did not fulfill the ICD-10 diagnostic criteria of alcohol dependence, and examined the therapeutic processes of the two groups. It was shown that most pre-alcoholic patients could finally take required courses of treatment by themselves without regard to diagnosis under ICD-10, even if they chose any treatment and made alcohol related mistakes on the way. Our findings suggested that pre-alcoholic patients, a portion of whom may have exhibited mild alcohol dependence, could select drinking reduction as a primary goal of treatment after a certain period of abstinence.

  19. The Tripler Army Medical Center LEAN Program: a healthy lifestyle model for the treatment of obesity.

    Science.gov (United States)

    James, L C; Folen, R A; Garland, F N; Edwards, C; Noce, M; Gohdes, D; Williams, D; Bowles, S; Kellar, M A; Supplee, E

    1997-05-01

    This paper provides an overview of the Tripler Army Medical Center LEAN Program for the treatment of obesity, hypercholesterolemia, and essential hypertension. The LEAN Program, a multi-disciplinary prevention program, emphasizes healthy Lifestyles, Exercise and Emotions, Attitudes, and Nutrition for active duty service members. The treatment model offers a medically healthy, emotionally safe, and reasonable, low-intensity exercise program to facilitate weight loss. We will discuss the philosophy behind the LEAN Program and the major components. Thereafter, we will briefly discuss the preliminary results.

  20. Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review.

    Science.gov (United States)

    Barrio, Pablo; Ezzeldin, Mohamed; Bruguera, Pol; Pérez, Ana; Mansilla, Sara; Fàbrega, Marina; Lligoña, Anna; Mondón, Sílvia; Balcells, Mercè

    2016-06-14

    Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.

  1. Rituximab is an efficient and safe treatment in adults with steroid-dependent minimal change disease.

    Science.gov (United States)

    Munyentwali, Helene; Bouachi, Khedidja; Audard, Vincent; Remy, Philippe; Lang, Philippe; Mojaat, Rachid; Deschênes, Georges; Ronco, Pierre M; Plaisier, Emmanuelle M; Dahan, Karine Y

    2013-03-01

    Development of steroid dependency in patients with nephrotic syndrome may require a long-term multi-drug therapy at risk of drug toxicity and renal failure. Rituximab treatment reduces the steroid dosage and the need for immunosuppressive therapy in pediatric patients. Here we retrospectively analyze the efficacy and safety of rituximab in adult patients with steroid-dependent minimal change disease. To do this, we analyzed the outcome of all adult patients treated with rituximab for steroid-dependent minimal change nephrotic syndrome over a mean follow-up of 29.5 months (range 5.1-82 months). Seventeen patients with steroid-dependent or frequently relapsing minimal change nephrotic syndrome, unresponsive to several immunosuppressive medications, were treated with rituximab. Eleven patients had no relapses after rituximab infusion (mean follow-up 26.7 months, range 5.1-82 months) and nine of them were able to come off all other immunosuppressive drugs and steroids during follow-up. Six patients relapsed at least once after a mean time of 11.9 months (mean follow-up 34.5 months, range 16.9-50.1 months), but their immunosuppressive drug treatment could be stopped or markedly reduced during this time. No adverse events were recorded. Thus, rituximab is efficient and safe in adult patients suffering from severe steroid-dependent minimal change disease. Prospective randomized trials are needed to confirm this study.

  2. Dependent-Chance Goal Programming for Water Resources Management under Uncertainty

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    Haiying Guo

    2016-01-01

    Full Text Available Without sufficient data, consulting experts is a good way to quantify unknown parameters in water resources management which will result in human uncertainty. The aim of this paper is to introduce a new tool-uncertainty theory to deal with such uncertainty which is treated as uncertain variable with uncertainty distribution. And a dependent-chance goal programming (DCGP model is provided for water resources management under such circumstance. In the model uncertain measure is used to measure possibility that an event will occur which is maximized by minimizing the deviation (positive or negative deviation from target of objective event under a given priority structure. In the end, the developed model is applied to a numerical example to illustrate the effectiveness of the model. The result obtained contributes to the desired water-allocation schemes for decision-markers.

  3. Activity-Dependent NPAS4 Expression and the Regulation of Gene Programs Underlying Plasticity in the Central Nervous System

    Directory of Open Access Journals (Sweden)

    José Fernando Maya-Vetencourt

    2013-01-01

    Full Text Available The capability of the brain to change functionally in response to sensory experience is most active during early stages of development but it decreases later in life when major alterations of neuronal network structures no longer take place in response to experience. This view has been recently challenged by experimental strategies based on the enhancement of environmental stimulation levels, genetic manipulations, and pharmacological treatments, which all have demonstrated that the adult brain retains a degree of plasticity that allows for a rewiring of neuronal circuitries over the entire life course. A hot spot in the field of neuronal plasticity centres on gene programs that underlie plastic phenomena in adulthood. Here, I discuss the role of the recently discovered neuronal-specific and activity-dependent transcription factor NPAS4 as a critical mediator of plasticity in the nervous system. A better understanding of how modifications in the connectivity of neuronal networks occur may shed light on the treatment of pathological conditions such as brain damage or disease in adult life, some of which were once considered untreatable.

  4. Activity-Dependent NPAS4 Expression and the Regulation of Gene Programs Underlying Plasticity in the Central Nervous System

    Science.gov (United States)

    2013-01-01

    The capability of the brain to change functionally in response to sensory experience is most active during early stages of development but it decreases later in life when major alterations of neuronal network structures no longer take place in response to experience. This view has been recently challenged by experimental strategies based on the enhancement of environmental stimulation levels, genetic manipulations, and pharmacological treatments, which all have demonstrated that the adult brain retains a degree of plasticity that allows for a rewiring of neuronal circuitries over the entire life course. A hot spot in the field of neuronal plasticity centres on gene programs that underlie plastic phenomena in adulthood. Here, I discuss the role of the recently discovered neuronal-specific and activity-dependent transcription factor NPAS4 as a critical mediator of plasticity in the nervous system. A better understanding of how modifications in the connectivity of neuronal networks occur may shed light on the treatment of pathological conditions such as brain damage or disease in adult life, some of which were once considered untreatable. PMID:24024041

  5. Dependence of patients' life quality on severity of oral pathology: optimization of treatment approaches

    Directory of Open Access Journals (Sweden)

    Ivanova S.V.

    2011-03-01

    Full Text Available The research goals include: 1 assessment the quality of life of those patients who have defects of tooth rows not replaced by orthopedic appliances on the basis of the complex analysis; 2 choice of more reasonable method of treatment. The use of dental questionnaires such as Oral Health Impact Profile-14 (OHIP-14 while treating oral pathology allows both optimizing an approach to choosing an appropriate treatment method and making more successful prognosis as to the efficiency of treatment being performed. The quality of life of those patients who have tooth rows defects not replaced by orthopedic appliances depends on sex, age, family status, employment and extent of tooth rows defects. Patients with tooth rows defects not replaced by orthopedic appliances accompanied by diseases of peri-odontium are characterized by worse quality of life. This fact must be taken into consideration while planning patients' treatment

  6. CLINICAL OBSERVATION ON THERAPEUTIC EFFECTS OF COMBINED TREATMENT OF NONINSULIN DEPENDENT DIABETES

    Institute of Scientific and Technical Information of China (English)

    ZHU Jin-gui; QU Hui-qing

    2005-01-01

    Objective: To observe the therapeutic effect of combined treatment of diabetes mellitus (DM) and its complications. Methods: 30 cases of noninsulin dependent diabetes were treated by electroacupuncture (EA)of Tianzhu (天柱 BL 10), Dashu (大杼 BL 11), Fengmen (风门 BL 12), Jueyinshu (厥阴俞 BL 14), etc, massage at the acupoints along the Bladder Meridian, point injection of Vitamin B1, B6, B12 plus lidocaine at Neiguan (内关 PC 6) and Sanyinjiao (三阴交 SP 6, once every 3 days), cupping and physiotherapy comprehensively. The therapeutic effect was analyzed after 40 treatments. Results: After treatment, of the 30 cases, 23 (76.7%) experienced remarkable improvement in their symptoms and the rest 7 (23.3%) had improvement, with the total effective rate being 100%. Conclusion: The abovementioned combined treatment method works well in improving clinical symptoms of type Ⅱ DM patients.

  7. Dependent Lung Tension Pneumothorax During 1-Lung Ventilation: Treatment by Transmediastinal Thoracentesis.

    Science.gov (United States)

    Kenta, Okitsu; Shoko, Arimoto; Takeshi, Iritakenishi; Satoshi, Hagihira; Yuji, Fujino; Yasushi, Shintani; Masato, Minami; Meinoshin, Okumura

    2015-08-15

    Contralateral tension pneumothorax during 1-lung ventilation is rare but life threatening. We report the case of a patient who developed tension pneumothorax of the dependent lung during 1-lung ventilation while the surgeon was anastomosing the bronchi after sleeve lobectomy. Ventilation was not possible in either the dependent or nondependent lung, leading to severe desaturation and cardiac arrest. While the surgeons were administering direct cardiac compression, we suspected tension pneumothorax. As soon as the surgeons pierced the mediastinal pleura, adequate circulation was restored. Immediate diagnosis and treatment is important for this complication.

  8. [Decitabine treatment in myelodysplastic syndromes--results of a compassionate patient program in Israel].

    Science.gov (United States)

    Klepfish, Abraham; Silbershatz, Itay; Lugassy, Gilles; Shimoni, Avichai; Mittelman, Moshe

    2013-10-01

    Hypermethylation of tumor suppressor genes (TSG) has been recognized as an important factor in the pathogenesis of malignancies, including myelodysplastic syndromes (MDS). Decitabine (trade name Dacogen; 5-aza-2'-deoxycytidine) is a cytosine analog which inhibits the enzyme DNA methyltransferase (DNMT), inducing hypomethylation and activates TSG, leading to tumor cell growth inhibition. In clinical trials with hypomethylating agents in advanced MDS, a total response rate of 30-73% has been observed, with a complete response (CR) of 9-37%, partial response (PR] of similar rate and a hematologic improvement (HI] in 20-48% of the patients. We report the results of a national Israeli compassionate program of decitabine administration to patients with advanced MDS. From July 2007 through August 2008, under the joint sponsorship of The Israel Society of Hematology and Blood Transfusions and Janssen, Israel, a compassionate program was conducted. Decitabine was administered to patients with advanced MDS who were not candidates for any other anti-MDS treatment, except for supportive care. The selected regimen was a 5-day intravenous administration of 20 mg/m/d, every 28 days. After the program had been completed, an approval of the institutional Helsinki committees was obtained, and the data were collected in an attempt to evaluate the results of this novel treatment. The standard response criteria, i.e. total response, CR, PR and HI were applied. Toxicity, survival and leukemic transformation rate were also analyzed. Twenty-four patients with advanced MDS participated in the program but evaluable information could be collected only on 17 patients. The median number of therapeutic cycles was two per patient. Twelve patients were transfusion-dependent at program onset, of whom 7 either benefited from reduced transfusion requirements or became transfusion-free. The overall response rate was 26%, with 23% PR and 13% HI. Two patients (13%) demonstrated leukemic transformation

  9. Assertive Community Treatment For People With Alcohol Dependence: A Pilot Randomized Controlled Trial

    Science.gov (United States)

    Gilburt, Helen; Burns, Tom; Copello, Alex; Crawford, Michael; Day, Ed; Deluca, Paolo; Godfrey, Christine; Parrott, Steve; Rose, Abigail; Sinclair, Julia; Coulton, Simon

    2017-01-01

    Abstract Aims A pilot randomized controlled trial (RCT) to assess the feasibility and potential efficacy of assertive community treatment (ACT) in adults with alcohol dependence. Methods Single blind, individually randomized, pilot RCT of 12 months of ACT plus treatment as usual (TAU) versus TAU alone in adults (age 18+ years) with alcohol dependence and a history of previous unsuccessful alcohol treatment attending specialist community alcohol treatment services. ACT aimed to actively engage participants for 12 months with assertive, regular, minimum weekly contact. ACT was combined with TAU. TAU comprised access to the full range of services provided by the community teams. Primary outcome is mean drinks per drinking day and percent days abstinent at 12 months follow up. Analysis of covariance was conducted using 80% confidence intervals, appropriate in the context of a pilot trial. Results A total of 94 participants were randomized, 45 in ACT and 49 in TAU. Follow-up was achieved with 98 and 88%, respectively at 12 months. Those in ACT had better treatment engagement, and were more often seen in their homes or local community than TAU participants. At 12 months the ACT group had more problems related to drinking and lower quality of life than TAU but no differences in drinking measures. The ACT group had a higher percentage of days abstinent but lower quality of life at 6 months. The ACT group had less unplanned healthcare use than TAU. Conclusions An trial of ACT was feasible to implement in an alcohol dependent treatment population. Trial registration ISRCTN22775534 PMID:27940571

  10. Leflunomide treatment in corticosteroid-dependent myasthenia gravis: an open-label pilot study.

    Science.gov (United States)

    Chen, Pei; Feng, Huiyu; Deng, Juan; Luo, Yufei; Qiu, Li; Ou, Changyi; Liu, Weibin

    2016-01-01

    Leflunomide is an effective drug used in the treatment of rheumatoid arthritis. Here we report the findings of an open-label pilot study, which found that leflunomide is also an effective treatment for myasthenia gravis (MG). This study recruited 15 corticosteroid-dependent MG patients. For 6 months, leflunomide 20 mg was given to these patients daily along with prednisone. The quantitative myasthenia gravis (QMG) scores and MG activities of daily living (MG-ADL) profiles were measured in these MG patients. After 6 months of treatment, 9 of the 15 patients enrolled in this study showed improvements in both QMG and MG-ADL. The mean QMG scores (13.4 to 8.5) and MG-ADL profiles (5.8 to 2.8) were significantly decreased (P = 0.01, 0.006 respectively). Furthermore, we found that the mean corticosteroid doses were reduced after treatment with leflunomide (24.3 to 12.3 mg per day). Leflunomide is a well-tolerated and efficacious treatment for corticosteroid-dependent MG, which may also enable lower doses of corticosteroids to be administered.

  11. The effectiveness of treatment for substance dependence within the prison system in England: A review.

    OpenAIRE

    Harrison, Larry; Cappello, Rose; Alaszewski, Andy; Appleton, Sarah; Cook, Geoff

    2003-01-01

    This review was jointly commissioned by Geoff Cooke, Area Drug Strategy Co-ordinator\\ud for the Prison Service, the East and West Kent Health Authorities and the West Sussex\\ud Drug Action Team, as part of a wider programme of work evaluating the outcome\\ud effectiveness of drug treatment services within Kent, East Surrey and Sussex prisons. The\\ud specific aims of this scoping review were to identify treatments that are used for those\\ud with substance dependence, describe the current regime...

  12. Increased Drinking in a Trial of Treatments for Marijuana Dependence: Substance Substitution?

    OpenAIRE

    Kadden, Ronald M.; Litt, Mark D.; Kabela-Cormier, Elise; Petry, Nancy M.

    2009-01-01

    This report examines whether participants in a study of treatments for marijuana dependence may have increased their use of alcohol when they reduced or ceased marijuana use. Participants were randomly assigned to one of four psychosocial treatments and followed at 3-month intervals for one-year. Findings are from 207 cases with data at posttreatment and at least one other follow-up. 73% of cases reported an increase of at least 10% in drinking days over their level at intake, and 65% reporte...

  13. Programmed stuttering treatment for children: comparison of two establishment programs through transfer, maintenance, and follow-up.

    Science.gov (United States)

    Ryan, B P; Van Kirk Ryan, B

    1995-02-01

    Two different Establishment programs, Delayed Auditory Feedback (DAF) and Gradual increase in Length and Complexity of Utterance (GILCU), for improving the fluency of school-age children who stutter, were compared. The programs were carried out by 12 clinicians under supervision with 24 clients (12 elementary and 12 junior/senior high school) in the schools. Both programs produced important improvement in fluency in 23/24 (96%) of the children in a reasonable time period (7.9 hours). Generally, the two programs were similar in performance. The only difference (between GILCU and DAF) was that the GILCU program provided initially for better generalization of fluency. Transfer and Maintenance programs (10.4 hours) demonstrated that the children from the two Establishment programs performed in a similar manner and that the Transfer and Maintenance Programs were helpful. In a total of 18.3 hours of establishment, transfer, and maintenance treatment, 11 subjects, who completed the programs, reduced their stuttering from 7.9 SW/M to .8 SW/M at a 14-month follow-up showing that the children had maintained their fluency. Clinicians' performances contributed to the effectiveness and efficiency of the programs.

  14. Designing a Successful Acupuncture Treatment Program for Gulf War Illness

    Science.gov (United States)

    2016-10-01

    consultants . Funding Support: N/A Name: Beth Ann Schmitt Project Role: Research Assistant Researcher Identifier: N/A Nearest person ...Arlington, VA 22202- 4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for...and review goals with consultants , 3. Complete IRB Review, 4. Begin program evaluation with study subjects (in process), 5. Plan Program evaluation

  15. Comparison of craving for opioid in opioid-dependent individuals and people under methadone maintenance treatment

    Directory of Open Access Journals (Sweden)

    Azita Chehri

    2014-02-01

    Full Text Available Background: Methadone Maintenance Therapy (MMT is the most important treatment for opioid -dependency recurrence. The aim of this study was to compare the craving level in opioid-dependent individuals and people under methadone maintenance therapy. Methods: In this case – control study, 120 men with opioid dependency were selected through cluster sampling method. They were divided into two groups, 60 people in opioid-dependent group and 60 people in MMT group. Both groups were matched for age, sex, marital status, education, duration of opioid dependency and method of consumption. Then, they completed INCAS Substance Abuse Profile (ISAP, opiate withdrawal symptoms checklist, self–report of craving, Desire for Drug Questionnaire (DDQ, Obsessive Compulsive Drug Use Scale (OCDUS and visual cue-induced craving questionnaire. Data were analyzed by SPSS 15 using t-test and ANOVA. Results: Mean craving for drug significantly was lower in MMT group comparing opioid-dependent group (P<0.01. Conclusion: Methadone Maintenance Therapy decreased the craving for drugs and substances This can have an important role in relapse prevention.

  16. A Multi-Criteria Framework with Voxel-Dependent Parameters for Radiotherapy Treatment Plan Optimization

    CERN Document Server

    Zarepisheh, Masoud; Li, Nan; Jia, Xun; Jiang, Steve B

    2012-01-01

    In a treatment plan optimization problem for radiotherapy, a clinically acceptable plan is usually generated by an optimization process with weighting factors or reference doses adjusted for organs. Recent discoveries indicate that adjusting parameters associated with each voxel may lead to better plan quality. However, it is still unclear regarding the mathematical reasons behind it. To answer questions related to this problem, we establish in this work a new mathematical framework equipped with two theorems. The new framework clarifies the different consequences of adjusting organ-dependent and voxel-dependent parameters for the treatment plan optimization of radiation therapy, as well as the different effects of adjusting weighting factors versus reference doses in the optimization process. The main discoveries are threefold: 1) While in the organ-based model the selection of the objective function has an impact on the quality of the optimized plans, this is no longer an issue for the voxel-based model sin...

  17. Clonazepam as Agonist Substitution Treatment for Benzodiazepine Dependence: A Case Report

    Directory of Open Access Journals (Sweden)

    Angelo Giovanni Icro Maremmani

    2013-01-01

    Full Text Available Nowadays, the misuse of benzodiazepines (BZDs is a cause for a serious concern among pharmacologically inexperienced patients, whether treated or untreated, that could lead to significant complications, including tolerance, dependence, and addiction. We present a case report in which an Italian patient affected by anxiety disorder and treated with BZDs presented a severe case of dependence on BZDs. We treated him according to an agonist substitution approach, switching from the abused BZD to a slow-onset, long-acting, high potency agonist (clonazepam, and looking at the methadone treatment model as paradigm. We decided to use clonazepam for its pharmacokinetic properties. The advantage of choosing a slow-onset, long-lasting BZD for the treatment of our patient was that it led us to a remarkable improvement in the clinical situation, including the cessation of craving, absence of withdrawal symptoms, reduced anxiety, improvements in social functioning, and a better cognition level.

  18. A Preliminary Investigation of Acceptance and Commitment Therapy as a Treatment for Marijuana Dependence in Adults

    OpenAIRE

    Twohig, Michael P.; Shoenberger, Deacon; Hayes, Steven C

    2007-01-01

    In this investigation, 3 adults who met criteria for marijuana dependence were treated using an abbreviated version of acceptance and commitment therapy (ACT). The treatment was delivered in eight weekly 90-min individual sessions. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design. Self-reported marijuana use, confirmed through oral swabs, reached zero levels for all participants at posttreatment. At a 3-month follow-up, 1 partici...

  19. Job-dependent prevalence of selected risk factors for cardiovascular diseases in the prevention program participants

    Directory of Open Access Journals (Sweden)

    Marek Bryła

    2013-06-01

    Full Text Available Background: The paper aims to assess the prevalence of CVD risk factors taking into account the job type among CVD Prevention and Early Detection Program participants and to assess the likelihood of positive changes. Materials and methods: A group of 393 Program participants was the subject of our observation twice (2006-2008, and 2009-2011. The study subjects had their arterial blood pressure measured. We also analysed the concentration of lipids and glucose before breakfast and anthropometric measurements. Moreover, we used a survey questionnaire about the socio-economic situation of the study subjects, their health behaviors and status. The obtained results were subjected to a statistical treatment, including the Chi2 independence test and logistic regression. Results: Our study confirmed an association between the job type and arterial blood pressure, lipid disorders and prevalence of diabetes. Blue-collar workers suffered more often from CVD risk factors (arterial hypertension, high total cholesterol, high triglycerides, high glucose level before breakfast, diabetes, overweight, obesity than their white-collar colleagues. A 3-year observation showed a higher chance for positive changes in total cholesterol (OR = 2.90, triglycerides (OR = 2.91, glucose before breakfast (OR = 3.11 and body mass index (OR = 2.56 among white-collar workers. Conclusions: The assessment of the prevalence of CVD risk factors indicated a worse situation among blue-collar workers. We estimated the likelihood of positive changes three years after the launch of the prevention program. It turned out to be higher among white-collar workers. Med Pr 2013;64(3:307–315

  20. Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs.

    Science.gov (United States)

    Cochran, Bryan N; Peavy, K Michelle; Robohm, Jennifer S

    2007-01-01

    Substance abuse research has demonstrated that client sexual orientation influences treatment outcomes. Consequently, many substance user treatment programs offer services for lesbian, gay, bisexual, and transgender (LGBT) individuals. In a recent search of SAMHSA treatment listings, 11.8% (N=911) of substance user treatment programs (including residential, outpatient, and partial hospitalization) in the United States and Puerto Rico indicated that they offer specialized services for LGBT clients. However, a telephone survey we conducted in 2003-2004 revealed that 70.8% of these "LGBT" programs were no different from services offered to the general population, and only 7.4% could identify a service specifically tailored to the needs of LGBT clients. Implications for LGBT individuals seeking services are discussed, the study's limitations are noted, and future research directions are identified.

  1. The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample.

    Science.gov (United States)

    Potthast, Nadine; Neuner, Frank; Catani, Claudia

    2014-05-01

    Studies reporting a link between child maltreatment and addiction have typically focused on physical and sexual abuse. In contrast, emotional maltreatment has rarely been studied in substance-abusing samples although it is associated with a wide range of dysfunction. The current study aimed to determine the specific impact of different types of maltreatment and peer victimization on alcohol dependence and to examine the potentially mediating role of psychopathology. A sample of treatment seeking adults with alcohol dependence (N=72) underwent an extensive clinical examination including both a standardized interview and self-report measures. Child maltreatment, peer victimization, severity of alcohol dependence, and general psychopathology were assessed. Regression analyses revealed that emotional maltreatment was the strongest predictor of alcohol dependence severity whereas a unique contribution of peer victimization was not found. Our findings suggest that emotional maltreatment might have a major role in the etiology of AD that seems to exceed the contribution of other abuse and victimization experiences. Thereby, the study underscores the need for considering child maltreatment experiences in the prevention and treatment of AD.

  2. Cost-effectiveness of buprenorphine and naltrexone treatments for heroin dependence in Malaysia.

    Science.gov (United States)

    Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Ng, Nora; Schottenfeld, Richard

    2012-01-01

    To aid public health policymaking, we studied the cost-effectiveness of buprenorphine, naltrexone, and placebo interventions for heroin dependence in Malaysia. We estimated the cost-effectiveness ratios of three treatments for heroin dependence. We used a microcosting methodology to determine fixed, variable, and societal costs of each intervention. Cost data were collected from investigators, staff, and project records on the number and type of resources used and unit costs; societal costs for participants' time were estimated using Malaysia's minimum wage. Costs were estimated from a provider and societal perspective and reported in 2004 US dollars. Muar, Malaysia. 126 patients enrolled in a randomized, double-blind, placebo-controlled clinical trial in Malaysia (2003-2005) receiving counseling and buprenorphine, naltrexone, or placebo for treatment of heroin dependence. Primary outcome measures included days in treatment, maximum consecutive days of heroin abstinence, days to first heroin use, and days to heroin relapse. Secondary outcome measures included treatment retention, injection drug use, illicit opiate use, AIDS Risk Inventory total score, and drug risk and sex risk subscores. Buprenorphine was more effective and more costly than naltrexone for all primary and most secondary outcomes. Incremental cost-effectiveness ratios were below $50 for primary outcomes, mostly below $350 for secondary outcomes. Naltrexone was dominated by placebo for all secondary outcomes at almost all endpoints. Incremental treatment costs were driven mainly by medication costs, especially the price of buprenorphine. Buprenorphine appears to be a cost-effective alternative to naltrexone that might enhance economic productivity and reduce drug use over a longer term.

  3. A Comprehensive Treatment Program for a Case of Disturbed Anger

    Science.gov (United States)

    DiGiuseppe, Raymond

    2011-01-01

    Santanello (2011) presented the case of a man with long-term anger problems who does not meet the criteria for any "DSM-IV-TR" diagnosis for treatment recommendations by several authors. This paper presents a comprehensive treatment package applied to this case. Of crucial importance is the building of a therapeutic alliance. In addition to…

  4. The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

    Science.gov (United States)

    Morgan, Vanessa

    2014-03-01

    The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

  5. Therapeutic effects of ritual ayahuasca use in the treatment of substance dependence--qualitative results.

    Science.gov (United States)

    Loizaga-Velder, Anja; Verres, Rolf

    2014-01-01

    This qualitative empirical study explores the ritual use of ayahuasca in the treatment of addictions. Ayahuasca is an Amazonian psychedelic plant compound created from an admixture of the vine Banisteriopsis caapi and the bush Psychotria viridis. The study included interviews with 13 therapists who apply ayahuasca professionally in the treatment of addictions (four indigenous healers and nine Western mental health professionals with university degrees), two expert researchers, and 14 individuals who had undergone ayahuasca-assisted therapy for addictions in diverse contexts in South America. The study provides empirically based hypotheses on therapeutic mechanisms of ayahuasca in substance dependence treatment. Findings indicate that ayahuasca can serve as a valuable therapeutic tool that, in carefully structured settings, can catalyze neurobiological and psychological processes that support recovery from substance dependencies and the prevention of relapse. Treatment outcomes, however, can be influenced by a number of variables that are explained in this study. In addition, issues related to ritual transfer and strategies for minimizing undesired side-effects are discussed.

  6. Sudden Gains in the Treatment of Depression in a Partial Hospitalization Program

    Science.gov (United States)

    Drymalski, Walter M.; Washburn, Jason J.

    2011-01-01

    Objective: This study examines sudden gains (SGs), or rapid improvements in symptoms, among adults in treatment for depression in a partial hospitalization program (PHP). This study identifies the proportion of people who experience SGs in a PHP, when SGs occur in treatment, and the association of SGs with outcomes at the end of treatment. Method:…

  7. Sudden Gains in the Treatment of Depression in a Partial Hospitalization Program

    Science.gov (United States)

    Drymalski, Walter M.; Washburn, Jason J.

    2011-01-01

    Objective: This study examines sudden gains (SGs), or rapid improvements in symptoms, among adults in treatment for depression in a partial hospitalization program (PHP). This study identifies the proportion of people who experience SGs in a PHP, when SGs occur in treatment, and the association of SGs with outcomes at the end of treatment. Method:…

  8. The use of art and music therapy in substance abuse treatment programs.

    Science.gov (United States)

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

    2014-01-01

    Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

  9. Young people with heroin dependence: findings from the Australian Treatment Outcome Study (ATOS).

    Science.gov (United States)

    Mills, Katherine L; Teesson, Maree; Darke, Shane; Ross, Joanne; Lynskey, Michael

    2004-07-01

    This paper examines the patterns and correlates of heroin use in a cohort of 210 young Australians aged between 18 and 24, who were participants in the Australian Treatment Outcome Study, a longitudinal study of treatment outcomes for heroin dependence. Of major importance were the high rates of psychiatric comorbidity found among this group (37% lifetime Post Traumatic Stress Disorder, 23% current Major Depression, 75% Anti-Social Personality Disorder, and 51% Borderline Personality Disorder). Seventeen percent had attempted suicide in the preceding year. Although both the young (aged 18-24 years) heroin users and their older counterparts (aged 25-56 years) initiated drug use at the same age, young heroin users progressed to heroin use, regular heroin use, and treatment for heroin use, twice as quickly as older heroin users. These findings suggest that there is a limited window of opportunity in which early interventions may be applied before young heroin users progress to problematic use.

  10. Profile of deferasirox for the treatment of patients with non-transfusion-dependent thalassemia syndromes.

    Science.gov (United States)

    Ricchi, Paolo; Marsella, Maria

    2015-01-01

    It has been clearly shown that iron overload adds progressively significant morbidity and mortality in patients with non-transfusion-dependent thalassemia (NTDT). The lack of physiological mechanisms to eliminate the excess of iron requires effective iron chelation therapy. The reduced compliance to deferoxamine and the risk of severe hematological adverse events during deferiprone treatment have limited the use of both these drugs to correct iron imbalance in NTDT. According to the principles of evidence-based medicine, following the demonstration of the effectiveness and the safety of deferasirox (Exjade(®)) in a prospective, randomized, controlled trial, deferasirox was approved by the US Food and Drug Administration in May 2013 for the treatment of iron overload associated with NTDT. This review, assessing the available scientific literature, will focus on the profile of DFX in the treatment of non-transfusional hemosiderosis in patients with NTDT.

  11. [Gamma-hydroxybutyric acid (GHB) dependence and the GHB withdrawal syndrome: diagnosis and treatment].

    Science.gov (United States)

    van Noorden, Martijn S; Kamal, Rama; de Jong, Cor A J; Vergouwen, A C M Ton; Zitman, Frans G

    2010-01-01

    Gamma-hydroxybutyric acid (GHB) is a neurotransmitter that occurs naturally in the brain and is increasingly being used as a 'party drug' because of its relaxing and euphoria-inducing effects. GHB has a limited medical use in the treatment of narcolepsy. GHB-intoxications occur often in non-medical use, and generally result in a coma of short duration. GHB use several times a day can lead to tolerance and dependence. After sudden cessation or reduction of intensive GHB use, a severe withdrawal syndrome may occur with symptoms varying from tremor, anxiety and agitation to autonomic instability, hallucinations and delirium. Treatment of the GHB withdrawal syndrome consists of supportive care and benzodiazepines, often in high doses. The controlled detoxification of GHB using pharmaceutical GHB in an adjusted dose is currently being investigated in the Netherlands. There is no literature concerning the treatment of patients following GHB intoxication or after detoxification.

  12. Cytisine in the treatment of tobacco dependence: safety, efficacy, market in Eastern Europe

    Directory of Open Access Journals (Sweden)

    Aleksandra Herbec

    2016-03-01

    Full Text Available Cytisine is a generic partial agonist of nicotine receptors α4β2 that has been available in Eastern Europe since 1960s. Through decades of observations and clinical studies, with much research conducted in Poland, cytisine has been shown to be safe and highly cost-effective medication in treatment for tobacco dependence, with a profile potentially more favourable than that of varenicline. Poland remains among few European countries allowing for sales of cytisine. Currently, cytisine-based treatment is available over-the counter in Poland, where it is the dominant form of cessation pharmacotherapy. This presentation will outline the current state of knowledge on cytisine, as well as discuss the observations on sales and use of cytisine in treatment of smoking cessation in Poland. A case will be made for cytisine emerging as an ‘aspirin’ in smoking cessation, and an important element of future tobacco control worldwide.

  13. Efficacy of treatment in an opioid -dependent population group using the Maudsley Addiction Profile (MAP) tool.

    Science.gov (United States)

    Collins, Ruth; Boggs, Bob; Taggart, Noel; Kelly, Martin; Drillington, Aileen; Swanton, Ivy; Patterson, Diane

    2009-01-01

    A pilot study was performed to assess the effectiveness of treatment in an opioid dependent population using the Maudsley Addiction Profile (MAP) tool1.The primary outcome of the study was to assess if treatment had an effect on 1. Substance use (quantity and frequency of use), 2. Health risk behaviour (injecting and sharing injecting equipment), 3. Health symptoms (physical and psychological) and 4. Personal /Social functioning (relationships, employment and crime). A secondary outcome was also sought.The study took place in 2007 in an inner city Belfast hospital specialising in the treatment of addiction, over a two month period. Fifteen patients, all opioid dependent and receiving outpatient community treatment, were interviewed at baseline (prior to the commencement of treatment) and at eight weeks follow up.Three patients were lost to follow up. Two patients stopped using altogether. Of the remaining patients, improvements were seen in most areas. There was a decrease in the use of heroin (71.28%), cocaine (99.72%), crack cocaine (100%), cannabis (99.94%) and alcohol (33.17%). There was a reduction in injecting behaviour (60.93%). Improvements were observed in health with a reduction in physical (41.35%) and psychological (35%) symptoms. Overall personal and social functioning improved regarding interactions with family and friends. A reduction in crime was also observed (75%).Opinions and views of staff involved in the study were generally positive.This patient population presents with multiple and complex needs. Effective treatment needs to address these needs and not just drug addiction alone. The Maudsley Addiction Profile tool highlights this.

  14. Program Models for Mental Health Treatment of Refugees.

    Science.gov (United States)

    Jaranson, James M.; Bamford, Pauline

    This paper presents the approach used by the Technical Assistance Center (TAC) of the University of Minnesota's Refugee Assistance Program in Mental Health for identifying successful and culturally sensitive mental health service delivery models. It divides these into four categories: the psychiatric model; the community mental health model; the…

  15. Alemtuzumab in the treatment of IVIG-dependent chronic inflammatory demyelinating polyneuropathy.

    LENUS (Irish Health Repository)

    Marsh, E A

    2010-06-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an idiopathic immune mediated neuropathy causing demyelination and conduction block thought to occur as the result of an aberrant autoimmune response resulting in peripheral nerve inflammation mediated by T cells and humoral factors. Diagnosis commonly prompts initial treatment with steroids or intravenous immunoglobulin (IVIG) on which 5-35% subsequently become dependent to maintain function. Despite a number of small scale trials, the role for alternative long-term immunosuppression remains unclear. Alemtuzumab is a humanised monoclonal antibody targeting the CD52 antigen present on the surface of lymphocytes and monocytes. A single intravenous infusion results in rapid and profound lymphopoenia lasting >12 months. We report its use and clinical outcome in a small series of patients with severe IVIG-dependent CIDP. Seven patients (4 Males; 3 Females) who had failed to respond to conventional immunosuppression were treated in 5 centres receiving 9 courses of alemtuzumab (dose range 60-150 mg). Following treatment, mean monthly IVIG use fell 26% from 202 to 149 g and IVIG administration frequency from 22 to 136 days. Two patients had prolonged remission, two patients had a partial response and no clear benefit was observed in the remaining three patients (2 Males, 1 Females). Responding patients had a younger age at onset (19.5 years) and shorter disease duration than non-responders. Three patients developed autoimmune disease following treatment. Alemtuzumab may offer an alternative treatment for a subset of early onset IVIG dependent CIDP patients failing conventional immunosuppressive agents, but concerns about toxicity may limit its use.

  16. Impact of Physical Health on Treatment for Co-occurring Depression and Substance Dependence.

    Science.gov (United States)

    Tripp, Jessica C; Skidmore, Jessica R; Cui, Ruifeng; Tate, Susan R

    2013-01-01

    There is a high rate of comorbidity among substance dependence, depression, and physical health problems. This study aimed to examine the impact of pre-treatment physical health stressors (acute and chronic conditions) on outcomes of treatment in a sample of veterans with dual disorders (depression and substance dependence) who were randomized to integrated cognitive behavioral therapy versus 12-Step interventions. This study included 205 veterans (89.8% male, mean age = 49.5 years) enrolled in a clinical treatment outcomes trial. Chronic health problems (persistent, ongoing conditions lasting 2 weeks or more; e.g., arthritis, diabetes) and acute health events (occurring on a discrete date; e.g., injury, surgery, myocardial infarction) were coded dichotomously (presence versus absence) and evaluated separately. The impact of physical health stressors on abstinence (defined dichotomously), percentage of days abstinent, and depression symptoms were analyzed at the end of 12 and 24 weeks of treatment. Additionally, associations between intake motivation to change, health stressors, and substance use were examined. Analyses revealed that participants who had experienced a pretreatment acute health event had higher rates of abstinence at 12-weeks, higher percentage of days abstinent at 24-weeks, and higher depression symptoms at intake. Participants with chronic health difficulties had more severe depression at intake and those participants with severe chronic difficulties had greater depression symptoms across all time points. Chronic health difficulties were related to the Taking Steps factor of motivation to change substance use, but acute health events were not related to motivation to change. Motivation to change was also not related to substance outcomes in our sample. Physical health appears to have a complex relationship with co-occurring depression and substance dependence. Acute health problems predicted lower substance use, whereas chronic health problems

  17. Treatment of patient-dependent beam modifiers in photon treatments by the Monte Carlo dose calculation code PEREGRINE

    Energy Technology Data Exchange (ETDEWEB)

    Schach von Wittenau, A.E.; Cox, L.J.; Bergstrom, P.M. Jr.; Hornstein, S.M. [Lawrence Livermore National Lab., CA (United States); Mohan, R.; Libby, B.; Wu, Q. [Medical Coll. of Virginia, Richmond, VA (United States); Lovelock, D.M.J. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    1997-03-01

    The goal of the PEREGRINE Monte Carlo Dose Calculation Project is to deliver a Monte Carlo package that is both accurate and sufficiently fast for routine clinical use. One of the operational requirements for photon-treatment plans is a fast, accurate method of describing the photon phase-space distribution at the surface of the patient. The open-field case is computationally the most tractable; we know, a priori, for a given machine and energy, the locations and compositions of the relevant accelerator components (i.e., target, primary collimator, flattening filter, and monitor chamber). Therefore, we can precalculate and store the expected photon distributions. For any open-field treatment plan, we then evaluate these existing photon phase-space distributions at the patient`s surface, and pass the obtained photons to the dose calculation routines within PEREGRINE. We neglect any effect of the intervening air column, including attenuation of the photons and production of contaminant electrons. In principle, for treatment plans requiring jaws, blocks, and wedges, we could precalculate and store photon phase-space distributions for various combinations of field sizes and wedges. This has the disadvantage that we would have to anticipate those combinations and that subsequently PEREGRINE would not be able to treat other plans. Therefore, PEREGRINE tracks photons through the patient-dependent beam modifiers. The geometric and physics methods used to do this are described here. 4 refs., 8 figs.

  18. Monitoring a Prison Opioid Treatment Program Over a Period of Change to Clinical Governance Arrangements, 2007-2013.

    Science.gov (United States)

    Larney, Sarah; Lai, Wilson; Dolan, Kate; Zador, Deborah

    2016-11-01

    Opioid substitution therapy (OST) is an effective treatment for opioid dependence that is provided in many correctional settings, including New South Wales (NSW), Australia. In 2011, changes to the clinical governance of the NSW prison OST program were implemented, including a more comprehensive assessment, additional specialist nurses, and centralization of program management and planning. This study aimed to document the NSW prison OST program, and assess the impact of the enhanced clinical governance arrangements on retention in treatment until release, the provision of an OST prescription to patients at release, and presentation to a community OST clinic within 48 hours of release from custody. Data from the NSW prison OST program were obtained for the calendar years 2007-2013. Outcomes were analyzed quarterly using log binomial segmented regression. 8577 people were treated with OST in NSW correctional centers, 2007-2013. Over the entire study period, patients were retained in OST until release in 82% of treatment episodes; a prescription for OST was able to be arranged prior to release in 90% of releases; and patients presented to a community clinic within 48 hours of release in 94% of releases with prescriptions. Following the introduction of the changes to clinical governance, there was a significant increasing trend in retention in OST until release, and in provision of an OST prescription at release. There was an initial increase, followed by a decreasing trend, in presentation to a community clinic within 48 hours of release. This large prison-based OST program has high rates of retention in treatment and continuity of care as patients transition from custody to the community. Strengthened clinical governance arrangements were associated with increased retention in treatment until release and increased provision of an OST prescription at release, but did not improve clinic attendance following release from custody. Copyright © 2016 Elsevier Inc. All

  19. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  20. From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

    Science.gov (United States)

    Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

    2015-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

  1. The MTHFR C677T variant is associated with responsiveness to disulfiram treatment for cocaine dependency

    Directory of Open Access Journals (Sweden)

    Catherine eSpellicy

    2013-01-01

    Full Text Available Objective: Disulfiram is a one of the few pharmacotherapies for cocaine addiction that shows promise. Since disulfiram and cocaine both affect levels of global methylation we hypothesized the MTHFR gene, whose product is involved in supplying methyl groups for DNA and protein methylation, may be associated with responsiveness to disulfiram in cocaine-dependent individuals. Methods: Sixty-seven cocaine dependent patients were stabilized on methadone for two weeks and then randomized into disulfiram (250 mg/day, N = 32 and placebo groups (N =35 for 10 weeks. Patients were genotyped for the MTHFR (rs1801133, also known as C677T polymorphism and the data was evaluated for association with cocaine-free urines in the disulfiram or placebo groups. Data from patients that completed all ten weeks of the study (N = 56 were analyzed using repeated measures analysis of variance (ANOVA, corrected for population structure. Results: The CT or TT MTHFR genotype group (N = 32 dropped from 73% to 52% on disulfiram (p = 0.0001, while the placebo group showed no treatment effect. The CC MTHFR genotype group (N = 24 showed a reduced, but still significant, reduction in cocaine-positive urines on disulfiram compared to placebo; 81-69% (p = 0.007. Conclusion: This study indicates that a patient’s MTHFR genotype may be used to identify individuals who might show improved response to disulfiram treatment for cocaine dependence.

  2. The role of flumazenil in the treatment of benzodiazepine dependence: physiological and psychological profiles.

    Science.gov (United States)

    Hood, S; O'Neil, G; Hulse, G

    2009-06-01

    Two-related studies are presented here, detailing our early experience with benzodiazepine-dependent patients treated with a four-day flumazenil infusion using a novel delivery technique. Patients with long-term benzodiazepine dependence who attended the Australian Medical Procedures Research Foundation (AMPRF, Perth, Australia) for treatment were recruited for these studies. Self-reported psychological and physical symptoms, as well as objective vital signs data were collected at intervals before, during and 2 weeks postinfusion. Study A is a case series with cardiovascular measures; study B is an open trial that tracks the psychological profiles of 13 subjects. Withdrawal symptoms were tracked, however, the nature and severity of these symptoms differed between patients. No major complications or discomfort prompting study dropout was observed. Significant benzodiazepine abstinence occurred with this flumazenil infusion method despite high levels of initial dependence, comorbid substance use and comorbid psychiatric illness. Low-dose flumazenil infusion appears to be a safe and effective treatment resulting in withdrawal symptoms of lesser severity than any other cessation method currently available. Recommendations for future research are discussed.

  3. Dual diagnosis and chronology of illness in treatment-seeking Italian patients dependent on heroin.

    Science.gov (United States)

    Maremmani, Angelo Giovanni Icro; Dell'Osso, Liliana; Pacini, Matteo; Popovic, Dina; Rovai, Luca; Torrens, Marta; Perugi, Giulio; Maremmani, Icro

    2011-04-01

    Although there are studies describing the prevalence of patients with drug addiction and dual diagnosis, there is a paucity of data regarding the progression from psychiatric disorders to drug addiction or vice versa. A total of 1,090 patients dependent on heroin were interviewed to examine the presence of dual diagnosis and the progression from psychiatric disorders to drug dependence or vice versa. A total of 574 patients met the criteria for a dual diagnosis. A total of 362 patients progressed from substance abuse disorders to psychiatric disorders (SUD-PR) and 144 patients progressed from psychiatric disorders to drug addiction (PSY-PR). SUD-PR patients are more frequently affected by mood disorders. PSY-PR patients were more frequently diagnosed as psychotic or affected by anxiety disorders. The authors' findings suggest that the self-medication theory of dual diagnosis was relevant only for those with existing diagnoses of schizophrenia or anxiety disorders. When treating patients with a dual diagnosis, clinicians should ensure that the same attention is given to the treatment of drug dependence as it is to the treatment of comorbid psychiatric conditions.

  4. A Literature Review of Cost-Benefit Analyses for the Treatment of Alcohol Dependence

    Directory of Open Access Journals (Sweden)

    Satya Mohapatra

    2011-08-01

    Full Text Available The purpose of this study was to conduct a literature review of cost-benefit studies on pharmacotherapy and psychotherapy treatments of alcohol dependence (AD. A literature search was performed in multiple electronic bibliographic databases. The search identified seven psychotherapy studies from the USA and two pharmacotherapy studies from Europe. In the psychotherapy studies, major benefits are typically seen within the first six months of treatment. The benefit-cost ratio ranged from 1.89 to 39.0. Treatment with acamprosate was found to accrue a net benefit of 21,301 BEF (528 € per patient over a 24-month period in Belgium and lifetime benefit for each patient in Spain was estimated to be Pta. 3,914,680 (23,528 €. To date, only a few studies exist that have examined the cost-benefit of psychotherapy or pharmacotherapy treatment of AD. Most of the available treatment options for AD appear to produce marked economic benefits.

  5. Widespread FRA1-dependent control of mesenchymal transdifferentiation programs in colorectal cancer cells.

    Directory of Open Access Journals (Sweden)

    Jeannine Diesch

    Full Text Available Tumor invasion and metastasis involves complex remodeling of gene expression programs governing epithelial homeostasis. Mutational activation of the RAS-ERK is a frequent occurrence in many cancers and has been shown to drive overexpression of the AP-1 family transcription factor FRA1, a potent regulator of migration and invasion in a variety of tumor cell types. However, the nature of FRA1 transcriptional targets and the molecular pathways through which they promote tumor progression remain poorly understood. We found that FRA1 was strongly expressed in tumor cells at the invasive front of human colorectal cancers (CRCs, and that its depletion suppressed mesenchymal-like features in CRC cells in vitro. Genome-wide analysis of FRA1 chromatin occupancy and transcriptional regulation identified epithelial-mesenchymal transition (EMT-related genes as a major class of direct FRA1 targets in CRC cells. Expression of the pro-mesenchymal subset of these genes predicted adverse outcomes in CRC patients, and involved FRA-1-dependent regulation and cooperation with TGFβ signaling pathway. Our findings reveal an unexpectedly widespread and direct role for FRA1 in control of epithelial-mesenchymal plasticity in CRC cells, and suggest that FRA1 plays an important role in mediating cross talk between oncogenic RAS-ERK and TGFβ signaling networks during tumor progression.

  6. TGF-β suppresses β-catenin-dependent tolerogenic activation program in dendritic cells.

    Directory of Open Access Journals (Sweden)

    Bryan Vander Lugt

    Full Text Available The mechanisms that underlie the critical dendritic cell (DC function in maintainance of peripheral immune tolerance are incompletely understood, although the β-catenin signaling pathway is critical for this role. The molecular details by which β-catenin signaling is regulated in DCs are unknown. Mechanical disruption of murine bone marrow-derived DC (BMDC clusters activates DCs while maintaining their tolerogenic potential and this activation is associated with β-catenin signaling, providing a useful model with which to explore tolerance-associated β-catenin signaling in DCs. In this report, we demonstrate novel molecular features of the signaling events that control DC activation in response to mechanical stimulation. Non-canonical β-catenin signaling is an essential component of this tolerogenic activation and is modulated by adhesion molecules, including integrins. This unique β-catenin-dependent signaling pathway is constitutively active at low levels, suggesting that mechanical stimulation is not necessarily required for induction of this unique activation program. We additionally find that the immunomodulatory cytokine TGF-β antagonizes β-catenin in DCs, thereby selectively suppressing signaling associated with tolerogenic DC activation while having no impact on LPS-induced, β-catenin-independent immunogenic activation. These findings provide new molecular insight into the regulation of a critical signaling pathway for DC function in peripheral immune tolerance.

  7. Selective amputation of the pharynx identifies a FoxA-dependent regeneration program in planaria

    Science.gov (United States)

    Adler, Carolyn E; Seidel, Chris W; McKinney, Sean A; Sánchez Alvarado, Alejandro

    2014-01-01

    Planarian flatworms regenerate every organ after amputation. Adult pluripotent stem cells drive this ability, but how injury activates and directs stem cells into the appropriate lineages is unclear. Here we describe a single-organ regeneration assay in which ejection of the planarian pharynx is selectively induced by brief exposure of animals to sodium azide. To identify genes required for pharynx regeneration, we performed an RNAi screen of 356 genes upregulated after amputation, using successful feeding as a proxy for regeneration. We found that knockdown of 20 genes caused a wide range of regeneration phenotypes and that RNAi of the forkhead transcription factor FoxA, which is expressed in a subpopulation of stem cells, specifically inhibited regrowth of the pharynx. Selective amputation of the pharynx therefore permits the identification of genes required for organ-specific regeneration and suggests an ancient function for FoxA-dependent transcriptional programs in driving regeneration. DOI: http://dx.doi.org/10.7554/eLife.02238.001 PMID:24737865

  8. Profile of deferasirox for the treatment of patients with non-transfusion-dependent thalassemia syndromes

    Directory of Open Access Journals (Sweden)

    Ricchi P

    2015-12-01

    Full Text Available Paolo Ricchi,1 Maria Marsella1,2 1UOSD Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale “Antonio Cardarelli”, Naples, 2UOC Pediatria, Azienda Ospedaliera di Rilievo Nazionale G. Rummo, Benevento, Italy Abstract: It has been clearly shown that iron overload adds progressively significant morbidity and mortality in patients with non-transfusion-dependent thalassemia (NTDT. The lack of physiological mechanisms to eliminate the excess of iron requires effective iron chelation therapy. The reduced compliance to deferoxamine and the risk of severe hematological adverse events during deferiprone treatment have limited the use of both these drugs to correct iron imbalance in NTDT. According to the principles of evidence-based medicine, following the demonstration of the effectiveness and the safety of deferasirox (Exjade® in a prospective, randomized, controlled trial, deferasirox was approved by the US Food and Drug Administration in May 2013 for the treatment of iron overload associated with NTDT. This review, assessing the available scientific literature, will focus on the profile of DFX in the treatment of non-transfusional hemosiderosis in patients with NTDT. Keywords: non-transfusion-dependent thalassemia, deferasirox, profile, iron overload

  9. Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

    Science.gov (United States)

    Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

    2016-04-01

    Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Chapter 11. Narratives of clients' experiences of drug use and treatment of substance use-related dependency.

    Science.gov (United States)

    von Braun, Therese; Larsson, Sam; Sjöblom, Yvonne

    2013-11-01

    The article focuses on narratives of clients' experiences of using/misusing alcohol and drugs and includes comments on their therapeutic process during treatment for dependency on psychoactive drugs. It discusses the role of narratives that focus on clients' experiences of understanding the use/misuse of psychoactive drugs, emphasizing the importance of the narratives. Narrative therapy for substance-use-related dependency is discussed. Insight into the treatment processes of dependency, based on narrative case illustrations, is also provided.

  11. Yoga in the treatment of eating disorders within a residential program: A randomized controlled trial.

    Science.gov (United States)

    Pacanowski, Carly R; Diers, Lisa; Crosby, Ross D; Neumark-Sztainer, Dianne

    2017-01-01

    To investigate the effect of yoga on negative affect (an eating disorders risk factor), 38 individuals in a residential eating disorder treatment program were randomized to a control or yoga intervention: 1 hour of yoga before dinner for 5 days. Negative affect was assessed pre- and post-meal. Mixed-effects models compared negative affect between groups during the intervention period. Yoga significantly reduced pre-meal negative affect compared to treatment as usual; however, the effect was attenuated post-meal. Many eating disorders programs incorporate yoga into treatment. This preliminary evidence sets the stage for larger studies examining yoga and eating disorder treatment and prevention.

  12. A Guide for the Management of Speical Education Programs. 4.0 Drug Information for Educators, Parents, and Students. Newday Operations Guide for Drug Dependent Minor Programs.

    Science.gov (United States)

    Santa Cruz County Superintendent of Schools, CA.

    Presented is the fourth component of a special day class program for drug dependent minors, Drug Information for Educators, Parents, and Students. The first section, intended for educators, includes a drug abuse chart, information on the drug subculture, information on patterns of drug abuse and misconceptions about drugs, and suggested activities…

  13. Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.

    Science.gov (United States)

    Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

    2017-09-01

    Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional

  14. Criminally Committed Inpatients in a Residential Forensic Pre-Release Treatment Program: An Exploratory Study.

    Science.gov (United States)

    Koetting, Mark G.; Grabarek, Joanna; Van Hasselt, Vincent B.; Hazelwood, Robert R.

    2003-01-01

    Investigation was conducted into the demographic, psychopathological, and offense characteristics of forensic psychiatric patients in residential treatment program. Descriptive findings, including victim variables, are presented. Select case vignettes, including offense profiles, are described. Clinical implications for risk assessment and…

  15. Effects of a Rational-Emotive Treatment Program on Type A Behavior Among College Students.

    Science.gov (United States)

    Thurman, Christopher W.

    1983-01-01

    Investigated the effectiveness of rational-emotive therapy in treating Type A behavior in college students (N=22). Results showed the RET program was significantly more effective than no treatment in reducing Type A behavior, irrational beliefs, and anxiety. (JAC)

  16. Operation of Wastewater Treatment Plants: A Home Study Training Program.

    Science.gov (United States)

    California State Univ., Sacramento. Dept. of Civil Engineering.

    This manual was prepared by experienced wastewater treatment plant operators to provide a home study course to develop new qualified workers and expand the abilities of existing workers. The objective of this manual is to provide the knowledge and skills necessary for certification. Participants learn the basic operational aspects of treatment…

  17. Effects of a Summer Treatment Program on Functional Sports Outcomes in Young Children with ADHD

    OpenAIRE

    O’Connor, Briannon C.; Fabiano, Gregory A.; Waschbusch, Daniel A.; Belin, Peter J.; Gnagy, Elizabeth M.; Pelham, William E.; Greiner, Andrew R.; Roemmich, James N

    2014-01-01

    Participation in youth sports can be very beneficial, but children with Attention Deficit Hyperactivity Disorder (ADHD) may participate less often and less successfully. The current study evaluated functional sports outcomes for children with ADHD who attended an intensive behavioral treatment program that included a sports training component, and it compared outcomes to children with ADHD who did not attend the program. Results suggest that treatment resulted in significant improvements in m...

  18. [Treatment of bedsores--combination of therapies depended the experimental design method].

    Science.gov (United States)

    Miyaji, Hiroko; Sakurai, Hirofumi; Kikawada, Masayuki; Yamaguchi, Katsuhiko; Kimura, Akihiro; Fujiwara, Takayuki; Imada, Nobuo; Imai, Mihoko; Iwamoto, Toshihiko; Takasaki, Masaru

    2005-01-01

    The treatment of bedsores is a particular problem in geriatric medicine. We selected standard drugs that may be effective for the decubitus ulcer, and investigated combination therapy to develop efficient treatment The subjects were 16 patients in whom the grade of the bedsore was evaluated as II to IV according to the Shea's depth classification. Treatment was performed while all patients were on air mats. We selected drugs and treatment methods based on the previously established experimental design of Taguchi. Based on this, we created and adapted 16 different component combination treatment programs in accordance with the L16 rectangular cross table. The following component factors were adopted: A: types of covering substances on the wound surface (Elase ointment, isodine sugar, isodine gel solcoseryl ointment); B: Isalopan powder; C: Spray of 10 ml physiological saline containing 500 microg of prostaglandin (concentration 0.005%); D: daily number of treatments; and F: presence or absence of tapping. We serially measured the wound surface area as an index of the speed of wound healing, and measured the interval (day) until the area decreased to one half of the original size (T1/2, half life). We analyzed data on one combination treatment each in 16 patients. Analysis of variance of the above factors showed significant F values for factors A, B, D and F. The contribution rates for factors A, B, D and F were 37.84%, 8.47%, 14.98% and 13.81%, respectively. The error term (e) was 16.37%. Optimal results were seen in the groups in which solcoseryl ointment had been applied twice a day. In this study, prostaglandin, which had been anticipated to be effective, did not show any effects. The error term (e) suggests the presence of other healing factors including individual differences. Concerning this point, it well be necessary to examine a larger number of patients in the future. With ointment treatment alone, without using an air mat, it was confirmed that bedsore

  19. Translationally invariant treatment of pair correlations in nuclei; 1, spin and isospin dependent correlations

    CERN Document Server

    Guardiola, R; Navarro, J; Bishop, R F; Puente, A; Walet, N R; Walet, Niels R.

    1996-01-01

    We study the extension of our translationally invariant treatment of few-body nuclear systems to heavier nuclei. At the same time we also introduce state-dependent correlation operators. Our techniques are tailored to those nuclei that can be dealt with in $LS$ coupling, which includes all nuclei up to the shell closure at $A=40$. We study mainly $p$-shell nuclei in this paper. A detailed comparison with other microscopic many-body approaches is made, using a variety of schematic nuclear interactions. It is shown that our methodology produces very good energies, and presumably also wave functions, for medium mass nuclei.

  20. Hereditary and acquired C1-inhibitor-dependent angioedema: from pathophysiology to treatment.

    Science.gov (United States)

    Zeerleder, Sacha; Levi, Marcel

    2016-01-01

    Uncontrolled generation of bradykinin (BK) due to insufficient levels of protease inhibitors controlling contact phase (CP) activation, increased activity of CP proteins, and/or inadequate degradation of BK into inactive peptides increases vascular permeability via BK-receptor 2 (BKR2) and results in subcutaneous and submucosal edema formation. Hereditary and acquired angioedema due to C1-inhibitor deficiency (C1-INH-HAE and -AAE) are diseases characterized by serious and potentially fatal attacks of subcutaneous and submucosal edemas of upper airways, facial structures, abdomen, and extremities, due to inadequate control of BK generation. A decreased activity of C1-inhibitor is the hallmark of C1-INH-HAE (types 1 and 2) due to a mutation in the C1-inhibitor gene, whereas the deficiency in C1-inhibitor in C1-INH-AAE is the result of autoimmune phenomena. In HAE with normal C1-inhibitor, a significant percentage of patients have an increased activity of factor XIIa due to a FXII mutation (FXII-HAE). Treatment of C1-inhibitor-dependent angioedema focuses on restoring control of BK generation by inhibition of CP proteases by correcting the balance between CP inhibitors and BK breakdown or by inhibition of BK-mediated effects at the BKR2 on endothelial cells. This review will address the pathophysiology, clinical picture, diagnosis and available treatment in C1-inhibitor-dependent angioedema focusing on BK-release and its regulation. Key Messages Inadequate control of bradykinin formation results in the formation of characteristic subcutaneous and submucosal edemas of the skin, upper airways, facial structures, abdomen and extremities as seen in hereditary and acquired C1-inhibitor-dependent angioedema. Diagnosis of hereditary and acquired C1-inhibitor-dependent angioedema may be troublesome as illustrated by the fact that there is a significant delay in diagnosis; a certain grade of suspicion is therefore crucial for quick diagnosis. Submucosal edema formation in

  1. Survey of the Navy’s Three-Tiered Obesity Treatment Program

    Science.gov (United States)

    1993-09-01

    exercise , with Results approximately 81% of program time being devoted to physical activity . Remaining time was divided among several secondary Seventy...command-directed) programs rely primarily on group exercise to treat obesity ; most level II (outpatient counseling) and level III (6-week inpatient...Management Programs Survey 5 Obesity treatment Physical fitness 16. PRICE CODE Navy Personnel 17. SECURITYCLASSIFICA- 18. SECURITY CLASSIFICA- 19. SECURITY

  2. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community... RDAP, they must participate in TDAT in the community. If inmates refuse or fail to complete TDAT,...

  3. Market impacts of a multiyear mechanical fuel treatment program in the U.S.

    Science.gov (United States)

    Jeffrey P. Prestemon; Karen L. Abt; Robert J. Jr. Huggett

    2008-01-01

    We describe a two-stage model of global log and chip markets that evaluates the spatial and temporal economic effects of government- subsidized fire-related mechanical fuel treatment programs in the U.S.West and South. The first stage is a goal program that allocates subsidies according to fire risk and location priorities, given a budget and a feasible, market-...

  4. A Search for Sources of Treatment Effects in a Teacher Effectiveness Training Program.

    Science.gov (United States)

    Harris, Alene Hawes

    This study investigated possible sources of teacher change in the Stallings Effective Use of time (EUOT) staff development program administered to preservice teachers. These sources were: (1) the full EUOT program with feedback plus workshops; (2) feedback only; and (3) the trainer as post-treatment observer. Over a 15-month period, 20 student…

  5. The Development of a Substance Abuse Treatment Program for Forensic Patients with Cognitive Impairment

    Science.gov (United States)

    Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.

    2007-01-01

    The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.

  6. Non-injecting routes of administration among entrants to three treatment modalities for heroin dependence.

    Science.gov (United States)

    Darke, Shane; Hetherington, Kate; Ross, Joanne; Lynskey, Michael; Teesson, Maree

    2004-06-01

    A sample of 535 entrants to opioid dependence treatments across three treatment modalities were administered a structured interview to ascertain the prevalence of non-injecting heroin use. Ten per cent of participants had used heroin primarily by smoking/inhaling in the month preceding interview, and 9% had used heroin and other drugs exclusively by non-injecting routes. Non-injectors were younger (25.3 vs. 29.5 years), had higher levels of education (10.6 vs. 10.0 years), were more likely to be employed (33 vs. 18%) and had lower levels of recent crime (31 vs. 56%). They also had shorter heroin using careers (5.1 vs. 9.9 years), fewer symptoms of dependence (5.1 vs. 5.6), had been enrolled in fewer previous treatment episodes (3.3 vs. 11.5) and had less extensive lifetime (8.0 vs. 9.1 drug classes) and recent (3.6 vs. 4.9) polydrug use. Non-injectors were substantially less likely to report lifetime (13% vs. 58%) or recent (2% vs. 29%) heroin overdoses. There were no differences between the general physical and psychological health of the two groups. While non-injectors had a lower level of post-traumatic stress disorder (29% vs. 34%), there were no differences in levels of major depression, attempted suicide, antisocial personality disorder, or borderline personality disorder. A substantial minority of Australian treatment entrants are now using heroin exclusively by non-injecting routes. While this group is younger, and has substantially reduced risk of overdose and blood borne virus transmission, the physical and psychological health of non-injectors mirrors that of injectors.

  7. Integrating buprenorphine treatment into a public healthcare system: the San Francisco Department of Public Health's office-based Buprenorphine Pilot Program.

    Science.gov (United States)

    Hersh, David; Little, Sherri L; Gleghorn, Alice

    2011-01-01

    Despite well-documented efficacy, US physicians have been relatively slow to embrace the use of buprenorphine for the treatment of opioid dependence. In order to introduce and support the use of buprenorphine across the San Francisco Department of Public Health system of care, the Buprenorphine Pilot Program was initiated in 2003. Program treatment sites included a centralized buprenorphine induction clinic and program pharmacy, and three community-based treatment sites; two primary care clinics and a private dual diagnosis group practice. The target patient population consisted of opioid-dependent patients typically seen in an urban, public health setting, including individuals experiencing extreme poverty, homelessness/unstable housing, unemployment, polysubstance abuse/dependence, coexisting mental health disorders, and/or little psychosocial support. This program evaluation reviews patient characteristics, treatment retention, substance use over time, patient impressions, and provider practices for the 57 patients admitted between 9/1/03 and 8/31/05. At baseline, over 80% of patients were injecting heroin, over 40% were homeless, and over one-third were using cocaine. Outcomes included an overall one-year retention rate of 61%, a rapid and dramatic decline in opioid use, very positive patient impressions of the program and of buprenorphine, and significant shifts in provider practices over time.

  8. A Brief Introduction to Researches on Treatment of Hormone-dependent Asthma with Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    崔红生; 武维屏

    2001-01-01

    @@In recent years, with the establishment of the theory of air passage inflammation concerning the pathologic mechanism of asthma, the glucocorticoid hormone (referred to hereafter only as hormone for short), a strong inflammation killer, has become a fundamental medication for treatment of asthma. However, long period of hormone administration will result in general side effects in the whole body as well as hormone dependence, which has now become a hard problem for physicians. Now a non-hormone medication of immunosuppressant has been chosen in western medicine to treat asthma as a replacement or partial replacement of hormone. Nevertheless, its therapeutic effect is not reliable and its side effects severe, hence hardly acceptable to patients. Traditional Chinese medicine (TCM) always adheres to the principle of holistic treatment and has a great advantage in the treatment of this disease. TCM doctors have made some trials and researches in this area and obtained some accomplishments. The following is a brief account of general researches on the treatment of asthma with TCM.

  9. Using behavioral economics to predict opioid use during prescription opioid dependence treatment.

    Science.gov (United States)

    Worley, Matthew J; Shoptaw, Steven J; Bickel, Warren K; Ling, Walter

    2015-03-01

    Research grounded in behavioral economics has previously linked addictive behavior to disrupted decision-making and reward-processing, but these principles have not been examined in prescription opioid addiction, which is currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. Secondary analyses examined participants with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial (N=353). Baseline measures assessed opioid source and indices of drug reinforcement value, including the total amount and proportion of income spent on drugs. Weekly urine drug screens measured opioid use. Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount (OR=1.30, peconomic resources to drugs, reflects propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. The Relationship between General Causality Orientation and Treatment Outcome among Marijuana-Dependent Adults

    Science.gov (United States)

    Blevins, Claire E.; Banes, Kelsey E.; Walker, Denise D.; Stephens, Robert S.; Roffman, Roger A.

    2015-01-01

    General causality orientations are motivational styles that are indicative of a person’s belief about personal change and their motivation to change. The purpose of the current study was to investigate whether causality orientations were associated with marijuana treatment outcomes in a sample of marijuana-dependent individuals. A total of 74 participants (66% male) were recruited from the Seattle, Washington area and randomly assigned to receive a combination of motivational enhancement and cognitive behavioral therapy or the combination treatment plus additional “check-up” sessions. Follow-up assessments evaluated frequency of use, use-related problems, and marijuana use disorder symptoms through 9 months. Causality orientations were relatively stable over time. Posttreatment Autonomy orientations were associated with lower frequency of use and Controlled orientations were associated with a reduction in use, problems, and marijuana use disorder symptoms. Autonomy and Controlled orientations were associated with readiness to change. Results suggest that both autonomous and controlled orientations have implications for response to treatment; perhaps for different reasons. Causality orientations may be a promising avenue of research to predict treatment response and outcome. PMID:26562679

  11. Self-management program in treatment of asthma

    Directory of Open Access Journals (Sweden)

    Milenković Branislava

    2007-01-01

    Full Text Available Introduction. Recently published national and international guidelines stress the importance of self-management in asthma. They have recommended that self-management plans should be an essential part of the long-term management of asthmatic patients. These plans essentially focus on the early recognition of unstable or deteoriorating asthma, by monitoring peak flow or symptoms. Objective. The aim of our one-year study was to compare the efficacy of peak-flow based self-management of asthma with traditional treatment. Method. Sixty clinically stable adult patients with mild and moderate persistent asthma were randomly allocated to peakflow based self-management (Group A, n=30 or to conventional treatment (Group B, n=30, with no significant difference between groups in terms of age, sex distribution and initial lung function. The recorded measurements were: lung function, asthma exacerbations, unscheduled ambulatory care facilities (hospital-based emergency department, consultations with general practitioner or pulmonologist, courses of oral prednisolone, courses of antibiotics, days off work. Results. There was a significant difference between groups in number of asthma exacerbations (p<0.05, unscheduled visits to ambulatory care facilities (p<0.005, days off work (p<0.0001, courses of oral prednisolone (p<0.001 and antibiotics (p<0.05. At the final visit, there was a significant improvement in some measurements of asthma severity in group A (reduced unscheduled visits for ambulatory care, reduced treatment requirements for oral corticosteroids and antibiotics, reduced days off work, but a lack of statistical difference in lung function and the maintenance-inhaled corticosteroid dose. There was no significant change in group B. Conclusion. These results suggest that peak-flow based self management is more effective than traditonal treatment in mild and moderate persistent asthma. .

  12. Time-Dependent Predictors of Loss to Follow-Up in a Large HIV Treatment Cohort in Nigeria

    Science.gov (United States)

    Meloni, Seema Thakore; Chang, Charlotte; Chaplin, Beth; Rawizza, Holly; Jolayemi, Oluwatoyin; Banigbe, Bolanle; Okonkwo, Prosper; Kanki, Phyllis

    2014-01-01

    Background  Most evaluations of loss to follow-up (LTFU) in human immunodeficiency virus (HIV) treatment programs focus on baseline predictors, prior to antiretroviral therapy (ART) initiation. As risk of LTFU is a continuous issue, the aim of this evaluation was to augment existing information with further examination of time-dependent predictors of loss. Methods  This was a retrospective evaluation of data collected between 2004 and 2012 by the Harvard School of Public Health and the AIDS Prevention Initiative in Nigeria as part of PEPFAR-funded program in Nigeria. We used multivariate modeling methods to examine associations between CD4+ cell counts, viral load, and early adherence patterns with LTFU, defined as no refills collected for at least 2 months since the last scheduled appointment. Results  Of 51 953 patients initiated on ART between 2004 and 2011, 14 626 (28%) were LTFU by 2012. Factors associated with increased risk for LTFU were young age, having nonincome-generating occupations or no education, being unmarried, World Health Organization (WHO) stage, having a detectable viral load, and lower CD4+ cell counts. In a subset analysis, adherence patterns during the first 3 months of ART were associated with risk of LTFU by month 12. Conclusions  In settings with limited resources, early adherence patterns, as well as CD4+ cell counts and unsuppressed viral load, at any time point in treatment are predictive of loss and serve as effective markers for developing targeted interventions to reduce rates of attrition. PMID:25734125

  13. Highly precise and developmentally programmed genome assembly in Paramecium requires ligase IV-dependent end joining.

    Directory of Open Access Journals (Sweden)

    Aurélie Kapusta

    2011-04-01

    Full Text Available During the sexual cycle of the ciliate Paramecium, assembly of the somatic genome includes the precise excision of tens of thousands of short, non-coding germline sequences (Internal Eliminated Sequences or IESs, each one flanked by two TA dinucleotides. It has been reported previously that these genome rearrangements are initiated by the introduction of developmentally programmed DNA double-strand breaks (DSBs, which depend on the domesticated transposase PiggyMac. These DSBs all exhibit a characteristic geometry, with 4-base 5' overhangs centered on the conserved TA, and may readily align and undergo ligation with minimal processing. However, the molecular steps and actors involved in the final and precise assembly of somatic genes have remained unknown. We demonstrate here that Ligase IV and Xrcc4p, core components of the non-homologous end-joining pathway (NHEJ, are required both for the repair of IES excision sites and for the circularization of excised IESs. The transcription of LIG4 and XRCC4 is induced early during the sexual cycle and a Lig4p-GFP fusion protein accumulates in the developing somatic nucleus by the time IES excision takes place. RNAi-mediated silencing of either gene results in the persistence of free broken DNA ends, apparently protected against extensive resection. At the nucleotide level, controlled removal of the 5'-terminal nucleotide occurs normally in LIG4-silenced cells, while nucleotide addition to the 3' ends of the breaks is blocked, together with the final joining step, indicative of a coupling between NHEJ polymerase and ligase activities. Taken together, our data indicate that IES excision is a "cut-and-close" mechanism, which involves the introduction of initiating double-strand cleavages at both ends of each IES, followed by DSB repair via highly precise end joining. This work broadens our current view on how the cellular NHEJ pathway has cooperated with domesticated transposases for the emergence of new

  14. Personality Dimensions Influencing the Relapse of Substance Abuse in Drug Dependents under Methadone Maintenance Treatment

    Directory of Open Access Journals (Sweden)

    Akram Asgari

    2011-11-01

    Full Text Available introduction: This study was aimed to determine the personality dimensions which can influence the relapse of opioid substance dependents that are under methadone maintenance treatment. Method: In this prospective study 210 addicts who were referred to methadone clinics in 1389 were selected through judgmental sampling. All participants completed the self made questionnaire and Temperament and Character Inventory and it was followed for 6 months. Data were analyzed by t test. Findings: Data analysis revealed that relapsed group has higher scores in novelty seeking and harm avoidance compared to non-relapsed group. Also, their scores in self directiveness and cooperativeness were lower than non-relapsed group. No significant differences were found in reward dependence and persistence. Conclusion: This personality profile due to dimensional personality model of Cloninger showed that patients who relapse are high in novelty seeking and harm avoidance and low in cooperativeness and self directiveness. has important information about nature of personality traits that effect relapse of addiction and has implications for treatment plan and relapse prevention.

  15. Pharmacological treatment and BBB-targeted genetic therapy for MCT8-dependent hypomyelination in zebrafish

    Directory of Open Access Journals (Sweden)

    David Zada

    2016-11-01

    Full Text Available Hypomyelination is a key symptom of Allan-Herndon-Dudley syndrome (AHDS, a psychomotor retardation associated with mutations in the thyroid-hormone (TH transporter MCT8 (monocarboxylate transporter 8. AHDS is characterized by severe intellectual deficiency, neuromuscular impairment and brain hypothyroidism. In order to understand the mechanism for TH-dependent hypomyelination, we developed an mct8 mutant (mct8−/− zebrafish model. The quantification of genetic markers for oligodendrocyte progenitor cells (OPCs and mature oligodendrocytes revealed reduced differentiation of OPCs into oligodendrocytes in mct8−/− larvae and adults. Live imaging of single glial cells showed that the number of oligodendrocytes and the length of their extensions are reduced, and the number of peripheral Schwann cells is increased, in mct8−/− larvae compared with wild type. Pharmacological analysis showed that TH analogs and clemastine partially rescued the hypomyelination in the CNS of mct8−/− larvae. Intriguingly, triiodothyronine (T3 treatment rescued hypomyelination in mct8−/− embryos before the maturation of the blood–brain barrier (BBB, but did not affect hypomyelination in older larvae. Thus, we expressed Mct8-tagRFP in the endothelial cells of the vascular system and showed that even relatively weak mosaic expression completely rescued hypomyelination in mct8−/− larvae. These results suggest potential pharmacological treatments and BBB-targeted gene therapy that can enhance myelination in AHDS and possibly in other TH-dependent brain disorders.

  16. Psychological Evaluation of Animal-assisted Intervention (AAI) Programs Involving Visiting Dogs and Cats for Alcohol Dependents: A Pilot Study.

    Science.gov (United States)

    Ohtani, Nobuyo; Narita, Shin; Yoshihara, Eiji; Ohta, Mitsuaki; Iwahashi, Kazuhiko

    2015-12-01

    The purpose of this study was to develop an evaluation method for animal-assisted intervention (AAI) programs involving Mood Check List-Short form.2 (MCL-S.2) and the State-Trait Anxiety Inventory (STAI) for psychiatric daycare of Japanese alcohol. dependents. A total of 36 alcohol dependents completed the study and questionnaires assessing their state. A single session of AAI reduced both subjective and physiological measures of state anxiety (A-State); and this program induced a significant reduction in the anxiety after an AAI program session with the dogs and cats involved in the intervention (p = 0.001). The Wilcoxon t-test showed that there were also significant differences in the "anxiety", "pleasantness", and "relaxation". scores for MCL-S.2 among the alcohol dependents, before and after AAI; a significantly decreased "anxiety" score (p = 0.006), and increased "pleasantness" (p = 0.002) and "relaxation" (p=0.012) scores for MCL-S.2 after AAI. The results of this study indicated that alcohol dependents who experienced a group AAI session-program exhibited significant improvements in their feeling; decreased anxiety, and increased pleasantness and relaxation.

  17. Significance of corporal practices in the treatment of the chemical dependency

    Directory of Open Access Journals (Sweden)

    Giuliano Gomes de Assis Pimentel

    2008-01-01

    Full Text Available The aim of this study was to analyze the social representations of addicted or chemically dependent women and the contribution of physical exercises and body activities to their recovery process and reinsertion into society. Fourteen women hospitalized in a rehabilitation institution were interviewed and observed in relation to their participation in a physical fitness program (corporal practice, systematized in the form of games and physical exercises. Their reports and practices revealed contradictions between their sensations, reasons or justifications, and perspectives related to the use of their own body. Based on the results, an attempt was made to understand how the social life conditions mediate the way such women organize themselves in benefit of their own health.

  18. BESCT (Biology, Education, Screening, Chemoprevention and Treatment) Program

    Science.gov (United States)

    2010-10-01

    Qian T, Trost LC, Elmore SP, Nishimura Y, Crowe RA, Cascio WE, Bradham CA, Brenner DA and Herman B. (1998). Biochim. Biophys. Acta., 1366, 177–196...82. 46. Qiu RG, Chen J, Kirn D, McCormick F, Symons M. An essential role for Rac in Ras transformation. Nature 1995;374:457^9. 47. Hess P, Pihan G...by Herman et al. (15). Briefly, DNA was denatured with 2 M NaOH, followed by treatment with 10 mM hydroqui- none and 3 M sodium bisulfite (Sigma

  19. Research Challenges: Implementing Standardized Outcome Measures in a Decentralized, Community-Based Residential Treatment Program

    Science.gov (United States)

    Butler, Linda S.; Little, Liza; Grimard, Andre R.

    2009-01-01

    With residential treatment services under pressure to produce outcome data, the process of executing research in such settings presents considerable challenges. This paper describes how a large, decentralized, community-based residential treatment program in southern and central Maine designed and implemented a research outcome process study using…

  20. Client Narratives about Experiences with a Multicouple Treatment Program for Intimate Partner Violence

    Science.gov (United States)

    Todahl, Jeff; Linville, Deanna; Tuttle Shamblin, Abby F.; Ball, David

    2012-01-01

    A handful of clinical trials have concluded that conjoint couples treatment for intimate partner violence is safe and at least as effective as conventional batterer intervention programs, yet very few researchers have explored couples' perspectives on conjoint treatment. Using qualitative narrative analysis methodology, the researchers conducted…

  1. Treatment Service Patterns and Organizational Structures: An Analysis of Programs in DATOS-A.

    Science.gov (United States)

    Delany, Peter J.; Broome, Kirk M.; Flynn, Patrick M.; Fletcher, Bennett W.

    2001-01-01

    Examined availability of various treatment services within a national sample of programs treating adolescent drug abuse patients. Created treatment service delivery profiles and examined them in context of organizational variables. Found that distinct profiles of services existed within residential and outpatient modalities and that these service…

  2. Water Treatment Plant Operation. Volume I. A Field Study Training Program.

    Science.gov (United States)

    California State Univ., Sacramento. School of Engineering.

    The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

  3. Water Treatment Plant Operation. Volume II. A Field Study Training Program.

    Science.gov (United States)

    California State Univ., Sacramento. School of Engineering.

    The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

  4. Water Treatment Plant Operation Volume 2. A Field Study Training Program. Revised.

    Science.gov (United States)

    California State Univ., Sacramento. School of Engineering.

    The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

  5. Operation of Wastewater Treatment Plants. Volume 1. A Field Study Training Program. Third Edition. Revised.

    Science.gov (United States)

    California State Univ., Sacramento. Dept. of Civil Engineering.

    The purpose of this wastewater treatment field study training program is to: (1) develop new qualified wastewater treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

  6. A Preliminary Outcome Study of an Outpatient Treatment Program for Gamblers.

    Science.gov (United States)

    Blackman, Sheldon; And Others

    The Gamblers Treatment Clinic (GTC) opened in 1982 as a New York State Office of Mental Health Demonstration Program. The basic premise of the GTC is that excessive gambling is a disorder of impulse control. Treatment, conducted in the community in a time-limited fashion, attempts to uncover the underlying dynamics that precipitate disorders of…

  7. Depression in People with Intellectual Disability: An Evaluation of a Staff-Administered Treatment Program

    Science.gov (United States)

    McGillivray, Jane A.; McCabe, Marita P.; Kershaw, Mavis M.

    2008-01-01

    The prevalence of co-morbid depression in people with intellectual disability (ID) provides a strong rationale for the early identification and treatment of individuals at risk. The aim of this study was to evaluate a staff-administered group CBT program for the treatment of depression in people with mild ID. A sample of 13 staff employed at two…

  8. Depression in People with Intellectual Disability: An Evaluation of a Staff-Administered Treatment Program

    Science.gov (United States)

    McGillivray, Jane A.; McCabe, Marita P.; Kershaw, Mavis M.

    2008-01-01

    The prevalence of co-morbid depression in people with intellectual disability (ID) provides a strong rationale for the early identification and treatment of individuals at risk. The aim of this study was to evaluate a staff-administered group CBT program for the treatment of depression in people with mild ID. A sample of 13 staff employed at two…

  9. Efficacy of additional treatment with azathioprine in a patient with prednisolone-dependent gastric sarcoidosis.

    Science.gov (United States)

    Murata, Masaki; Sugimoto, Mitsushige; Yokota, Yoshihiro; Ban, Hiromitsu; Inatomi, Osamu; Bamba, Shigeki; Kushima, Ryoji; Andoh, Akira

    2016-12-21

    Gastric sarcoidosis with noncaseating granuloma is rare. Although corticosteroid produces a dramatic clinical response, it is unknown whether azathioprine show efficacy in prednisolone-dependent cases. Here, we report a case of gastric sarcoidosis in a 25-year-old man with severe epigastlargia. Gastroendoscopy revealed multiple map-like ulcerations. Histological examination showed multiple noncaseating granulomatous lesions in gastric mucosa, which were incompatible with diagnoses of Crohn's disease or tuberculosis. He was started on prednisolone at 30 mg/d, and his symptoms improved within 7-d. The prednisolone was gradually tapered by 5 mg every 2-wk, but oral azathioprine at 50 mg was added after symptoms recurred at tapered dose of 10 mg. Endoscopy 4-wk later showed healing ulcers, and, lymphocytic infiltration was absent. The efficacy of additional azathioprine in gastric sarcoidosis is not well defined. Here, we report a case of prednisolone-dependent gastric sarcoidosis that improved after additional azathioprine, and also review the literature concerning the treatment, especially for prednisolone-dependent cases.

  10. The MTHFR C677T Variant is Associated with Responsiveness to Disulfiram Treatment for Cocaine Dependency

    Science.gov (United States)

    Spellicy, Catherine J.; Kosten, Thomas R.; Hamon, Sara C.; Harding, Mark J.; Nielsen, David A.

    2013-01-01

    Objective: Disulfiram is a one of the few pharmacotherapies for cocaine addiction that shows promise. Since disulfiram and cocaine both affect levels of global methylation we hypothesized the MTHFR gene, whose product is involved in supplying methyl groups for DNA and protein methylation, may be associated with responsiveness to disulfiram in cocaine-dependent individuals. Methods: Sixty-seven cocaine-dependent patients were stabilized on methadone for 2 weeks and then randomized into disulfiram (250 mg/day, N = 32) and placebo groups (N = 35) for 10 weeks. Patients were genotyped for the MTHFR (rs1801133, also known as C677T) polymorphism and the data was evaluated for association with cocaine-free urines in the disulfiram or placebo groups. Data from patients that completed all 10 weeks of the study (N = 56) were analyzed using repeated measures analysis of variance (ANOVA), corrected for population structure. Results: The CT or TT MTHFR genotype group (N = 32) dropped from 73 to 52% cocaine-positive urines on disulfiram (p = 0.0001), while the placebo group showed no treatment effect. The CC MTHFR genotype group (N = 24) showed a smaller, but still significant, reduction in cocaine-positive urines on disulfiram compared to placebo; 81–69% (p = 0.007). Conclusion: This study indicates that a patient’s MTHFR genotype may be used to identify individuals who might show improved response to disulfiram treatment for cocaine dependence. Clinical Trial: Pharmacogenetics of Disulfiram for Cocaine, clinicaltrials.gov/ct2/show/NCT00149630, NIDA-18197-2, NCT00149630. PMID:23335901

  11. The Effectiveness of Stress Management Program on Quality of Life among Methadone Maintenance Treatment Members

    Directory of Open Access Journals (Sweden)

    s Zarei

    2014-11-01

    Full Text Available Objective: The aim of present study was to investigate the effectiveness of stress management program on quality of life among methadone maintenance treatment members. Method: In this pre-test, post-test experimental study, 30 individual who referred to Saba MMT center in Pakdasht were randomly divided into experimental group (n=15 participants and control group (n=15 participants. The experimental group was undergone ten 90 minutes sessions of stress management program and the control group didn’t receive any treatment program. Quality of life questionnaire (SF-36 was administered. Result: The results showed that the mean sf-36 score in the experimental group had significant higher increased in comparison of control group. Conclusion: It can be concluded stress management program is effective on increasing of quality of life among methadone maintenance treatment members.

  12. The effect of different intervention programs on treatment adherence of HIV-infected children, a retrospective study.

    Science.gov (United States)

    van der Plas, Atie; Scherpbier, Henriette; Kuijpers, Taco; Pajkrt, Dasja

    2013-01-01

    In HIV-infected children, long-term adherence to combination anti-retroviral therapy (cART) is difficult. In this retrospective study, we evaluated the effect of two different treatment adherence programs on treatment adherence (as indicated by cART failures) and the need for additional supportive care measures in a cohort of 31 HIV-infected children between 3 and 18 years of age. In a follow-up period of 6 years, we evaluated the treatment adherence at baseline (before introduction of any treatment adherence program in 2004) and compared this to cART failures during two treatment adherence programs (in respectively 2006 and 2009). The need for additional supportive care measures (the frequency of hospitalizations, daily observed treatment, use of child protection service, attendance of special schools, and placement in foster homes) was also evaluated at these three time points. The first treatment adherence program focused on increasing patient's obedience by imposing negative measures in case of treatment failure, whereas the second program aimed to increase treatment adherence by rewarding optimal medication intake. Prior to start of any treatment adherence intervention program, cART failures were observed in 29% of the pediatric patients. After introduction of the first treatment adherence program, cART failures decreased to 6%. During the second treatment adherence program, the cART failures remained equally low (10%), but the need for some specific additional supportive care measures (the frequency of hospitalizations and placement in foster homes) was importantly reduced. Treatment adherence programs are effective in increasing treatment adherence to cART in HIV-infected children. A novel reward treatment interventional program as an addition to social supportive care programs is a promising new positive enforcement program and can reduce the need for additional supportive care programs. Further prospective studies are needed to evaluate the long

  13. Use of fugacity model to analyze temperature-dependent removal of micro-contaminants in sewage treatment plants.

    Science.gov (United States)

    Thompson, Kelly; Zhang, Jianying; Zhang, Chunlong

    2011-08-01

    Effluents from sewage treatment plants (STPs) are known to contain residual micro-contaminants including endocrine disrupting chemicals (EDCs) despite the utilization of various removal processes. Temperature alters the efficacy of removal processes; however, experimental measurements of EDC removal at various temperatures are limited. Extrapolation of EDC behavior over a wide temperature range is possible using available physicochemical property data followed by the correction of temperature dependency. A level II fugacity-based STP model was employed by inputting parameters obtained from the literature and estimated by the US EPA's Estimations Programs Interface (EPI) including EPI's BIOWIN for temperature-dependent biodegradation half-lives. EDC removals in a three-stage activated sludge system were modeled under various temperatures and hydraulic retention times (HRTs) for representative compounds of various properties. Sensitivity analysis indicates that temperature plays a significant role in the model outcomes. Increasing temperature considerably enhances the removal of β-estradiol, ethinyestradiol, bisphenol, phenol, and tetrachloroethylene, but not testosterone with the highest biodegradation rate. The shortcomings of BIOWIN were mitigated by the correction of highly temperature-dependent biodegradation rates using the Arrhenius equation. The model predicts well the effects of operating temperature and HRTs on the removal via volatilization, adsorption, and biodegradation. The model also reveals that an impractically long HRT is needed to achieve a high EDC removal. The STP model along with temperature corrections is able to provide some useful insight into the different patterns of STP performance, and useful operational considerations relevant to EDC removal at winter low temperatures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Sexual Dysfunction Improved in Heroin-Dependent Men after Methadone Maintenance Treatment in Tianjin, China

    Science.gov (United States)

    Zhang, Minying; Zhang, Huifang; Shi, Cynthia X.; McGoogan, Jennifer M.; Zhang, Baohua; Zhao, Linglong; Zhang, Mianzhi; Rou, Keming; Wu, Zunyou

    2014-01-01

    Objective To investigate whether methadone maintenance treatment (MMT) is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT. Methods The study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15), and Self-rating Depression Scale. Results Sexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found. Conclusions While high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study. PMID:24520361

  15. Sexual dysfunction improved in heroin-dependent men after methadone maintenance treatment in Tianjin, China.

    Directory of Open Access Journals (Sweden)

    Minying Zhang

    Full Text Available OBJECTIVE: To investigate whether methadone maintenance treatment (MMT is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT. METHODS: The study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15, and Self-rating Depression Scale. RESULTS: Sexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found. CONCLUSIONS: While high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study.

  16. Evaluations of correctional treatment programs in Germany: a review and meta-analysis.

    Science.gov (United States)

    Egg, R; Pearson, F S; Cleland, C M; Lipton, D S

    2000-01-01

    This study presents a review and meta-analyses of research on the recidivism-reducing impact of correctionally based treatment programs in Germany. The data are part of the Correctional Drug Abuse Treatment Effectiveness (CDATE) project meta-analytic database (covering 1968-1996) of evaluation research studies of correctional interventions. Overall, the five studies of educational programs show no practical impact of these programs in reducing recidivism. Four studies of programs to counsel driving-under-the-influence (DUI) offenders fall in an intermediate area (not statistically significant, but promising enough to warrant further research). The eight studies of Social Therapy programs did show, on the average, a statistically significant practical impact in reducing recidivism.

  17. Mechanism-based medication development for the treatment of nicotine dependence

    Institute of Scientific and Technical Information of China (English)

    Zheng-xiong XI; Krista SPILLER; Eliot L GARDNER

    2009-01-01

    Tobacco use is a global problem with serious health consequences. Though some treatment options exist, there remains a great need for new effective pharmacotherapies to aid smokers in maintaining long-term abstinence. In the present article, we first discuss the neural mechanisms underlying nicotine reward, and then review various mechanism-based pharmacological agents for the treatment of nicotine dependence. An oversimplified hypothesis of addiction to tobacco is that nicotine is the major addictive component of tobacco. Nicotine binds to a4β2 and a7 nicotinic acetylcholine receptors (nAChRs) located on dopaminergic, glutamatergic and GABAergic neurons in the mesolimbic dopamine (DA) system, which causes an increase in extracellular DA in the nucleus accumbens (NAc). That increase in DA reinforces tobacco use, particularly during the acquisition phase. Enhanced glutamate transmission to DA neurons in the ventral tegmental area appears to play an important role in this process. In addition, chronic nicotine treatment increases endocannabinoid levels in the mesolimbic DA system, which indirectly modulates NAc DA release and nicotine reward. Accordingly, pharmacological agents that target brain acetylcholine, DA, glutamate, GABA, or endocannabonoid signaling systems have been proposed to interrupt nicotine action. Furthermore, pharmacokinetic strategies that alter plasma nicotine availability, metabolism and clearance also significantly alter nicotine's action in the brain. Progress using these pharmacodynamic and pharmacokinetic agents is reviewed. For drugs in each category, we discuss the mechanistic rationale for their potential anti-nicotine efficacy, major findings in preclinical and clinical studies, and future research directions.

  18. Dose- and duration-dependent effects of betahistine dihydrochloride treatment on histamine turnover in the cat.

    Science.gov (United States)

    Tighilet, Brahim; Trottier, Suzanne; Lacour, Michel

    2005-10-31

    Drugs interacting with the histaminergic system are currently used for vertigo treatment and it was shown in animal models that structural analogues of histamine like betahistine improved the recovery process after vestibular lesion. This study was aimed at determining the possible dose and duration effects of betahistine treatment on histamine turnover in normal adult cats, as judged by the level of messenger RNA for histidine decarboxylase (enzyme synthesizing histamine) in the tuberomammillary nuclei. Experiments were conducted on betahistine-treated cats receiving daily doses of 2, 5, 10, or 50 mg/kg during 1 week, 3 weeks, 2 months, or 3 months. The 1-week, 3-week, and 2- and 3-month treatments correspond to the acute, compensatory, and sustained compensatory stages of vestibular compensation, respectively. The lowest dose (2 mg/kg) given the longest time (3 months) was close to the dosage for vestibular defective patients. Data from the experimental groups were compared to control, untreated cats and to placebo-treated animals. The results clearly show that betahistine dihydrochloride administered orally in the normal cat interferes with histamine turnover by increasing the basal expression level of histidine decarboxylase mRNA of neurons located in the tuberomammillary nuclei of the posterior hypothalamus. The effects were both dose- and time-dependent. In conclusion, compensation of both static and dynamic deficits is subtended by long-term adaptive mechanisms that could be facilitated pharmacologically using betahistine dihydrochloride.

  19. Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis.

    Science.gov (United States)

    Aletraris, Lydia; Roman, Paul M

    2015-10-01

    The provision of HIV education and testing in substance use disorder (SUD) treatment programs is an important public health strategy for reducing HIV incidence. For many at-risk individuals, SUD treatment represents the primary point of access for testing and receiving HIV-related services. This study uses two waves of nationally representative data of 265 privately-funded SUD treatment programs in the U.S. to examine organizational and patient characteristics associated with offering a dedicated HIV/AIDS treatment track, onsite HIV/AIDS support groups, and onsite HIV testing. Our longitudinal analysis indicated that the majority of treatment programs reported providing education and prevention services, but there was a small, yet significant, decline in the number of programs providing these services. Programs placed more of an emphasis on providing information on the transmission of HIV rather than on acquiring risk-reduction skills. There was a notable and significant increase (from 26.0% to 31.7%) in programs that offered onsite HIV testing, including rapid HIV testing, and an increase in the percentage of patients who received testing in the programs. Larger programs were more likely to offer a dedicated HIV/AIDS treatment track and to offer onsite HIV/AIDS support groups, while accredited programs and programs with a medical infrastructure were more likely to provide HIV testing. The percentage of injection drug users was positively linked to the availability of specialized HIV/AIDS tracks and HIV/AIDS support groups, and the percentage of female clients was associated with the availability of onsite support groups. The odds of offering HIV/AIDS support groups were also greater in programs that had a dedicated LGBT track. The findings suggest that access to hospitals and medical care services is an effective way to facilitate adoption of HIV services and that programs are providing a needed service among a group of patients who have a heightened risk of HIV

  20. Treatment programs for severe night-time fears: a methodological note.

    Science.gov (United States)

    Friedman, A G; Ollendick, T H

    1989-06-01

    A multiple baseline design across subjects was used to examine the efficacy of a treatment package consisting of relaxation, reinforcement, and cognitive self-instruction in the reduction of severe night-time fears in six children. Although the disruptive bedtime behaviors of five of the six children were reduced, the multiple baseline analysis revealed that changes were not solely due to treatment. For children with extended baselines, improvement preceded treatment. The implications of these findings for the treatment of fear of the dark and multicomponent treatment programs are discussed.

  1. Antiretroviral treatment is associated with increased attentional load-dependent brain activation in HIV patients.

    Science.gov (United States)

    Chang, L; Yakupov, R; Nakama, H; Stokes, B; Ernst, T

    2008-06-01

    The purpose of this paper was to determine whether antiretroviral medications, especially the nucleoside analogue reverse transcriptase inhibitors, lead to altered brain activation due to their potential neurotoxic effects in patients with human immunodeficiency virus (HIV) infection. Forty-two right-handed men were enrolled in three groups: seronegative controls (SN, n = 18), HIV subjects treated with antiretroviral medications (HIV+ARV, n = 12), or not treated with antiretroviral medications (HIV+NARV, n = 12). Each subject performed a set of visual attention tasks with increasing difficulty or load (tracking two, three or four balls) during functional magnetic resonance imaging. HIV subjects, both groups combined, showed greater load-dependent increases in brain activation in the right frontal regions compared to SN (p-corrected = 0.006). HIV+ARV additionally showed greater load-dependent increases in activation compared to SN in bilateral superior frontal regions (p-corrected = 0.032) and a lower percent accuracy on the performance of the most difficult task (tracking four balls). Region of interest analyses further demonstrated that SN showed load-dependent decreases (with repeated trials despite increasing difficulty), while HIV subjects showed load-dependent increases in activation with the more difficult tasks, especially those on ARVs. These findings suggest that chronic ARV treatments may lead to greater requirement of the attentional network reserve and hence less efficient usage of the network and less practice effects in these HIV patients. As the brain has a limited reserve capacity, exhausting the reserve capacity in HIV+ARV would lead to declined performance with more difficult tasks that require more attention.

  2. Treatment impact of an integrated sex offender program as measured by J-SOAP-II.

    Science.gov (United States)

    Rehfuss, Mark C; Underwood, Lee A; Enright, Morgan; Hill, Savannah; Marshall, Rod; Tipton, Paula; West, Laura; Warren, Kellie

    2013-04-01

    Despite the increase in juvenile sex offending in society and the significant growth in the number of treatment programs, relatively few studies have examined the effectiveness of these programs. This study examined the effectiveness of an integrated sex offender program on a sample of 309 adjudicated male sex offenders in a juvenile correctional facility using the dynamic scale score of the Juvenile Sex Offender Assessment Protocol II (J-SOAP-II). The youth participated in one of the three treatment groups characterized by length of treatment and risk of recidivism: low risk (0 to 9 months), moderate risk (9 to 23 months), and high risk (23 to 56 months). A significant decrease in the dynamic scale scores of the J-SOAP-II was found only for the moderate treatment group (9 to 23 months).

  3. CUDA programs for solving the time-dependent dipolar Gross-Pitaevskii equation in an anisotropic trap

    Science.gov (United States)

    Lončar, Vladimir; Balaž, Antun; Bogojević, Aleksandar; Škrbić, Srdjan; Muruganandam, Paulsamy; Adhikari, Sadhan K.

    2016-03-01

    In this paper we present new versions of previously published numerical programs for solving the dipolar Gross-Pitaevskii (GP) equation including the contact interaction in two and three spatial dimensions in imaginary and in real time, yielding both stationary and non-stationary solutions. New versions of programs were developed using CUDA toolkit and can make use of Nvidia GPU devices. The algorithm used is the same split-step semi-implicit Crank-Nicolson method as in the previous version (Kishor Kumar et al., 2015), which is here implemented as a series of CUDA kernels that compute the solution on the GPU. In addition, the Fast Fourier Transform (FFT) library used in the previous version is replaced by cuFFT library, which works on CUDA-enabled GPUs. We present speedup test results obtained using new versions of programs and demonstrate an average speedup of 12-25, depending on the program and input size.

  4. Level of interest in a weight management program among adult U.S. military dependents

    Science.gov (United States)

    There is little information on the extent to which different challenged populations with high rates of overweight and obesity have interest in participating in weight management programs. The purpose of this study was to identify potential rates of enrollment in a weight management program among adu...

  5. The Early Maladaptive Schemas of an Opioid Dependent Sample of Treatment Seeking Young Adults: A Descriptive Investigation

    Science.gov (United States)

    Shorey, Ryan C.; Stuart, Gregory L.; Anderson, Scott

    2011-01-01

    Opioid dependence is an increasingly prevalent problem throughout the world, particularly for young adults (e.g., ages 17–25). Opioid dependence is associated with a wealth of negative consequences and is often a chronic, relapsing condition. Research on factors that may contribute to the etiology of opioid dependence could result in improved treatment outcomes. Using pre-existing patient records, the current study examined the early maladaptive schemas among young adult opioid dependent residential treatment patients (N = 169), as it is theorized that early maladaptive schemas may underlie or maintain substance use. Results showed that all 18 early maladaptive schemas were endorsed at various levels among male and female patients, with insufficient self-control being the most prevalent schema. In addition, females scored significantly higher than males on 11 of the 18 schemas. Findings from the current study are discussed in terms of future research and implications for the treatment of opioid dependence. PMID:22014405

  6. New concepts for treatment of non-insulin-dependent diabetes mellitus.

    Science.gov (United States)

    Larkins, R G

    1997-07-01

    Non-insulin-dependent diabetes mellitus remains a major cause of morbidity and premature mortality in our community. Although potentially amenable to control by lifestyle modification, this is difficult to achieve in practice. Additional approaches using drugs that enhance insulin secretion, suppress hepatic glucose production, and increase insulin sensitivity are available, and new agents are being developed. The thiazolidinedione drugs hold particular promise as insulin-sensitizing agents; however, at present, insulin administration is often also required. The importance of detection and treatment of risk factors for cardiovascular disease and the earlier detection and management of microvascular and infective complications remain of crucial importance. (Trends Endocrinol Metab 1997;8:187-191). (c) 1997, Elsevier Science Inc.

  7. An empirical description of phases of maintenance following treatment for alcohol dependence.

    Science.gov (United States)

    Murphy, S A; Hoffman, A L

    1993-01-01

    This article reports two longitudinal prospective studies conducted sequentially to describe participants' maintenance of abstinence experiences up to 36 months posttreatment. Study 1 reports responses of 102 subjects who maintained alcohol abstinence following treatment and who were assessed for duration and intensity of symptoms associated with postacute withdrawal at baseline, 3, 6, and 12 months. A decreasing linear trend of symptoms was found as time of alcohol abstinence increased. Study 2 obtained interview and survey data from 23 successful abstainers from Study 1 at 12, 18, and 36 months posttreatment to describe coping strategies, perceptions of relapse risk, extent and duration of "aftercare," and substitute addictions as these phenomena developed and changed over time. Multiple occasions of data collection supported the description of three phases of maintenance: symptom stabilization/management accompanied by a cognitive paradigm shift, distancing self from alcohol-dependent behavior, and normalization of life processes.

  8. Continuous treatment of azo acid dyes by photo-dependent denitrifying sludge

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Simultaneous removals of dye and nitrate by photo-dependent denitrifying sludge(PDDS) have been demonstrated in a continuousflow bench-scale reactor.The best C/N for the degradation of azo dyes by PDDS was 1.5.The specific removal rate of azo dye AB92 decreased with a decrease in hydraulic retention time and increased with a decrease in solids retention time.The degradation rate of TOC decreased with a decrease in hydraulic retention time.AB92,which has nitro and hydroxyl substitutions in non-para positions,was uniquely degraded.During continuous flow treatment experiments using PDDS,complete degradation of azo dyes AB92 and AO20 at influent concentrations of 40 mg/L and 30 mg/L,respectively,was achieved with an HRT of 16.

  9. How you evaluate treatment results in low back pain patients depends on who the patient is

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    2008-01-01

    How you evaluate treatment results in low back pain patients depends on who the patient is Lauridsen, HH 1*, Hartvigsen, J1,2, Manniche, C1,3, Korsholm, L1,4, Grunnet-Nilsson, N1 1.    Clinical Locomotion Science, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark...... of an evaluative instrument in back pain patients is complicated because of lack of head-to-head comparisons of clinimetric properties of the various instruments. In addition, little is known about instrument behaviour in clinical subgroups. The objective of this study was to concurrently compare responsiveness...... and minimal clinically important differences (MCID) for commonly used pain scales and functional instruments in four subpopulations of LBP patients. Methods The Danish versions of the Oswestry Disability Index (ODI), the 23-item Roland Morris Disability Questionnaire (RMQ), the physical function and bodily...

  10. Sex-Dependent Decrease of Sphingomyelinase Activity During Alcohol Withdrawal Treatment

    Directory of Open Access Journals (Sweden)

    Christiane Mühle

    2014-06-01

    Full Text Available Background: In vitro and in vivo studies have demonstrated the role of the acid sphingomyelinase (ASM in pathophysiological processes and alterations in response to ethanol exposure. Cellular and plasmatic ASM activities are increased in male alcohol dependent patients and decrease during physical withdrawal. Methods: Here, we analyzed the time course of ASM in male and also female acutely intoxicated patients during alcohol withdrawal and compared the activity levels to those under long-term maintenance treatment. Craving and further psychometric parameters were assessed by questionnaires. Results: The gradual decrease of serum ASM was confirmed in males (pConclusion: These data support the potential of ASM as a biomarker for the course of withdrawal therapy in males and provide the first associations of this enzyme with psychological variables such as craving and depression.

  11. Sodium retention and insulin treatment in insulin-dependent diabetes mellitus

    DEFF Research Database (Denmark)

    Nørgaard, K; Feldt-Rasmussen, B

    1994-01-01

    newly diagnosed diabetic patients (aged 20-35 years, median 27 years) who were studied on two occasions on different insulin doses. Study 3 was a 12-month prospective intervention study of 21 type 1 diabetic patients with incipient nephropathy, who had been randomized either to receive continuous...... subcutaneous insulin infusion for improvement of glycaemic control or to remain on conventional insulin treatment. In study 1, ENa was higher in short-duration type 1 diabetic men than in controls (3003 +/- 325 vs 2849 +/- 207 mEq/1.73 m2, P ...The hypothesis that total body exchangeable sodium (ENa) is elevated in type 1 (insulin-dependent) diabetic patients with short-duration diabetes and no signs of microangiopathy was tested. Also tested was whether peripheral hyperinsulinaemia, in terms of the amounts of insulin injected...

  12. The effect of cyclin-dependent kinases inhibitor treatment on experimental herpes simplex encephalitis mice.

    Science.gov (United States)

    Zhou, Yu; Zeng, Yan-Ping; Zhou, Qin; Guan, Jing-Xia; Lu, Zu-Neng

    2016-08-01

    Herpes simplex encephalitis(HSE) is the most common and serious viral encephalitis in humans. There is a lack of effective medication to date for HSE. A better understanding of the mediators of tissue damage is essential for finding new targets for therapeutic intervention. In this project, we explored the effect of cyclin-dependent kinases inhibitor olomoucine treatment on experimental HSE mice. The following results were obtained: (1) olomoucine increased survival in HSE mice; (2) olomoucine inhibited microglial activation and reduced HSV-1-induced cytokines release; (3) olomoucine prevented neural cells apoptosis and attenuated brain tissue pathological changes following HSV-1 infection; (4) olomoucine reduced brain edema and improved neurological function in HSE. Overall, olomoucine can induce a blunted inflammatory response, maintain the blood vessel wall intact, improve neurological function and increase survival in HSE mice.

  13. [Limitations of insulin-dependent drugs in the treatment of type 2 diabetes mellitus].

    Science.gov (United States)

    Valerón, Pino Fuente; de Pablos-Velasco, Pedro L

    2013-09-01

    In this study, we review the efficacy and safety limitations of insulin-dependent oral antidiabetic agents. In terms of efficiency, the main drawback of metformin, sulfonylureas, gliptins and -to a lesser extent-glitazones is durability. No drug per se is able to maintain stable blood glucose control for years. Metformin, sulfonylureas and gliptins have demonstrated safety. Experience with the first two drug groups is more extensive. The main adverse effect of metformin is gastrointestinal discomfort. Major concerns related to the use of sulfonylureas are hypoglycemia and weight gain. The use of pioglitazone has been associated with an increased risk of bladder cancer, edema, heart failure, weight gain, and distal bone fractures in postmenopausal women. The most common adverse reactions associated with glucagon-like peptide-1 agonists are gastrointestinal discomfort that sometimes leads to treatment discontinuation.

  14. Dependence Analysis of Double Grammar Rule Program%双语法规则程序依赖性分析

    Institute of Scientific and Technical Information of China (English)

    王扶

    2011-01-01

    A new program analysis method is proposed to enlarge the range of application in the dependence analysis of traditional program.The analysis is divided into two parts: incomplete analysis and complete analysis.In gcc 3.2 and Linux kernel 2.4.20-8 compilation environment , the program structure, date dependency and control informatian are extracted by using the different lexical and syntax analysis module.It accelerates the pace of program analysis, and reduces the algorithm complexity in the program data flow dependence analysis and control flow dependence analysis.The feasibility of this method is proved with the achieved specific procedures.%为了提高传统程序依赖性分析的应用范围和灵活性,提出一种新的程序分析方法.该方法分为不完整性分析和完整性分析两部分.在gcc3.2和Linux内核2.4.20-8的编译环境下,利用不同的词法和语法分析模块对程序结构、数据依赖和控制信息进行提取,加快了程序分析的速度,并有效降低了程序数据流依赖分析和控制流依赖分析中算法的复杂度.最后用具体的程序实现证明了该算法的可行性.

  15. A randomized comparative trial in the management of Alcohol Dependence: Individualized Homoeopathy versus standard Allopathic Treatment

    Directory of Open Access Journals (Sweden)

    Raj K Manchanda

    2016-01-01

    Full Text Available Objectives: This study was undertaken to compare the effects of IH with standard allopathic (SA treatment. Methods: A randomized controlled, open-label, comparative trial, was conducted, in which alcohol dependents were screened verbally using the CAGE scale. The participants 80 patients fulfilling the inclusion criteria were randomized either IH (n=40 or SA (n=40 and treated cum followed up for 12 months. The primary outcome was more than 50% reduction in the Severity of Alcohol Dependence Questionnaire [SADQ] rating scale at 12 th month. Data analysis was done for both intention-to-treat (ITT and per-protocol (PP populations. Results: ITT analysis reflected 80% (n = 32 of the patients in IH and 37.5% (n = 15 of the patients in the SA responding to CI before 2.4 treatment with absolute difference was 42.5% (42.5 [95% confidence interval [CI]: 23.0, 61.6] and estimated effect: 6.6 (95% C.I: 2.4, 18.2, P = 0.0002. A significant difference favoring IH was also observed in three out of four domains of WHO QOL-BREF. Statistically significant difference was found in the number of drinking days (median difference: −24.00; CI: −39.0-−8.0; P = 0.001 and number of drinks per drinking day (median difference: −6.3 [95% CI: −11.3-−1.9]; P = 0.004, favoring IH. The results showed a similar trend in PP analysis. Medicines found useful were Sulphur, Lycopodium clavatum, Arsenicum album, Nux vomica, Phosphorus, and Lachesis. Conclusion: The results conclude that IH is not inferior to SA in the management of AD patients. More rigorous studies with large sample size are however desirable.

  16. Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence.

    Science.gov (United States)

    Mutschler, J; Grosshans, M; Soyka, M; Rösner, S

    2016-07-01

    As an alcohol-aversive agent, disulfiram occupies an exceptional position in the pharmacological relapse prevention of alcohol dependence. In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol. Therapeutic and adverse effects are therefore closely related: On the one hand, the aversiveness of the disulfiram ethanol reaction has the potential to support abstinence in a subgroup of alcohol-dependent patients, while on the other hand it becomes a health threat if the patient fails to maintain complete abstinence. The exceptional position of disulfiram is also related to the role that expectations play in the mediation of therapeutic effects. These are not determined by the pharmacological effects or the actual occurrence of a disulfiram-ethanol reaction, but are attributable to patient awareness that the drug was consumed and the corresponding anticipation of an aversive reaction if combined with alcohol. This is in line with the findings of a recent meta-analysis that only showed significant effects for disulfiram in open-label trials. The authors of the meta-analysis conclude that due to expectations induced in both the treatment and placebo groups, blinded studies are incapable of distinguishing a difference between groups. The mediation of therapeutic effects through expectation has a number of consequences for clinical practice and future research on disulfiram.

  17. The role of the glutamatergic system in the patogenesis and treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Karina Łukasik

    2010-10-01

    Full Text Available The lack of satisfactory results of alcohol dependence treatment has necessitated the search for new directions of studies. One of them is connected with glutamatergic transmission. The influence of alcohol on this transmission is very complex and relates to changes including at the molecular level. However, the diversity of glutamatergic receptors creates a new possibility of modulation of its activity. It leads to decrease of alcohol reward abilities, prolongs abstinence time and reduces the incidence of acute alcohol intoxication in alcohol addicts. The use of acamprosate – a glutamatergic transmission modulator drug – and naltrexone (an opioid receptor antagonist improves therapy effectiveness of acamprosate alone. Satisfactory results were achieved in the studies of topiramate – an antagonist of AMPA and KA receptors. Its effectiveness was proved in clinical studies. Topiramate reduced alcohol craving and prolonged abstinence time, which decreased the probability of relapse. There are promising preclinical results of groups I and II metabotropic receptor antagonists. However, further studies are necessary to elucidate precisely their role in alcohol dependence.

  18. Are the effects of gamma-hydroxybutyrate (GHB) treatment partly physiological in alcohol dependence?

    Science.gov (United States)

    Ameisen, Olivier

    2008-01-01

    It has been hypothesized that the therapeutic effects of Gamma-hydroxybutyrate (GHB) in alcohol dependence could be related to ethanol-mimicking action of the drug and that GHB could reduce alcohol craving, intake and withdrawal by acting as a "substitute" of the alcohol in the central nervous system. Nevertheless, alcohol being the strongest trigger of craving and intake, it is difficult to ascribe reduction of craving and intake to ethanol-mimicking activity of GHB. I have recently proposed that alcohol/substance dependence could result from a GHB-deficiency-related dysphoric syndrome in which alcohol/substances would be sought to "substitute" for insufficient GHB effect. GHB is the sole identified naturally occurring gamma-aminobutyric acid B (GABA (B)) receptor agonist. Here, I propose that exogenous GHB might in fact "substitute" for deficient endogeneous GHB and represent true substitutive treatment for GHB-deficiency. And that baclofen and GHB could both compensate for deficient effect of the physiological GABA (B) receptor agonist(s).

  19. Enhancement or inhibition of tumor growth by interferon: dependence on treatment protocol.

    Science.gov (United States)

    Murasko, D M; Fresa, K; Mark, R

    1983-12-15

    MSC cells are tumor cells originally induced in BALB/c mice by Moloney sarcoma virus. In these studies we demonstrated that, although these tumor cells are sensitive in vitro both to lysis by NK or NK-like cells and to the growth-inhibitory effect of murine L-cell interferon (IFN), the growth of the tumor in vivo could be either inhibited or enhanced by IFN. The outcome of in vivo IFN treatment was dependent on the timing and route of IFN administration relative to tumor challenge. IFN given systematically at the same time as tumor challenge resulted in enhancement of primary tumor formation, rate of tumor growth and subsequent progressive tumor growth. In contrast, IFN administered at the site of tumor inoculation on days 1-3 after tumor challenge inhibited tumor formation and growth. Histopathology of tissue sections obtained from the site of tumor challenge confirmed these results. Similar studies performed in mice given 450 rads of X-irradiation showed that IFN could still inhibit tumor growth when administered at the site of tumor inoculation on days 1-3 after tumor challenge. IFN administered simultaneously with tumor challenge, however, did not enhance tumor growth in irradiated mice. These results are consistent with the interpretation that 1) inhibition of MSC-induced tumor growth by IFN has a radioresistant component and 2) the enhancement of MSC-induced tumor formation by IFN is dependent on interaction with a radiosensitive population of cells, possibly lymphoid cells.

  20. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Science.gov (United States)

    2010-07-01

    ... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Alcohol and...

  1. Dose- and Time-Dependent Response of Human Leukemia (HL-60 Cells to Arsenic Trioxide Treatment

    Directory of Open Access Journals (Sweden)

    Paul B. Tchounwou

    2006-06-01

    Full Text Available The treatment of acute promyelocytic leukemia (APL has been based on the administration of all-trans retinoic acid plus anthracycline chemotherapy, which is very effective as first line therapy; however 25 to 30% of patients will relapse with their disease becoming refractory to conventional therapy. Recently, studies have shown arsenic trioxide to be effective in the treatment of acute promyelocytic leukemia. In this study, we used the human leukemia (HL-60 cell line as a model to evaluate the cytoxicity of arsenic trioxide based on the MTT assay. Data obtained from this assay indicated that arsenic trioxide significantly reduced the viability of HL-60 cells, showing LD50 values of 14.26 + 0.5μg/mL, 12.54 + 0.3μg/mL, and 6.4 + 0.6μg/mL upon 6, 12, and 24 hours of exposure, respectively; indicating a dose- and time-dependent response relationship. Findings from the present study indicate that arsenic trioxide is highly cytotoxic to human leukemia (HL-60 cells, supporting its use as an effective therapeutic agent in the management of acute promyelocytic leukemia.

  2. Antenatal treatment in two Dutch families with pyridoxine-dependent seizures.

    Science.gov (United States)

    Bok, Levinus A; Been, Jasper V; Struys, Eduard A; Jakobs, Cornelis; Rijper, Elisabeth A M; Willemsen, Michèl A

    2010-03-01

    Incidental reports suggest that antenatal treatment of pyridoxine dependent seizures (PDS) may improve neurodevelopmental outcome of affected patients. Two families with PDS are reported, both with two affected siblings. Antenatal treatment with pyridoxine was instituted during the second pregnancy in each family (50 and 60 mg daily from 3 and 10 weeks of gestation, respectively). Perinatal characteristics and neurodevelopmental outcome at 4 (Family A) and 12 (Family B) years of age were compared between the untreated and treated child within each family. Meconium-stained amniotic fluid was present in both first pregnancies and abnormal foetal movements were noticed in one. In the treated infants, pregnancy and birth were uncomplicated. In family A, postnatal pyridoxine supplementation prevented neonatal seizures. Both children in family A were hypotonic and started walking after 2 years of age; both had white matter changes on MRI, and the first child was treated for squint. IQ was 73 and 98 in the antenatally untreated and treated child, respectively. The second child in family B developed seizures on the seventh day, because pyridoxine maintenance therapy had not been instituted after birth. Seizures responded rapidly to pyridoxine supplementation. MRI showed large ventricles and a mega cisterna magna. IQ was 80 and 106 in the antenatally untreated and treated child respectively. Both children had normal motor development. These results suggest that antenatal pyridoxine supplementation may be effective in preventing intrauterine seizures, decreasing the risk of complicated birth and improving neurodevelopmental outcome in PDS.

  3. Assessment of chemical composition of tomato fruits depending on the cultivar and 1-MCP treatment

    Directory of Open Access Journals (Sweden)

    Anna Wrzodak

    2016-09-01

    Full Text Available The experiments on influence of 1-MCP treatment on the content of some chemical compounds in tomato fruits were performed. For the experiments two greenhouse cultivars of tomato were selected: ‘Faustine F1’ and ‘Habana F1’ (LSL type – long shelf life. Both tomato cultivars were grown on stakes in the field. Tomato fruits were harvested in mature green and full-red stages of maturity. Tomato fruit were treated with 1-MCP at the concentrations of 1.0 or 2.0 μl·l-1 and then stored at the temperature of 12.5°C or 20°C, and 85–90% of relative humidity in ambient atmosphere. Immediately after harvest and after 4 weeks of storage chemical analyses were carried out. The results showed some significant differences in the content of determined compounds depending on 1-MCP treatment, stage of maturity and storage temperature. Fruits of both cultivars showed a higher content of phenolics and dry matter in the case of fruits treated with 1-MCP. The highest content of lycopene was found in tomato fruits of both cultivars harvested in full-red stage, after storage at 20°C. Tomato fruits treated with 1-MCP were characterized by a lower content of lycopene and vitamin C compared to the untreated fruits.

  4. Cannabis withdrawal is common among treatment-seeking adolescents with cannabis dependence and major depression, and is associated with rapid relapse to dependence.

    Science.gov (United States)

    Cornelius, Jack R; Chung, Tammy; Martin, Christopher; Wood, D Scott; Clark, Duncan B

    2008-11-01

    Recently, reports have suggested that cannabis withdrawal occurs commonly in adults with cannabis dependence, though it is unclear whether this extends to those with comorbid depression or to comorbid adolescents. We hypothesized that cannabis withdrawal would be common among our sample of comorbid adolescents and young adults, and that the presence of cannabis withdrawal symptoms would be associated with a self-reported past history of rapid reinstatement of cannabis dependence symptoms (rapid relapse). The participants in this study included 170 adolescents and young adults, including 104 with cannabis dependence, 32 with cannabis abuse, and 34 with cannabis use without dependence or abuse. All of these subjects demonstrated current depressive symptoms and cannabis use, and most demonstrated current DSM-IV major depressive disorder and current comorbid cannabis dependence. These subjects had presented for treatment for either of two double-blind, placebo-controlled trials involving fluoxetine. Cannabis withdrawal was the most commonly reported cannabis dependence criterion among the 104 subjects in our sample with cannabis dependence, being noted in 92% of subjects, using a two-symptom cutoff for determination of cannabis withdrawal. The most common withdrawal symptoms among those with cannabis dependence were craving (82%), irritability (76%), restlessness (58%), anxiety (55%), and depression (52%). Cannabis withdrawal symptoms (in the N=170 sample) were reported to have been associated with rapid reinstatement of cannabis dependence symptoms (rapid relapse). These findings suggest that cannabis withdrawal should be included as a diagnosis in the upcoming DSM-V, and should be listed in the upcoming criteria list for the DSM-V diagnostic category of cannabis dependence.

  5. Um novo escore para dependência a nicotina e uma nova escala de conforto do paciente durante o tratamento do tabagismo A new nicotine dependence score and a new scale assessing patient comfort during smoking cessation treatment

    Directory of Open Access Journals (Sweden)

    Jaqueline Scholz Issa

    2012-12-01

    Full Text Available O tabagismo é considerado a maior causa evitável de morbidade e mortalidade. O manuseio farmacológico da síndrome de abstinência de nicotina possibilita melhores taxas de cessação. Desenvolvemos um sistema de coleta de dados em nosso programa de assistência ao fumante, que inclui dois instrumentos novos: um escore para dependência de nicotina em fumantes de Smoking is considered the leading preventable cause of morbidity and mortality. The pharmacological management of nicotine withdrawal syndrome enables better cessation rates. In our smoking cessation program, we have developed a data collection system, which includes two new instruments: a score that assesses nicotine dependence in smokers of < 10 cigarettes/day; and a patient comfort scale to be used during smoking cessation treatment. Here, we describe the two instruments, both of which are still undergoing validation.

  6. MOVE! multidisciplinary programs: Challenges and resources for weight management treatment in VHA.

    Science.gov (United States)

    Rosenberger, Patricia H; Ruser, Christopher; Kashaf, Susan

    2011-12-01

    The MOVE! program has been a successful weight management and physical activity initiative from the Veteran's Health Administration. While it embraces a multicomponent approach to weight management, local facilities have primarily focused on the implementation of delivery of MOVE! educational materials to groups or individuals. We discuss additional MOVE!-related weight management efforts within VHA that reflect treatment strategies beyond delivery of these educational materials. First, we present a case study that highlights the special challenges associated with the Veteran overweight/obese population. Second, we describe the implementation of our local, multidisciplinary, individualized weight management clinic as an example of on-the-ground provision of a higher treatment intensity program as part of MOVE!'s multicomponent model. Third, we present program outcomes and consider challenges to program sustainability.

  7. Impacts of gantry angle dependent scanning beam properties on proton PBS treatment

    Science.gov (United States)

    Lin, Yuting; Clasie, Benjamin; Lu, Hsiao-Ming; Flanz, Jacob; Shen, Tim; Jee, Kyung-Wook

    2017-01-01

    While proton beam models in treatment planning systems are generally assumed invariant with respect to the beam deliveries at different gantry angles. Physical properties of scanning pencil beams can change. The gantry angle dependent properties include the delivered charge to the monitor unit chamber, the spot position and the spot shape. The aim of this study is to investigate the extent of the changes and their dosimetric impacts using historical pencil beam scanning (PBS) treatment data. Online beam delivery records at the time of the patient-specific qualify assurance were retrospectively collected for a total of 34 PBS fields from 28 patients treated at our institution. For each field, proton beam properties at two different gantry angles (the planned and zero gantry angles) were extracted by a newly-developed machine log analysis method and used to reconstruct the delivered dose distributions in the cubic water phantom geometry. The reconstructed doses at the two different angles and a planar dose measurement by a 2D ion-chamber array were compared and the dosimetric impacts of the gantry angle dependency were accessed by a 3D γ-index analysis. In addition, the pencil beam spot size was independently characterized as a function of the gantry angle and the beam energy. The dosimetric effects of the perturbed beam shape were also investigated. Comparisons of spot-by-spot beam positions between both gantry angles show a mean deviation of 0.4 and 0.7 mm and a standard deviation of 0.3 and 0.6 mm for x and y directions, respectively. The delivered giga-protons per spot show a percent mean difference and a standard deviation of 0.01% and 0.3%, respectively, from each planned spot weight. These small deviations lead to an excellent agreement in dose comparisons with an average γ passing rate of 99.1%. When each calculation for both planned and zero gantry angles was compared to the measurement, a high correlation in γ values was also observed, also

  8. Impacts of gantry angle dependent scanning beam properties on proton PBS treatment.

    Science.gov (United States)

    Lin, Yuting; Clasie, Benjamin; Lu, Hsiao-Ming; Flanz, Jacob; Shen, Tim; Jee, Kyung-Wook

    2017-01-21

    While proton beam models in treatment planning systems are generally assumed invariant with respect to the beam deliveries at different gantry angles. Physical properties of scanning pencil beams can change. The gantry angle dependent properties include the delivered charge to the monitor unit chamber, the spot position and the spot shape. The aim of this study is to investigate the extent of the changes and their dosimetric impacts using historical pencil beam scanning (PBS) treatment data. Online beam delivery records at the time of the patient-specific qualify assurance were retrospectively collected for a total of 34 PBS fields from 28 patients treated at our institution. For each field, proton beam properties at two different gantry angles (the planned and zero gantry angles) were extracted by a newly-developed machine log analysis method and used to reconstruct the delivered dose distributions in the cubic water phantom geometry. The reconstructed doses at the two different angles and a planar dose measurement by a 2D ion-chamber array were compared and the dosimetric impacts of the gantry angle dependency were accessed by a 3D γ-index analysis. In addition, the pencil beam spot size was independently characterized as a function of the gantry angle and the beam energy. The dosimetric effects of the perturbed beam shape were also investigated. Comparisons of spot-by-spot beam positions between both gantry angles show a mean deviation of 0.4 and 0.7 mm and a standard deviation of 0.3 and 0.6 mm for x and y directions, respectively. The delivered giga-protons per spot show a percent mean difference and a standard deviation of 0.01% and 0.3%, respectively, from each planned spot weight. These small deviations lead to an excellent agreement in dose comparisons with an average γ passing rate of 99.1%. When each calculation for both planned and zero gantry angles was compared to the measurement, a high correlation in γ values was also observed, also

  9. Predictive validity of the MMPI-2 among female offenders in a residential treatment program.

    Science.gov (United States)

    McAnulty, Richard D; McAnulty, David P; Sipp, Jennifer E; Demakis, George J; Heggestad, Eric D

    2014-01-01

    This study investigated the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity, clinical, restructured clinical, supplementary, and content scales in a female correctional population. The study used archival data for a final sample of 116 women who had been evaluated for acceptance into a residential rehabilitative treatment program for nonviolent female offenders in North Carolina. MMPI-2 scale elevations are reported and assessed for predictive validity in relation to treatment success, as measured by treatment attendance and graduation status. In relation to predictive validity, logistic regression analyses revealed that elevations on Scales FRS (Fears) and R (Repression) differentiated women who attended the program from women who did not. Elevations on Scales 4, DEP (Depression), Re (Responsibility), and AAS (Addiction Admission Scale) differentiated women who graduated the program from women who did not. Implications for the rehabilitation of female offenders, as well as limitations of this exploratory study, are discussed.

  10. Reduced frontal brain volume in non-treatment seeking cocaine dependent individuals: exploring the role of impulsivity, depression and smoking

    Directory of Open Access Journals (Sweden)

    Cleo Lina Crunelle

    2014-01-01

    Full Text Available In cocaine-dependent patients, grey matter (GM volume reductions have been observed in the frontal lobes that are associated with duration of cocaine use. Studies are mostly restricted to treatment-seekers and studies in non-treatment seeking cocaine abusers are sparse. Here, we assessed GM volume differences between 30 non-treatment-seeking cocaine-dependent individuals and 33 non drug using controls using voxel-based morphometry (VBM. Additionally, within the group of non-treatment-seeking cocaine-dependent individuals, we explored the role of frequently co-occurring features such as of trait impulsivity (Barratt Impulsivity Score, BIS, smoking, depressive symptoms (Beck Depression Inventory (BDI, as well as the role of cocaine use duration, on frontal GM volume. Smaller GM volumes in non-treatment-seeking cocaine-dependent individuals were observed in the left middle frontal gyrus. Moreover, within the group of cocaine users, trait impulsivity was associated with reduced GM volume in the right OFC, the left precentral gyrus and the right superior frontal gyrus, whereas no effect of smoking severity, depressive symptoms or duration of cocaine use was observed on regional GM volumes. Our data show an important association between trait impulsivity and frontal GM volumes in cocaine-dependent individuals. In contrast to previous studies with treatment-seeking cocaine-dependent patients, no significant effects of smoking severity, depressive symptoms or duration of cocaine use on frontal GM volume were observed. Reduced frontal GM volumes in non-treatment-seeking cocaine-dependent subjects are associated with trait impulsivity and are not associated with co-occurring nicotine dependence or depression.

  11. Bench to Bedside: Understanding Symptom Response to Acupuncture Treatment and Designing a Successful Acupuncture Treatment Program

    Science.gov (United States)

    2015-10-01

    free survival in patients with myocardial infarction : the ENRICHD experience. J Psychosom Res. 2009 Jul;67(1):45-56. Epub 2009 Apr 1. 3 Cohen, S., et...now turn to better understand what took place during the individual diagnosis and treatment plans. Our naturalistic data, is heterogeneous and... diagnosis ) to begin to articulate how to talk about GWI in terms of TCM. Our eventual project goal is to add treatment data and develop a TCM model (or

  12. A Comparative Analysis of Three Water Treatment Programs for Cooling Tower Systems

    Science.gov (United States)

    1991-09-01

    Gallic Acid Powder (item 2063) METHOD: It is necessary to follow the instructions furnished with the conductivity meter that is being used . The...the location and costs of AFLC towers. 2 Definition of Terms Terms commonly used in cooling tower water treatment. Acid : A substance that dissolves...the sulfuric acid program. This program is still indorsed by Air Force Regulation 91-40. System operators use sulfuric acid to lower the pH and

  13. Power Burst Facility/Boron Neutron Capture Therapy Program for cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. (ed.); Dorn, R.V. III.

    1990-08-01

    This report discusses monthly progress in the Power Boron Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program for Cancer Treatment. Highlights of the PBF/BNCT Program during August 1990 include progress within the areas of: Gross Boron Analysis in Tissue, Blood, and Urine, boron microscopic (subcellular) analytical development, noninvasive boron quantitative determination, analytical radiation transport and interaction modeling for BNCT, large animal model studies, neutron source and facility preparation, administration and common support and PBF operations.

  14. Power Burst Facility/Boron Neutron Capture Therapy Program for cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. (ed.); Dorn, R.V. III.

    1990-08-01

    This report discusses monthly progress in the Power Boron Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program for Cancer Treatment. Highlights of the PBF/BNCT Program during August 1990 include progress within the areas of: Gross Boron Analysis in Tissue, Blood, and Urine, boron microscopic (subcellular) analytical development, noninvasive boron quantitative determination, analytical radiation transport and interaction modeling for BNCT, large animal model studies, neutron source and facility preparation, administration and common support and PBF operations.

  15. The Efficacy of a Condensed "Seeking Safety" Intervention for Women in Residential Chemical Dependence Treatment at 30 Days Posttreatment

    Science.gov (United States)

    Cash Ghee, Anna; Bolling, Lanny C.; Johnson, Candace S.

    2009-01-01

    This study examined the efficacy of a condensed version of the "Seeking Safety" intervention in the reduction of trauma-related symptoms and improved drug abstinence rates among women in residential chemical dependence treatment. One hundred and four women were randomly assigned to treatment including a condensed (six session) "Seeking Safety"…

  16. Functional Magnetic Resonance Imaging Clinical Trial of a Dual-Processing Treatment Protocol for Substance-Dependent Adults

    Science.gov (United States)

    Matto, Holly C.; Hadjiyane, Maria C.; Kost, Michelle; Marshall, Jennifer; Wiley, Joseph; Strolin-Goltzman, Jessica; Khatiwada, Manish; VanMeter, John W.

    2014-01-01

    Objectives: Empirical evidence suggests substance dependence creates stress system dysregulation which, in turn, may limit the efficacy of verbal-based treatment interventions, as the recovering brain may not be functionally capable of executive level processing. Treatment models that target implicit functioning are necessary. Methods: An RCT was…

  17. Correlates of Motivational Interviewing Use Among Substance Use Treatment Programs Serving American Indians/Alaska Natives.

    Science.gov (United States)

    Dickerson, Daniel; Moore, Laurie A; Rieckmann, Traci; Croy, Calvin D; Venner, Kamilla; Moghaddam, Jacquelene; Gueco, Rebekah; Novins, Douglas K

    2017-02-24

    Motivational interviewing (MI) offers a treatment modality that can help meet the treatment needs of American Indians/Alaska Natives (AI/ANs) with substance use disorders. This report presents results from a national survey of 192 AI/AN substance abuse treatment programs with regard to their use of MI and factors related to its implementation, including program characteristics, workforce issues, clinician perceptions of MI, and how clinicians learned about MI. Sixty-six percent of programs reported having implemented the use of MI in their programs. In the final logistic regression model, the odds of implementing MI were significantly higher when programs were tribally owned (OR = 2.946; CI95 1.014, 8.564), where more than 50% of staff were Certified Alcohol and Drug Counselors (CADCs) (OR = 5.469; CI95 1.330, 22.487), and in programs in which the survey respondent perceived that MI fit well with their staff's expertise and training (OR = 3.321; CI95 1.287, 8.569).

  18. Longitudinal spirometry among patients in a treatment program for community members with World Trade Center (WTC)-related illness

    Science.gov (United States)

    Liu, Mengling; Qian, Meng; Cheng, Qinyi; Berger, Kenneth I.; Shao, Yongzhao; Turetz, Meredith; Kazeros, Angeliki; Parsia, Sam; Goldring, Roberta M.; Fernandez-Beros, Maria Elena; Marmor, Michael; Reibman, Joan

    2013-01-01

    Objective The course of lung function in community members exposed to World Trade Center (WTC) dust and fumes remains undefined. We studied longitudinal spirometry among patients in the WTC Environmental Health Center (WTCEHC) treatment program. Methods Observational study of 946 WTCEHC patients with repeated spirometry measures analyzed on the population as a whole and stratified by smoking status, initial spirometry pattern and WTC-related exposure category. Results Improvement in forced expiratory volume (FVC; 54.4 ml/year; 95% CI: 45.0-63.8) and forced expiratory volume in one second (FEV1; 36.8 ml/year; 95% CI: 29.3-44.3) was noted for the population as a whole. Heavy smokers did not improve. Spirometry changes differed depending on initial spirometry pattern and exposure category. Conclusions These data demonstrate spirometry improvement in select populations suggesting reversibility in airway injury and reinforcing the importance of continued treatment. PMID:22995806

  19. The implementation of health care aimed at the cessation of tobacco use, treatment of tobacco dependence and consequences of tobacco consumption in the Russian Federation

    Directory of Open Access Journals (Sweden)

    S. A. Boytsov

    2016-01-01

    Full Text Available The summarizing of the experience of medical care at the cessation of tobacco use and the treatment of tobacco addiction and consequences of tobacco consumption in the Russian Federation (RF as well as suggestions for their improvement are presented.For the effective implementation of health care, aimed at the cessation of tobacco use, treatment of tobacco addiction and consequences of tobacco consumption in the RF it is necessary to solve the following problems:to include doctors of all specialties in the process of medical care and treatment oftobacco addiction and consequences oftobacco consumption in the RF; to ensure effective implementation of the existing legal documents determining the procedure for providing medical aid, aimed at ending the use of tobacco, treatment of tobacco dependence and consequences of tobacco consumption, greater control over their performance and quality of their implementation; to expand of the network of medical offices for cessation of tobacco consumption on the basis of existing structures in primary health care settings (including women's and children’s outpatient clinics, as well as hospitals and health resorts, their provision of personnel and equipment, introduction of group forms of work; to ensure a permanent system of training on assistance at the cessation of tobacco consumption, the treatment of tobacco dependence and consequences of tobacco consumption, including the introduction of medical assistance cycle on cessation of tobacco consumption for student training in medical schools and programs for postgraduate education of health professionals

  20. Pressure sore and skin tear prevention and treatment during a 10-month program.

    Science.gov (United States)

    Brillhart, Barbara

    2005-01-01

    This article reports the results of a 10-month skin care program for 30 clients on a residential Alzheimer's disease unit. The majority (n = 26) of the clients were free of pressure sores and skin tears through preventive care during this study. Four clients with Stage I pressure sores and/or skin tears were successfully identified by consistent assessment and healed quickly due to rapidly initiated treatments. This skin care program's success was attributed to consistent education, preventive care, assessment, documentation, and treatment executed by the entire care team under the leadership of nurse practitioners, one of whom was certified as a rehabilitation nurse.

  1. Treatment effects model for assessing disease management: measuring outcomes and strengthening program management.

    Science.gov (United States)

    Wendel, Jeanne; Dumitras, Diana

    2005-06-01

    This paper describes an analytical methodology for obtaining statistically unbiased outcomes estimates for programs in which participation decisions may be correlated with variables that impact outcomes. This methodology is particularly useful for intraorganizational program evaluations conducted for business purposes. In this situation, data is likely to be available for a population of managed care members who are eligible to participate in a disease management (DM) program, with some electing to participate while others eschew the opportunity. The most pragmatic analytical strategy for in-house evaluation of such programs is likely to be the pre-intervention/post-intervention design in which the control group consists of people who were invited to participate in the DM program, but declined the invitation. Regression estimates of program impacts may be statistically biased if factors that impact participation decisions are correlated with outcomes measures. This paper describes an econometric procedure, the Treatment Effects model, developed to produce statistically unbiased estimates of program impacts in this type of situation. Two equations are estimated to (a) estimate the impacts of patient characteristics on decisions to participate in the program, and then (b) use this information to produce a statistically unbiased estimate of the impact of program participation on outcomes. This methodology is well-established in economics and econometrics, but has not been widely applied in the DM outcomes measurement literature; hence, this paper focuses on one illustrative application.

  2. From cancer screening to treatment: service delivery and referral in the National Breast and Cervical Cancer Early Detection Program.

    Science.gov (United States)

    Miller, Jacqueline W; Hanson, Vivien; Johnson, Gale D; Royalty, Janet E; Richardson, Lisa C

    2014-08-15

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. © 2014 American Cancer Society.

  3. Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis

    Science.gov (United States)

    Skinner, Marilyn D.; Lahmek, Pierre; Pham, Héloïse; Aubin, Henri-Jean

    2014-01-01

    supportive pharmacological treatments or to no disulfiram in supervised studies for problems of alcohol abuse or dependence. PMID:24520330

  4. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Marilyn D Skinner

    pharmacological treatments or to no disulfiram in supervised studies for problems of alcohol abuse or dependence.

  5. Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

    Directory of Open Access Journals (Sweden)

    Menke J Michael

    2008-12-01

    Full Text Available Abstract Background This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures. Methods The 20-item survey was developed by The University of Arizona HealthCare Partnership in collaboration with the Arizona Department of Health Services Bureau of Tobacco Education and Prevention. It was mailed to representatives of Arizona's 40 healthcare systems, including commercial and Medicare managed care organizations, "managed Medicaid" organizations, Veterans Affairs Health Care Systems, and Indian Health Service Medical Centers. Thirty-three healthcare systems (83% completed the survey. Results The majority of healthcare systems reported awareness of at least one tobacco cessation and prevention clinical practice guideline, but only one third reported full guideline implementation. While a majority covered some form of behavioral therapy, less than half reported covering tobacco treatment medications. "Managed Medicaid" organizations administered through the Arizona Health Care Cost Containment System were significantly less likely to offer coverage for behavioral therapy and less likely to cover pharmacotherapy than were their non-Medicaid counterparts in managed care, Veterans Affairs Health Care Systems and Indian Health Service Medical Centers. Conclusion Arizona healthcare system coverage for tobacco cessation in the year 2000 was comparable to national survey findings of the same year. The findings that only 10% of "Managed Medicaid" organizations covered tobacco treatment medication and were significantly less likely to cover behavioral therapy were important given the nearly double smoking prevalence among Medicaid patients. Throughout the years of the program, the strategic plan of the Arizona Department of Health Services Bureau of Tobacco

  6. Disadvantageous decision-making as a predictor of drop-out among cocaine-dependent individuals in long-term residential treatment.

    Directory of Open Access Journals (Sweden)

    Laura eStevens

    2013-11-01

    Full Text Available Background: The treatment of cocaine-dependent individuals (CDI is substantially challenged by high drop-out rates, raising questions regarding contributing factors. Recently, a number of studies have highlighted the potential of greater focus on the clinical significance of neurocognitive impairments in treatment-seeking cocaine users. In the present study, we hypothesized that disadvantageous decision-making would be one such factor placing CDI at greater risk for treatment drop-out. Methods: In order to explore this hypothesis, the present study contrasted baseline performance (at treatment onset on two validated tasks of decision-making, the Iowa Gambling Task (IGT and the Cambridge Gamble Task (CGT in CDI who completed treatment in a residential Therapeutic Community (TC (N=66 and those who dropped out of TC prematurely (N=84. Results: Compared to treatment completers, CDI who dropped out of TC prematurely did not establish a consistent and advantageous response pattern as the IGT progressed and exhibited a poorer ability to choose the most likely outcome on the CGT. There were no group differences in betting behavior.Conclusions: Our findings suggest that neurocognitive rehabilitation of disadvantageous decision-making may have clinical benefits in CDI admitted to long-term residential treatment programs.

  7. Disadvantageous Decision-Making as a Predictor of Drop-Out among Cocaine-Dependent Individuals in Long-Term Residential Treatment.

    Science.gov (United States)

    Stevens, Laura; Betanzos-Espinosa, Patricia; Crunelle, Cleo L; Vergara-Moragues, Esperanza; Roeyers, Herbert; Lozano, Oscar; Dom, Geert; Gonzalez-Saiz, Francisco; Vanderplasschen, Wouter; Verdejo-García, Antonio; Pérez-García, Miguel

    2013-01-01

    The treatment of cocaine-dependent individuals (CDI) is substantially challenged by high drop-out rates, raising questions regarding contributing factors. Recently, a number of studies have highlighted the potential of greater focus on the clinical significance of neurocognitive impairments in treatment-seeking cocaine users. In the present study, we hypothesized that disadvantageous decision-making would be one such factor placing CDI at greater risk for treatment drop-out. In order to explore this hypothesis, the present study contrasted baseline performance (at treatment onset) on two validated tasks of decision-making, the Iowa Gambling Task (IGT) and the Cambridge Gamble Task (CGT) in CDI who completed treatment in a residential Therapeutic Community (TC) (N = 66) and those who dropped out of TC prematurely (N = 84). Compared to treatment completers, CDI who dropped out of TC prematurely did not establish a consistent and advantageous response pattern as the IGT progressed and exhibited a poorer ability to choose the most likely outcome on the CGT. There were no group differences in betting behavior. Our findings suggest that neurocognitive rehabilitation of disadvantageous decision-making may have clinical benefits in CDI admitted to long-term residential treatment programs.

  8. Two-year prognosis after residential treatment for patients with alcohol dependence: three chief guidelines for sobriety in Japan

    Science.gov (United States)

    Cho, Tetsuji; Negoro, Hideki; Saka, Yasuhiro; Morikawa, Masayuki; Kishimoto, Toshifumi

    2016-01-01

    Background In Japan, the three chief traditional guidelines for sobriety (3CGS) are regular medical checkups, participation in self-help groups, and pharmacotherapy with antidipsotropics. However, the official record of the origins of 3CGS is not clear. The aim of this current study was to assess 3CGS by an examination of the prognosis of patients with alcohol dependence 2 years after their discharge from a residential treatment program. Subjects and methods The association between subjects’ abstinence from alcohol and their regular medical checkups, participation in self-help groups, and treatment with antidipsotropics were prospectively examined. Two years after discharge, the relationship between the 3CGS compliance and abstinence rates was investigated as the primary outcome. In addition, the following were examined as secondary outcomes: the time taken till the first drink after discharge, whether the participants were readmitted to residential treatment, the number of days to readmission, the number of heavy drinking days, and recovery. Results A total of 98 patients participated. The perfect and partial abstinence rates for patients who followed all the principles of 3CGS were significantly higher than those for patients who followed no guidelines (P<0.05 and P<0.01, respectively). The perfect abstinence rates for patients who had continued attending checkup sessions (P<0.001) and who were taking antidipsotropics (P<0.05) were significantly higher than those for patients who did not follow these components of 3CGS. However, the perfect abstinence rates were not higher for patients who had continued to participate in self-help groups. In addition, the perfect abstinence rate was statistically associated with regular medical checkups (adjusted odds ratio =5.33, 95% confidence interval =1.35–21.0) and participation in self-help groups (adjusted odds ratio =3.79, 95% confidence interval =1.17–12.3). Conclusion This study, reports the effectiveness of 3CGS

  9. Activation and inflammation markers in HIV-1-infected patients in dependency of treatment strategies

    Directory of Open Access Journals (Sweden)

    R Ehret

    2012-11-01

    Full Text Available Purpose of the study: HIV-1-infected patients have elevated levels of immune activation and systemic inflammatory markers which are partially strong predictors of disease progression or are associated with increased cardiovascular risk. The dependency of anti-retroviral treatment (ART, the usage of NNRTI or PI-based and the application of non-nuc regimens is analysed here on the basis of a dataset (Chronic Inflammation Dependency on TREatment: CIDRE cohort from 1500 patients in Berlin. Methods: In a retrospective analysis we compared relative CD4+ cell counts, viral load, relative CD8+CD38+DR-and CD3+DR+cells, concentration of high-sensitivity C-reactive protein (hsCRP and interleukin-6 (IL-6 in therapy-naïve or treated patients dependent on usage or non-usage of NUCs, PI or NNRTI. Statistics were performed with R (R Core Team; 2012; R: A language and environment for statistical computing using Wilcoxon rank sum test in two-sided analysis. Summary of results: As to expect, ART-naïve patients (n=190 had significantly higher viral loads and lower CD4+cell counts (p: both<0.05 and showed higher activation levels than treated patient (CD8+CD38+DR- and CD3+DR+both<0.05. But no significant difference was calculated for hsCRP or IL-6. Nuc-sparing regimen (n=46 did not show any distinction compared to nuc-containing therapies (n=1249 for the analysed parameters. Significant differences were detected for PI-regimen (n=711 with lower CD4+ cell counts and higher activation (CD8+38+DR-, CD3+DR+ and IL-6 (p: all<0.05 but not for hsCRP (p=0.39. The opposite was true for NNRTI-based therapies (n=445 with higher CD4+ cell percentages and lower activation and inflammation markers (p: all<0.05 and as well no difference in hsCRP (p=0.97 compared with all other treated patients. Conclusions: The lack of differences between therapy-naïve patients and patients on ART for inflammation markers may be due to the relative good immunological state of the first group

  10. Time- and Site-Dependent Life Cycle Assessment of Thermal Waste Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hellweg, Stefanie; Hofstetter, Thomas B.; Hungerbuehler, Konrad [Swiss Federal Inst. of Technology (ETH), Zuerich (Switzerland). Chemical Engineering Dept.

    2002-12-01

    The high living standard of many industrial countries has directly lead to an increase in the amount of municipal solid waste generated. Parallel to this increase in waste, there has been a raising demand for environmentally benign waste treatment processes. In Switzerland, the predominant way of treatment is incineration. Since the environmental impact of waste incineration depends on the technology used, a comprehensive assessment of the different thermal processes is necessary. In order to determine the environmental impact, we propose a model that quantifies the emissions and resource use resulting from the incineration of waste using different technologies, the landfills for the incineration residues, the transport of waste, related infrastructure, as well as the production of ancillary products. Using the Life-Cycle Assessment (LCA) methodology, we performed a case study that compared the conventional grate technology to new high temperature processes recovering metals and vitrifying the incineration residues. The results show that if the plant is equipped with a modern gas purification system the incineration process itself is not a key environmental problem of the system considered. Using the energy gained from waste incineration as the functional unit, the environmental impacts of incineration plants are comparable to that of a conventional power plant. If long-term time horizons are considered, the critical aspect is the release of heavy metals from the landfilled incineration residues. Due to the better quality of the solid outputs new technologies have a lower potential for environmental impact than the conventional grate technology. This, however, depends on the time horizon considered. With a temporal system boundary of 100 years, the grate technology appears better, because new technologies generally use more energy and short-term emissions are of minor importance no matter what technology is used. The evaluation of waste incineration technologies

  11. Generation Expansion Planning with Large Amounts of Wind Power via Decision-Dependent Stochastic Programming

    DEFF Research Database (Denmark)

    Zhan, Yiduo; Zheng, Qipeng; Wang, Jianhui

    2016-01-01

    , the probability distribution function is determined by not only input parameters but also decision variables. To deal with the nonlinear constraints in our model, a quasi-exact solution approach is then introduced to reformulate the multistage stochastic investment model to a mixed-integer linear programming......Power generation expansion planning needs to deal with future uncertainties carefully, given that the invested generation assets will be in operation for a long time. Many stochastic programming models have been proposed to tackle this challenge. However, most previous works assume predetermined...

  12. Enhancement of antibody-dependent cell mediated cytotoxicity: a new era in cancer treatment

    Directory of Open Access Journals (Sweden)

    Rajasekaran N

    2015-05-01

    Full Text Available Narendiran Rajasekaran,1,* Cariad Chester,1,* Atsushi Yonezawa,1,2 Xing Zhao,1,3 Holbrook E Kohrt1 1Division of Oncology, Stanford School of Medicine, Stanford University, Stanford, CA, USA; 2Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan; 3Tissue Engineering and Stem Cells Research Center, Department of Immunology, Guiyang Medical University, Guiyang, Guizhou Province, People's Republic of China *These authors contributed equally to this work Abstract: The therapeutic efficacy of some anti-tumor monoclonal antibodies (mAbs depends on the capacity of the mAb to recognize the tumor-associated antigen and induce cytotoxicity via a network of immune effector cells. This process of antibody-dependent cell-mediated cytotoxicity (ADCC against tumor cells is triggered by the interaction of the fragment crystallizable (Fc portion of the mAb with the Fc receptors on effector cells like natural killer cells, macrophages, γδ T cells, and dendritic cells. By augmenting ADCC, the antitumor activity of mAbs can be significantly increased. Currently, identifying and developing therapeutic agents that enhance ADCC is a growing area of research. Combining existing tumor-targeting mAbs and ADCC-promoting agents that stimulate effector cells will translate to greater clinical responses. In this review, we discuss strategies for enhancing ADCC and emphasize the potential of combination treatments that include US Food and Drug Administration-approved mAbs and immunostimulatory therapeutics. Keywords: ADCC, NK cell, reovirus, TLR, CD137

  13. Sex-dependent effects of maternal deprivation and adolescent cannabinoid treatment on adult rat behaviour.

    Science.gov (United States)

    Llorente-Berzal, Alvaro; Fuentes, Sílvia; Gagliano, Humberto; López-Gallardo, Meritxell; Armario, Antonio; Viveros, María-Paz; Nadal, Roser

    2011-10-01

    Early life experiences such as maternal deprivation (MD) exert long-lasting changes in adult behaviour and reactivity to stressors. Adolescent exposure to cannabinoids is a predisposing factor in developing certain psychiatric disorders. Therefore, the combination of the two factors could exacerbate the negative consequences of each factor when evaluated at adulthood. The objective of this study was to investigate the long-term effects of early MD [24 hours at postnatal day (PND) 9] and/or an adolescent chronic treatment with the cannabinoid agonist CP-55,940 (0.4 mg/kg, PND 28-42) on diverse behavioural and physiological responses of adult male and female Wistar rats. We tested them in the prepulse inhibition (PPI) of the startle response and analysed their exploratory activity (holeboard) and anxiety (elevated plus maze, EPM). In addition, we evaluated their adrenocortical reactivity in response to stress and plasma leptin levels. Maternal behaviour was measured before and after deprivation. MD induced a transient increase of maternal behaviour on reuniting. In adulthood, maternally deprived males showed anxiolytic-like behaviour (or increased risk-taking behaviour) in the EPM. Adolescent exposure to the cannabinoid agonist induced an impairment of the PPI in females and increased adrenocortical responsiveness to the PPI test in males. Both, MD and adolescent cannabinoid exposure also induced sex-dependent changes in plasma leptin levels and body weights. The present results indicate that early MD and adolescent cannabinoid exposure exerted distinct sex-dependent long-term behavioural and physiological modifications that could predispose to the development of certain neuropsychiatric disorders, though no synergistic effects were found.

  14. Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT Team

    Directory of Open Access Journals (Sweden)

    Nicole B. Washington, DO, Assistant Professor

    2012-01-01

    Full Text Available Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers. Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed. Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI, haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable. Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.

  15. The SAFETY Program: a treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters.

    Science.gov (United States)

    Asarnow, Joan Rosenbaum; Berk, Michele; Hughes, Jennifer L; Anderson, Nicholas L

    2015-01-01

    The purpose of this article is to describe feasibility, safety, and outcome results from a treatment development trial of the SAFETY Program, a brief intervention designed for integration with emergency services for suicide-attempting youths. Suicide-attempting youths, ages 11 to 18, were enrolled in a 12-week trial of the SAFETY Program, a cognitive-behavioral family intervention designed to increase safety and reduce suicide attempt (SA) risk (N = 35). Rooted in a social-ecological cognitive-behavioral model, treatment sessions included individual youth and parent session-components, with different therapists assigned to youths and parents, and family session-components to practice skills identified as critical in the pathway for preventing repeat SAs in individual youths. Outcomes were evaluated at baseline, 3-month, and 6-month follow-ups. At the 3-month posttreatment assessment, there were statistically significant improvements on measures of suicidal behavior, hopelessness, youth and parent depression, and youth social adjustment. There was one reported SA by 3 months and another by 6 months, yielding cumulative attempt rates of 3% and 6% at 3 and 6 months, respectively. Treatment satisfaction was high. Suicide-attempting youths are at high risk for repeat attempts and continuing mental health problems. Results support the value of a randomized controlled trial to further evaluate the SAFETY intervention. Extension of treatment effects to parent depression and youth social adjustment are consistent with our strong family focus and social-ecological model of behavior change.

  16. Alcohol-Adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence.

    Science.gov (United States)

    Walitzer, Kimberly S; Deffenbacher, Jerry L; Shyhalla, Kathleen

    2015-12-01

    A randomized controlled trial for an innovative alcohol-adapted anger management treatment (AM) for outpatient alcohol dependent individuals scoring moderate or above on anger is described. AM treatment outcomes were compared to those of an empirically-supported intervention, Alcoholics Anonymous Facilitation treatment (AAF). Clients in AM, relative to clients in AAF, were hypothesized to have greater improvement in anger and anger-related cognitions and lesser AA involvement during the 6-month follow-up. Anger-related variables were hypothesized to be stronger predictors of improved alcohol outcomes in the AM treatment condition and AA involvement was hypothesized to be a stronger predictor of alcohol outcomes in the AAF treatment group. Seventy-six alcohol dependent men and women were randomly assigned to treatment condition and followed for 6 months after treatment end. Both AM and AAF treatments were followed by significant reductions in heavy drinking days, alcohol consequences, anger, and maladaptive anger-related thoughts and increases in abstinence and self-confidence regarding not drinking to anger-related triggers. Treatment with AAF was associated with greater AA involvement relative to treatment with AM. Changes in anger and AA involvement were predictive of posttreatment alcohol outcomes for both treatments. Change in trait anger was a stronger predictor of posttreatment alcohol consequences for AM than for AAF clients; during-treatment AA meeting attendance was a stronger predictor of posttreatment heavy drinking and alcohol consequences for AAF than for AM clients. Anger-related constructs and drinking triggers should be foci in treatment of alcohol dependence for anger-involved clients. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Process evaluation of an up-scaled community based child obesity treatment program: NSW Go4Fun

    National Research Council Canada - National Science Library

    Welsby, Debra; Nguyen, Binh; O'Hara, Blythe J; Innes-Hughes, Christine; Bauman, Adrian; Hardy, Louise L

    2014-01-01

    ...® program. Delivered across the state of NSW (Australia) by Local Health Districts (LHDs), Go4Fun® is a community-based, multidisciplinary family obesity treatment program adapted from the United Kingdom Mind Exercise Nutrition Do...

  18. A mathematical programming framework for early stage design of wastewater treatment plants

    DEFF Research Database (Denmark)

    Bozkurt, Hande; Quaglia, Alberto; Gernaey, Krist

    2015-01-01

    a process flow diagram. Towards this end, a superstructure approach is used to represent the treatment alternatives for reaction and separation. A generic process interval model is used to describe each alternative in terms of inputeoutput mass balances including conversion and separation factors. Next......The increasing number of alternative wastewater treatment technologies and stricter effluent requirements make the optimal treatment process selection for wastewater treatment plant design a complicated problem. This task, defined as wastewater treatment process synthesis, is currently based...... on expert decisions and previous experiences. This paper proposes a new approach based on mathematical programming to manage the complexity of the problem. The approach generates/identifies novel and optimal wastewater treatment process selection, and the interconnection between unit operations to create...

  19. Effects of a Family-Based Childhood Obesity Treatment Program on Parental Weight Status

    DEFF Research Database (Denmark)

    Trier, Cæcilie; Dahl, Maria; Stjernholm, Theresa

    2016-01-01

    during their child's treatment. CONCLUSION: There is a high prevalence of overweight/obesity among parents of children entering childhood obesity treatment. Family-based childhood obesity treatment with a focus on the child has a positive effect on parental BMI with both mothers and fathers losing weight......OBJECTIVE: The aim of this study was to investigate the prevalence of overweight/obesity among parents of children entering childhood obesity treatment and to evaluate changes in the parents' weight statuses during their child's treatment. METHODS: The study included parents of 1,125 children...... and adolescents aged 3-22 years, who were enrolled in a multidisciplinary childhood obesity treatment program. At baseline, weight and height of the parents were obtained by self-reported information and parental body mass index (BMI) was calculated. Weight and height of the children were measured in the clinic...

  20. Survey of methadone-drug interactions among patients of methadone maintenance treatment program in Taiwan

    Directory of Open Access Journals (Sweden)

    Lee Hsin-Ya

    2012-03-01

    Full Text Available Abstract Background Although methadone has been used for the maintenance treatment of opioid dependence for decades, it was not introduced in China or Taiwan until 2000s. Methadone-drug interactions (MDIs have been shown to cause many adverse effects. However, such effects have not been scrutinized in the ethnic Chinese community. Methods The study was performed in two major hospitals in southern Taiwan. A total of 178 non-HIV patients aged ≥ 20 years who had participated in the Methadone Maintenance Treatment Program (MMTP ≥ 1 month were recruited. An MDI is defined as concurrent use of drug(s with methadone that may result in an increase or decrease of effectiveness and/or adverse effect of methadone. To determine the prevalence and clinical characteristics of MDIs, credible data sources, including the National Health Insurance (NHI database, face-to-face interviews, medical records, and methadone computer databases, were linked for analysis. Socio-demographic and clinical factors associated with MDIs and co-medications were also examined. Results 128 (72% MMTP patients took at least one medication. Clinically significant MDIs included withdrawal symptoms, which were found among MMTP patients co-administered with buprenorphine or tramadol; severe QTc prolongation effect, which might be associated with use of haloperidol or droperidol; and additive CNS and respiratory depression, which could result from use of methadone in combination with chlorpromazine or thioridazine. Past amphetamine use, co-infection with hepatitis C, and a longer retention in the MMTP were associated with increased odds of co-medication. Among patients with co-medication use, significant correlates of MDIs included the male gender and length of co-medication in the MMTP. Conclusions The results demonstrate clinical evidence of significant MDIs among MMTP patients. Clinicians should check the past medical history of MMTP clients carefully before prescribing medicines

  1. Treatment in hospital for alcohol-dependent patients decreases attentional bias

    Directory of Open Access Journals (Sweden)

    Flaudias V

    2013-05-01

    Full Text Available Valentin Flaudias,1,2 Georges Brousse,1,2 Ingrid De Chazeron,1,2 François Planche,2 Julien Brun,2 Pierre-Michel Llorca1,2 1Clermont Université, EA 7280 NPsy-Sydo, Clermont-Ferrand, France; 2Pôle Psychiatrie B, CHU Gabriel-Montpied, Clermont-Ferrand, France Background and objectives: Previous studies in alcohol-dependent patients have shown an attentional bias (AB under related substance cues, which can lead to relapse. This AB can be evaluated by the alcohol Stroop test (AST. The AST is a modified Stroop task in which participants have to name the color of an alcohol-related word or a neutral word. AB is the response-time difference between these two types of words. The goal of the current study was to examine modification of AB during specialized hospitalization for alcohol dependence, with the suppression of a training bias that could be present in within-subject design. Methods: Individuals with alcohol-dependence disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th edition and admitted for withdrawal in the addiction unit of the University Hospital of Clermont-Ferrand (test group, n = 42 and persons with no alcohol or psychiatric disorder (control group, n = 16, recruited among colleagues and friends of the staff, performed the AST. A subgroup of the test group performed the AST in admission (admission group, n = 19, and another subgroup undertook the test immediately before discharge (discharge group, n = 23. Results: Results showed an AB only for patients seen at admission (F[1,55] = 3.283, P = 0.075. Moreover, we observed that the AB in the admission group (mean = 34 ms, standard deviation [SD] = 70.06 was greater than the AB in the control group (mean = 23 ms, SD = 93.42, itself greater than the AB in the discharge group (mean = −12 ms, SD = 93.55 (t[55] = −1.71; P = 0.09. Conclusion: Although the results are preliminary, the present study provides evidence for changes in the AB during alcohol-addiction treatment

  2. The Summer Treatment Program Meets the South Side of Chicago: Bridging Science and Service in Urban After-School Programs.

    Science.gov (United States)

    Frazier, Stacy L; Chacko, Anil; Van Gessel, Christine; O'Boyle, Caroline; Pelham, William E

    2012-05-01

    BACKGROUND: This paper describes efforts to apply the principles and strategies of an empirically-supported treatment for children with disruptive behaviour problems to a park after-school program serving children in urban poverty. METHOD: Collaboration with staff proceeded in stages: (1) relationship building, needs assessment, and resource mapping; (2) intervention adaptation and implementation; and (3) implementation support, problem-solving, and sustainability. RESULTS: Four tools capitalised on inherent strengths of the parks, accommodated child and staff needs, and emerged as feasible and effective: Group Discussion, Good Behaviour Game, Peers as Leaders, and Good News Notes. CONCLUSIONS: Recreational settings offer opportunities for mental health promotion for children in urban poverty.

  3. Expressing Coarse-Grain Dependencies Among Tasks in Shared Memory Programs

    DEFF Research Database (Denmark)

    Larsen, Per; Karlsson, Sven; Madsen, Jan

    2011-01-01

    Designers of embedded systems face tight constraints on resources, response time and cost. The ability to analyze embedded systems is essential to timely delivery of new designs. Many analysis techniques model parallel programs as task graphs. Task graphs capture the worst-case execution times of...

  4. 75 FR 56660 - Agency Information Collection (Dependent's Request for Change of Program or Place of Training...

    Science.gov (United States)

    2010-09-16

    ... Control No. 2900-0099'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise..., (202) 461-7485, FAX (202) 273-0443 or e-mail denise.mclamb@va.gov . Please refer to ``OMB Control No..., 2010. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records...

  5. C programs for solving the time-dependent Gross-Pitaevskii equation in a fully anisotropic trap

    Science.gov (United States)

    Vudragović, Dušan; Vidanović, Ivana; Balaž, Antun; Muruganandam, Paulsamy; Adhikari, Sadhan K.

    2012-09-01

    We present C programming language versions of earlier published Fortran programs (Muruganandam and Adhikari (2009) [1]) for calculating both stationary and non-stationary solutions of the time-dependent Gross-Pitaevskii (GP) equation. The GP equation describes the properties of dilute Bose-Einstein condensates at ultra-cold temperatures. C versions of programs use the same algorithms as the Fortran ones, involving real- and imaginary-time propagation based on a split-step Crank-Nicolson method. In a one-space-variable form of the GP equation, we consider the one-dimensional, two-dimensional, circularly-symmetric, and the three-dimensional spherically-symmetric harmonic-oscillator traps. In the two-space-variable form, we consider the GP equation in two-dimensional anisotropic and three-dimensional axially-symmetric traps. The fully-anisotropic three-dimensional GP equation is also considered. In addition to these twelve programs, for six algorithms that involve two and three space variables, we have also developed threaded (OpenMP parallelized) programs, which allow numerical simulations to use all available CPU cores on a computer. All 18 programs are optimized and accompanied by makefiles for several popular C compilers. We present typical results for scalability of threaded codes and demonstrate almost linear speedup obtained with the new programs, allowing a decrease in execution times by an order of magnitude on modern multi-core computers. New version program summary Program title: GP-SCL package, consisting of: (i) imagtime1d, (ii) imagtime2d, (iii) imagtime2d-th, (iv) imagtimecir, (v) imagtime3d, (vi) imagtime3d-th, (vii) imagtimeaxial, (viii) imagtimeaxial-th, (ix) imagtimesph, (x) realtime1d, (xi) realtime2d, (xii) realtime2d-th, (xiii) realtimecir, (xiv) realtime3d, (xv) realtime3d-th, (xvi) realtimeaxial, (xvii) realtimeaxial-th, (xviii) realtimesph. Catalogue identifier: AEDU_v2_0. Program Summary URL: http://cpc.cs.qub.ac.uk/summaries/AEDU_v2_0.html

  6. A Randomized Trial of Extended Telephone-Based Continuing Care for Alcohol Dependence: Within-Treatment Substance Use Outcomes

    Science.gov (United States)

    McKay, James R.; Van Horn, Deborah H. A.; Oslin, David W.; Lynch, Kevin G.; Ivey, Megan; Ward, Kathleen; Drapkin, Michelle L.; Becher, Julie R.; Coviello, Donna M.

    2010-01-01

    Objective: The study tested whether adding up to 18 months of telephone continuing care, either as monitoring and feedback (TM) or longer contacts that included counseling (TMC), to intensive outpatient programs (IOPs) improved outcomes for alcohol-dependent patients. Method: Participants (N = 252) who completed 3 weeks of IOP were randomized to…

  7. The STEPPS Group Treatment Program as an alternative in helping people with borderline personality disorder

    Directory of Open Access Journals (Sweden)

    Jerica Radež

    2015-06-01

    Full Text Available Borderline personality disorder is a complex mental disorder which has severe impact on the quality of an individual's life. Although it is the most common type of personality disorder in the population of people with mental disorders, it has so far proven to be rather resistant to pharmacological treatments. This may suggest that effective psychotherapeutic methods need to be developed to help people with this diagnosis. There have been several attempts to develop successful therapeutic interventions for borderline personality disorder. Most of them were developed either from cognitive-behavioural or from psychoanalytic paradigm. More recent studies have focused on developing a more holistic approach. One such approach is the STEPPS program. This programme combines elements from cognitive-behavioural and systemic approaches. STEPPS is a 20-week, manually based group treatment for patients with borderline personality disorder. In comparison with other established approaches, the STEPPS program does not interfere with patient's other ongoing treatments. In this article we present the basics of the STEPPS program. We also provide a review of studies, investigating the effectiveness of the program. We also discuss advantages and disadvantages of the program and suggest some topics for further research.

  8. Developing employment services for criminal justice clients enrolled in drug user treatment programs.

    Science.gov (United States)

    Kemp, Kathleen; Savitz, Barry; Thompson, William; Zanis, David A

    2004-01-01

    Approximately 80% of parolees have a history of substance abuse and nearly all are unemployed following release from prison. Common stipulations of parole require offenders to obtain employment and to not use mood-altering substances. This article explores a series of strategies implemented from 1999 to 2001 to help offenders paroled to substance user treatment to gain employment. A total of 245 paroled offenders enrolled in an outpatient substance abuse treatment program voluntarily agreed to participate in one of four different vocational intervention programs (Job Skill Development and Supported Work, Life Skill Development, Job Training, and Welfare to Work). Programmatic data (e.g., attendance, completion, job acquisition, and wage) were collected and reported for each of the vocational programs. Additionally, a 12-month pilot study examined criminal justice, substance use, and employment outcomes of 36 offenders referred to the job skill development and supported work project. Overall, 78% of the offenders enrolled in the vocational services completed the program and 134/245 (55%) were able to obtain employment. The data showed that completion of vocational services was strongly associated with obtaining employment 12 months postenrollment. Offenders identified the employment services as an integral part of their improved overall functioning. A series of practice recommendations and policy suggestions is offered to develop and manage vocational services for substance-using offenders. Employment services for parolees require considerable coordination of activities with parole officers, vocational programs, substance abuse treatment professionals, and funding systems.

  9. Group Lidcombe Program Treatment for Early Stuttering: A Randomized Controlled Trial

    Science.gov (United States)

    Arnott, Simone; Onslow, Mark; O'Brian, Sue; Packman, Ann; Jones, Mark; Block, Susan

    2014-01-01

    Purpose: This study adds to the Lidcombe Program evidence base by comparing individual and group treatment of preschoolers who stutter. Method: A randomized controlled trial of 54 preschoolers was designed to establish whether group delivery outcomes were not inferior to the individual model. The group arm used a rolling group model, in which a…

  10. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    Science.gov (United States)

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  11. Evaluation of a brief treatment program of cognitive behavior therapy for insomnia in older adults.

    Science.gov (United States)

    Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

    2014-01-01

    To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behavior therapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sleep. The brief group-administered CBT-I program produced improvements in the timing and quality of sleep including later bedtimes, earlier out-of-bed times, reduced wake after sleep onset, and improved sleep efficiency. Participants also reported a reduction of the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. The treatment program used in the current study has demonstrated potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population.

  12. Treatment Plans in Psychiatric Community Housing Programs : Do They Reflect Rehabilitation Principles?

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Visser, Ellen; Caro-Nienhuis, Annemarie D.; van Weeghel, Jaap; Sytema, Sjoerd; Wiersma, Durk

    2012-01-01

    Objective: This study examined the extent to which treatment plans of service users of community housing programs measure up to rehabilitation principles according to the Choose-Get-Keep model of psychiatric rehabilitation. The study evaluates whether these plans correspond with service-user and key

  13. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

    Science.gov (United States)

    Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

    2008-01-01

    Objective: Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access…

  14. Treatment Plans in Psychiatric Community Housing Programs : Do They Reflect Rehabilitation Principles?

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Visser, Ellen; Caro-Nienhuis, Annemarie D.; van Weeghel, Jaap; Sytema, Sjoerd; Wiersma, Durk

    2012-01-01

    Objective: This study examined the extent to which treatment plans of service users of community housing programs measure up to rehabilitation principles according to the Choose-Get-Keep model of psychiatric rehabilitation. The study evaluates whether these plans correspond with service-user and key

  15. Treatment of osteoarthritis using a helper-dependent adenoviral vector retargeted to chondrocytes

    Directory of Open Access Journals (Sweden)

    Merry ZC Ruan

    2016-01-01

    Full Text Available Osteoarthritis (OA is a joint disease characterized by degeneration of the articular cartilage, subchondral bone remodeling, and secondary inflammation. It is among the top three causes of chronic disability, and currently there are no treatment options to prevent disease progression. The localized nature of OA makes it an ideal candidate for gene and cell therapy. However, gene and cell therapy of OA is impeded by inefficient gene transduction of chondrocytes. In this study, we developed a broadly applicable system that retargets cell surface receptors by conjugating antibodies to the capsid of helper-dependent adenoviral vectors (HDVs. Specifically, we applied this system to retarget chondrocytes by conjugating an HDV to an α-10 integrin monoclonal antibody (a10mab. We show that a10mab-conjugated HDV (a10mabHDV-infected chondrocytes efficiently in vitro and in vivo while detargeting other cell types. The therapeutic index of an intra-articular injection of 10mabHDV-expressing proteoglycan 4 (PRG4 into a murine model of post-traumatic OA was 10-fold higher than with standard HDV. Moreover, we show that PRG4 overexpression from articular, superficial zone chondrocytes is effective for chondroprotection in postinjury OA and that α-10 integrin is an effective protein for chondrocyte targeting.

  16. Traditional Chinese and Indian medicine in the treatment of opioid-dependence: a review

    Directory of Open Access Journals (Sweden)

    Fatemeh Doosti

    2013-05-01

    Full Text Available Objective: In this study, the current literatures on the use of herbs and herbal preparations of Traditional Chinese and Indian Medicine for the treatment of opioid addiction were reviewed. Methods: Search was done in databases such as Pub Med, Science Direct, Scopus, Springer Link, and Google Scholar. Results: Among 18 retrieved studies, 3 studies were about asafetida extract, an approved preparation for ameliorating drug abstinence in China. Chinese preparations including Composite Dong Yuan Gao, Qingjunyin and TJ-97 (a water extract of dai-bofu-to as well as Indian ones, Mentate and Shilajit, were reported to have positive effects against opioid withdrawal, dependence, and tolerance. Moreover, Levo-tetrahydropalmatine and L-Stepholidine, in addition to extracts of Caulis Sinomenii and Sinomenium acutum showed similar effects. Banxia Houpu Decoction, Fu-Yuan pellet, Jinniu capsules, Qingjunyin, Tai-Kang-Ning capsule, and Xuan Xia Qudu Jiaonang (WeiniCom from Chinese preparations, showed anti-addiction effects in randomized, double-blind and, in some studies, multicenter clinical trials. Conclusion: Traditional herbal preparations of China and India have anti-addiction effects with less adverse effects than alpha2-adrenergic or opioid agonists.

  17. Traditional Chinese and Indian medicine in the treatment of opioid-dependence: a review

    Science.gov (United States)

    Doosti, Fatemeh; Dashti, Saeedeh; Tabatabai, Seyed Meghdad; Hosseinzadeh, Hossein

    2013-01-01

    Objective: In this study, the current literatures on the use of herbs and herbal preparations of Traditional Chinese and Indian Medicine for the treatment of opioid addiction were reviewed. Matherials and Methods: Search was done in databases such as Pub Med, Science Direct, Scopus, Springer Link, and Google Scholar. Results: Among 18 retrieved studies, 3 studies were about asafetida extract, an approved preparation for ameliorating drug abstinence in China. Chinese preparations including Composite Dong Yuan Gao, Qingjunyin and TJ-97 (a water extract of dai-bofu-to) as well as Indian ones, Mentate and Shilajit, were reported to have positive effects against opioid withdrawal, dependence, and tolerance. Moreover, Levo-tetrahydropalmatine and L-Stepholidine, in addition to extracts of Caulis Sinomenii and Sinomenium acutum showed similar effects. Banxia Houpu Decoction, Fu-Yuan pellet, Jinniu capsules, Qingjunyin, Tai-Kang-Ning capsule, and Xuan Xia Qudu Jiaonang (WeiniCom) from Chinese preparations, showed anti-addiction effects in randomized, double-blind and, in some studies, multicenter clinical trials. Conclusion : Traditional herbal preparations of China and India have anti-addiction effects with less adverse effects than alpha2-adrenergic or opioid agonists. PMID:25050276

  18. Dependence of radon emanation of red mud bauxite processing wastes on heat treatment.

    Science.gov (United States)

    Jobbágy, V; Somlai, J; Kovács, J; Szeiler, G; Kovács, T

    2009-12-30

    Natural radioactivity content, radon emanation and some other physical characteristics of red mud were investigated, so that to identify the possibilities of the safe utilization of such material as a building material additive. Based on the radionuclide concentration, red mud is not permitted to be used directly as a building material, however, mixing of a maximum 20% red mud and 80% clay meets the requirements. The main aim of this work was to determine the dependence of the emanation factor of red mud firing temperature and some other parameters. The relevant experimental procedure was carried out in two different ways: without any additional material, and by adding a known amount of sawdust (5-35 wt%) then firing the sample at a given temperature (100-1000 degrees C). The average emanation factor of the untreated dry red mud was estimated to 20%, which decreased to about 5% at a certain heat treatment. Even lower values were found using semi-reductive atmosphere. It has been concluded that all emanation measurements results correlate well to the firing temperature, the specific surface and the pore volume.

  19. Optimizing treatments for nicotine dependence by increasing cognitive performance during withdrawal

    Science.gov (United States)

    Ashare, Rebecca L; Schmidt, Heath D

    2014-01-01

    Introduction Current FDA-approved smoking cessation pharmacotherapies have limited efficacy and are associated with high rates of relapse. Therefore, there is a clear need to develop novel antismoking medications. Nicotine withdrawal is associated with cognitive impairments that predict smoking relapse. It has been proposed that these cognitive deficits are a hallmark of nicotine withdrawal that could be targeted in order to prevent smoking relapse. Thus, pharmacotherapies that increase cognitive performance during nicotine withdrawal may represent potential smoking cessation agents. Areas covered The authors review the clinical literature demonstrating that nicotine withdrawal is associated with deficits in working memory, attention and response inhibition. They then briefly summarize different classes of compounds and strategies to increase cognitive performance during nicotine withdrawal. Particular emphasis has been placed on translational research in order to highlight areas for which there is strong rationale for pilot clinical trials of potential smoking cessation medications. Expert opinion There is emerging evidence that supports deficits in cognitive function as a plausible nicotine withdrawal phenotype. The authors furthermore believe that the translational paradigms presented here may represent efficient and valid means for the evaluation of cognitive-enhancing medications as possible treatments for nicotine dependence. PMID:24707983

  20. An Exploration of Responses to Drug Conditioned Stimuli during Treatment for Substance Dependence

    Directory of Open Access Journals (Sweden)

    Benjamin Goddard

    2013-01-01

    Full Text Available Although it is well established that drug conditioned stimuli produce a variety of conditioned responses, it is not known whether such stimuli can also reinforce an arbitrary operant response and thus serve as conditioned reinforcers. Volunteers (n=39 recruited from a residential treatment center for substance dependence were tested on a task in which presses on computer keys activated images of drugs/drug paraphernalia on a progressive ratio schedule of reinforcement. They also completed a personalized craving questionnaire and a personalized Implicit Association Test. A significant bias in responding was found for images of preferred drugs/route of drug administration. Craving, however, was low and the images generated negative evaluative reactions. Two additional studies were performed to ascertain the generalizability of the effects to a different population of drug-using individuals (i.e., students who drink and to incentive stimuli of a different nature (i.e., sexual. The additional studies partially replicated and extended the central findings of the main study. Therefore, although these data should be considered preliminary in light of small group sizes, it is concluded that cue specificity and availability of the unconditioned stimuli (drugs and sex plays a role in modulating responding maintained by conditioned reinforcers.

  1. Home discharge of technology-dependent children: evaluation of a respiratory-therapist driven family education program.

    Science.gov (United States)

    Tearl, Donna K; Hertzog, James H

    2007-02-01

    Initial hospital discharge to home of technology-dependent children requires extensive training and education of the family caregivers. Education of adult family members should promote positive interactions in a nonthreatening manner while facilitating the development of the knowledge and skills to competently and independently provide all aspects of the medical care. We utilize a training program for adult family members of children who have undergone tracheostomy to facilitate long-term mechanical ventilatory support and who are being prepared for their initial discharge from the hospital to home. A dedicated respiratory therapist family educator directs this program. Multiple teaching tools, activities, and training sessions, based on adult learning theory, are utilized to develop appropriate clinical skills to manage children with tracheostomies and the associated technological supports. We evaluated the effectiveness of our program by administering a written test to caregivers, at the start and the conclusion of their training. We also surveyed the caregivers about their satisfaction with the educational program and the respiratory therapist family educator's performance. We also surveyed employees of the durable medical equipment companies used by the families, regarding the caregivers' knowledge and competency in the home one month following discharge. Our program was associated with a statistically significant improvement in caregiver test performance, and the caregivers expressed a high degree of satisfaction with the program. The employees of the durable medical equipment companies perceived a high degree of knowledge and competence on the part of the home caregivers. Our training program appears to have a positive impact on the educational preparation of caregivers.

  2. Better definition of vocational services is critical within substance user treatment programs.

    Science.gov (United States)

    Blankertz, Laura; Magura, Stephen

    2004-01-01

    Vocational rehabilitation in substance user treatment programs is often poorly defined; programs rarely provide adequate descriptions of the vocational services they offer. There is no standardization in the content of vocational counseling, in the format of its delivery, or in the qualifications of staff that deliver it. Thus, the type, intensity, and quality of vocational services can vary widely among programs, as well as over time within a given program due to vocational staff turnover. However, current demands for greater accountability in social services pose a challenge to this state of affairs. There is no evidence that vocational services as currently delivered in treatment programs are either effective or even reasonably efficient. Note that "programs are increasingly called on to justify their existence, their expenditure of funds and their achievement of objectives. Behind the call for accountability is an awareness of the gap between almost unlimited social need and limited resources" (Weiss, 2004). It is difficult to achieve accountability for ill-defined and variable vocational services.

  3. Implementing HIV Testing in Substance Use Treatment Programs: A Systematic Review.

    Science.gov (United States)

    Simeone, Claire A; Seal, Stella M; Savage, Christine

    People who use drugs are at increased risk for HIV acquisition, poor engagement in health care, and late screening for HIV with advanced HIV at diagnosis and increased HIV-related morbidity, mortality, and health care costs. This systematic review evaluates current evidence about the effectiveness and feasibility of implementing HIV testing in U.S. substance use treatment programs. The literature search identified 535 articles. Full text review was limited to articles that explicitly addressed strategies to implement HIV testing in substance use programs: 17 met criteria and were included in the review; nine used quantitative, qualitative, or mixed-method designs to describe or quantify HIV testing rates, acceptance by clients and staff, and cost-effectiveness; eight organization surveys described barriers and facilitators to testing implementation. The evidence supported the effectiveness and feasibility of rapid, routine, and streamlined HIV testing in substance use treatment programs. Primary challenges included organizational support and sustainable funding.

  4. An Integer Linear Programming Model for the Radiotherapy Treatment Scheduling Problem

    CERN Document Server

    Burke, Edmund K; Petrovic, Sanja

    2011-01-01

    Radiotherapy represents an important phase of treatment for a large number of cancer patients. It is essential that resources used to deliver this treatment are employed effectively. This paper presents a new integer linear programming model for real-world radiotherapy treatment scheduling and analyses the effectiveness of using this model on a daily basis in a hospital. Experiments are conducted varying the days on which schedules can be created. Results obtained using real-world data from the Nottingham University Hospitals NHS Trust, UK, are presented and show how the proposed model can be used with different policies in order to achieve good quality schedules.

  5. Success in a High School Completion Program and Its Relation to Field Dependence-Independence.

    Science.gov (United States)

    Donnarumma, Theresa; And Others

    1980-01-01

    This study explored the cognitive style of field dependence-independence (FDI) and its relation to student attrition and performance on the General Educational Development Test and the Test of Adult Basic Education. Resultant correlations are discussed in terms of the usefulness of FDI in assessing the needs of adult learners. (Author/SK)

  6. Recurrent mutations, including NPM1c, activate a BRD4-dependent core transcriptional program in acute myeloid leukemia.

    Science.gov (United States)

    Dawson, M A; Gudgin, E J; Horton, S J; Giotopoulos, G; Meduri, E; Robson, S; Cannizzaro, E; Osaki, H; Wiese, M; Putwain, S; Fong, C Y; Grove, C; Craig, J; Dittmann, A; Lugo, D; Jeffrey, P; Drewes, G; Lee, K; Bullinger, L; Prinjha, R K; Kouzarides, T; Vassiliou, G S; Huntly, B J P

    2014-02-01

    Recent evidence suggests that inhibition of bromodomain and extra-terminal (BET) epigenetic readers may have clinical utility against acute myeloid leukemia (AML). Here we validate this hypothesis, demonstrating the efficacy of the BET inhibitor I-BET151 across a variety of AML subtypes driven by disparate mutations. We demonstrate that a common 'core' transcriptional program, which is HOX gene independent, is downregulated in AML and underlies sensitivity to I-BET treatment. This program is enriched for genes that contain 'super-enhancers', recently described regulatory elements postulated to control key oncogenic driver genes. Moreover, our program can independently classify AML patients into distinct cytogenetic and molecular subgroups, suggesting that it contains biomarkers of sensitivity and response. We focus AML with mutations of the Nucleophosmin gene (NPM1) and show evidence to suggest that wild-type NPM1 has an inhibitory influence on BRD4 that is relieved upon NPM1c mutation and cytosplasmic dislocation. This leads to the upregulation of the core transcriptional program facilitating leukemia development. This program is abrogated by I-BET therapy and by nuclear restoration of NPM1. Finally, we demonstrate the efficacy of I-BET151 in a unique murine model and in primary patient samples of NPM1c AML. Taken together, our data support the use of BET inhibitors in clinical trials in AML.

  7. Taking CHARGE: A self-management program for women following breast cancer treatment.

    Science.gov (United States)

    Cimprich, Bernadine; Janz, Nancy K; Northouse, Laurel; Wren, Patricia A; Given, Barbara; Given, Charles W

    2005-09-01

    The purpose of the study was to develop and evaluate Taking CHARGE, a self-management intervention designed to facilitate successful transitions to survivorship after breast cancer treatment. The Taking CHARGE intervention involves a two-pronged approach building on self-regulation principles to (1) equip women with self-management skills to address concerns following breast cancer treatment, and (2) provide information about common survivorship topics. The program involved four intervention contacts, two small group meetings and two individualized telephone sessions, delivered by nurse/health educators. This paper focuses on the process evaluation findings from a preliminary test of the Taking CHARGE intervention conducted with 25 women, aged 34-66 years, completing breast cancer treatment, who were randomly assigned to the intervention group. The process evaluation was conducted to obtain systematic information about the relevance and usefulness of the self-regulation approach, informational aspects, and program delivery. The findings indicated that intervention group participants found the Taking CHARGE program to be timely, relevant, and to have high utility in dealing with concerns that exist following breast cancer treatment. The process evaluation findings provide early evidence of the usefulness of the Taking CHARGE intervention for successful transition to survivorship following breast cancer treatment.

  8. Exploring the relationship between treatment satisfaction, perceived improvements in functioning and well-being and gambling harm reduction among clients of pathological gambling treatment programs.

    Science.gov (United States)

    Monnat, Shannon M; Bernhard, Bo; Abarbanel, Brett L L; St John, Sarah; Kalina, Ashlee

    2014-08-01

    The objective of this study was to evaluate the relationship between treatment service quality, perceived improvement in social, functional, and material well-being and reduction in gambling behaviors among clients of Nevada state-funded pathological gambling treatment programs. Utilizing survey data from 361 clients from 2009 to 2010, analyses revealed that client satisfaction with treatment services is positively associated with perceived improvements in social, functional, and material well-being, abstinence from gambling, reduction in gambling thoughts and reduction in problems associated with gambling, even after controlling for various respondent characteristics. These findings can be useful to treatment program staff in managing program development and allocating resources.

  9. Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2010-01-01

    Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

  10. Chemical dependency in women. Meeting the challenges of accurate diagnosis and effective treatment.

    OpenAIRE

    1988-01-01

    Women dependent on alcohol or prescribed or nonprescribed psychoactive drugs present special diagnostic challenges to physicians. Chemical dependency likewise has adverse effects on women who are nonusers through the disease of co-dependency. The natural history of chemical dependency in women includes sex-specific differences in presenting signs and symptoms. Collateral medical history may come from a variety of community sources. Diagnoses may also use sex-specific criteria, with simultaneo...

  11. Long-term treatment of childhood refractory and steroid dependent nephrotic syndrome with Cyclosporin A

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    Madani A

    2002-07-01

    Full Text Available Background: Cyclosporin A (CsA is now commonly used in the management of children with steroid-dependent and steroid resistant nephoitic syndrome. It has been reported to be effective in maintaining remission in 70-100 percent of patients with SDNS but somewhat SRNS 0-100 percent. The aim of this study was to evaluate the efficacy of long-term (CsA in children with refractory nephrotic syndrome (RNS and steroid dependent nephrotic syndrome (SDNS. Materials and Methods: The long-term effect of (CsA in 91 Iranian children aged 3 months to 11 years (54 with RNS and 37 with SDNS was assessed between 1984 and 1999. Eighty of 91 children received renal biopsy prior to introduction of (CsA, and the other 11 patients had not consent for kidney biopsy. If the patients did not show remission aftre receiving 3-6 months of (CsA, the medication was discontinued. Results: All patient were treated with (CsA in combination with low dose alternate day prednisolone. In children with RNS and SDNS, therapy with (CsA induced, remission in 25 of 54 (46.2 percent and 27 of 37 (73 percent respectively (P<0.02. Of the 32 patients with minimal change disease (MCD, 23 (72 percent responded to therapy, compared with 4 of 18 (22 percent with focal segmental glomerulosclerosis (FSGS (P<0.005. Twenty-four (48 percent of 50 who entered complete remission, had relapse 1-12 months after cessation of (CsA. The duration between the onset of nephrotic syndrome (NS and administration of (CsA and sexuality of patients had no effect in result of treatment. Side effects occurred in 25 patients (27.4 percent. No patients exhibited raised transaminases, 8 (8.7 percent of the children developed hirsutism, 7 (7.6 percent hypertension, 7 (7.6 percent gingival hyperplasia, (2.2 percent neurological toxicity and 1 (1 percent increase in serum creatinine. Conclusion: Our findings suggest that (CsA can be used to induce a complete remission in a significant proportion of patients with RNS and

  12. Gender Differences in Early Maladaptive Schemas in a Treatment-Seeking Sample of Alcohol-Dependent Adults

    Science.gov (United States)

    Shorey, Ryan C.; Anderson, Scott E.; Stuart, Gregory L.

    2012-01-01

    The current study examined early maladaptive schemas among alcohol-dependent men and women and sought to determine whether men and women differed in their early maladaptive schemas. Using preexisting patient records of adults diagnosed with alcohol dependence from a residential treatment center in the Southeastern United States, from 2005 to 2010 (N = 854), results showed that women scored significantly higher than men on 14 of the 18 early maladaptive schemas assessed. Both women and men endorsed having a number of early maladaptive schemas, with four schemas being particularly prevalent across gender. Study limitations are noted and implications of these findings for treatment and future research are discussed. PMID:22060801

  13. Baclofen for maintenance treatment of opioid dependence: A randomized double-blind placebo-controlled clinical trial [ISRCTN32121581

    Directory of Open Access Journals (Sweden)

    Ahmadi-Abhari Seyed Ali

    2003-11-01

    Full Text Available Abstract Background Results of preclinical studies suggest that the GABAB receptor agonist baclofen may be useful in treatment of opioid dependence. This study was aimed at assessing the possible efficacy of baclofen for maintenance treatment of opioid dependence. Methods A total of 40 opioid-dependent patients were detoxified and randomly assigned to receive baclofen (60 mg/day or placebo in a 12-week, double blind, parallel-group trial. Primary outcome measure was retention in treatment. Secondary outcome measures included opioids and alcohol use according to urinalysis and self-report ratings, intensity of opioid craving assessed with a visual analogue scale, opioid withdrawal symptoms as measured by the Short Opiate Withdrawal Scale and depression scores on the Hamilton inventory. Results Treatment retention was significantly higher in the baclofen group. Baclofen also showed a significant superiority over placebo in terms of opiate withdrawal syndrome and depressive symptoms. Non-significant, but generally favorable responses were seen in the baclofen group with other outcome measures including intensity of opioid craving and self-reported opioid and alcohol use. However, no significant difference was seen in the rates of opioid-positive urine tests. Additionally, the drug side effects of the two groups were not significantly different. Conclusion The results support further study of baclofen in the maintenance treatment of opioid dependence.

  14. Buprenorphine in the treatment of opiate dependence: its pharmacology and social context of use in the U.S.

    Science.gov (United States)

    Wesson, Donald R

    2004-05-01

    Buprenorphine's physiological effects are produced when it attaches to specific opiate receptors that are designated mu, kappa, or delta. Buprenorphine, a partial agonist at the mu receptor and an antagonist at the kappa receptor, produces typical morphine-like effects at low doses. At higher doses, it produces opiate effects that are less than those of full opiate agonists. Knowledge of the physiological effects of opiate receptors and the way they interact with opiate agonists, partial opiate agonists, and opiate antagonists is fundamental to understanding the safety and efficacy of buprenorphine in treatment of pain and opiate addiction. Knowledge of the historical and social context of opiate agonist treatment of opiate dependence is fundamental to understanding how nonpharmacological factors may limit the clinical adoption and utility of a safe and effective medication in treatment of opiate dependence. This article reviews the pharmacology of sublingual buprenorphine and the historical context of opiate agonist therapy; delineates classes of opiate receptors and their interaction with opiate agonists, partial agonists, and antagonists; and describes the commercially available pharmaceutical formulations of buprenorphine. It focuses on sublingual buprenorphine tablets, Subutex and Suboxone, the FDA-approved formulations of buprenorphine for treatment of opiate dependence. Sublingual buprenorphine, and the combination of sublingual buprenorphine/naloxone, have unique pharmacological properties that make them a logical first-line intervention in the treatment of opioid dependence.

  15. Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs

    Directory of Open Access Journals (Sweden)

    Messina Nena P

    2007-05-01

    Full Text Available Abstract Background Research has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their drug/alcohol problem. Methods Subjects were 4,165 male and female parolees who received prison-based therapeutic community substance abuse treatment and who subsequently participated in only outpatient or only residential treatment following release from prison. The dependent variable of interest was return to prison within 12 months. The primary independent variables of interest were alcohol/drug problem severity (low, high and type of aftercare (residential, outpatient. Chi-square analyses were conducted to examine the differences in 12-month RTP rates between and within the two groups of parolees (residential and outpatient parolees based on alcohol/drug problem severity (low severity, high severity. Logistic regression analyses were performed to determine if aftercare modality (outpatient only vs. residential only was a significant predictor of 12-month RTP rates for subjects who were classified as low severity versus those who were classified as high severity. Results Subjects benefited equally from outpatient and residential aftercare, regardless of the severity of their drug/alcohol problem. Conclusion As states and the federal prison system further expand prison-based treatment services, the demand and supply of aftercare treatment services will also increase. As this occurs, systems and policies governing the transitioning of individuals from prison- to community-based treatment should include a systematic and validated assessment of post

  16. Efficacy of the Modifying Phonation Intervals (MPI) Stuttering Treatment Program With Adults Who Stutter

    Science.gov (United States)

    Ingham, Janis C.; Bothe, Anne K.; Wang, Yuedong; Kilgo, Martin

    2015-01-01

    Purpose This study compared a new adult stuttering treatment program (Modifying Phonation Intervals, or MPI) with the standard of care for reducing stuttered speech in adults (prolonged speech). Method Twenty-seven adults who stutter were assigned to either MPI or prolonged speech treatment, both of which used similar infrastructures. Speech and related variables were assessed in 3 within-clinic and 3 beyond-clinic speaking situations for participants who successfully completed all treatment phases. Results At transfer, maintenance, and follow-up, the speech of 14 participants who successfully completed treatment was similar to that of normally fluent adults. Successful participants also showed increased self-identification as a “normal speaker,” decreased self-identification as a “stutterer,” reduced short intervals of phonation, and some increased use of longer duration phonation intervals. Eleven successful participants received the MPI treatment, and 3 received the prolonged speech treatment. Conclusions Outcomes for successful participants were very similar for the 2 treatments. The much larger proportion of successful participants in the MPI group, however, combined with the predictive value of specific changes in PI durations suggest that MPI treatment was relatively more effective at assisting clients to identify and change the specific speech behaviors that are associated with successful treatment of stuttered speech in adults. PMID:25633470

  17. A computational hypothesis for allostasis: delineation of substance dependence, conventional therapies, and alternative treatments

    Directory of Open Access Journals (Sweden)

    Yariv Z. Levy

    2013-12-01

    Full Text Available The allostatic theory of drug abuse describes the brain's reward system alterations as substance misuse progresses. Neural adaptations arising from the reward system itself and from the antireward system provide the subject with functional stability, while affecting the person's mood. We propose a computational hypothesis describing how a virtual subject's drug consumption, cognitive substrate, and mood interface with reward and antireward systems. Reward system adaptations are assumed interrelated with the ongoing neural activity defining behavior towards drug intake, including activity in the nucleus accumbens, ventral tegmental area, and prefrontal cortex (PFC. Antireward system adaptations are assumed to mutually connect with higher-order cognitive processes occurring within PFC, orbitofrontal cortex, and anterior cingulate cortex. The subject's mood estimation is a provisional function of reward components.The presented knowledge repository model incorporates pharmacokinetic, pharmacodynamic, neuropsychological, cognitive, and behavioral components. Patterns of tobacco smoking exemplify the framework's predictive properties: escalation of cigarette consumption, conventional treatments similar to nicotine patches, and alternative medical practices comparable to meditation. The primary outcomes include an estimate of the virtual subject's mood and the daily account of drug intakes. The main limitation of this study resides in the 21 time-dependent processes which partially describe the complex phenomena of drug addiction and involve a large number of parameters which may underconstrain the framework.Our model predicts that reward system adaptations account for mood stabilization, whereas antireward system adaptations delineate mood improvement and reduction in drug consumption. This investigation provides formal arguments encouraging current rehabilitation therapies to include meditation-like practices along with pharmaceutical drugs and

  18. Current Situations of the Integration of RTIs Prevention and Treatment into Routine FP Program

    Institute of Scientific and Technical Information of China (English)

    Li-xia DOU; Wei YUAN; Meng-ye PENG; Er-sheng GAO

    2007-01-01

    Objective To understand the current situation of the integration of reproductive tract infections (RTIs) prevention and treatment into routine Family planning (FP) program. Methods Literature review, in depth interview and focus group discussion were employed to collect the related information. Questionnaire survey was conducted in 59 county level FP facilities. Results Both central and local governments provide policy supports to RTIs prevention and treatment. Nearly 98.3% of local FP facilities had integrated this work into their routine FP program. A comprehensive network system of family planning has been established in China and there were plenty of FP human resources. The existing FP resource should be effectively used, which could produce great social benefit if RTIs prevention and treatment be integrated into routine FP program. However, some problems still need to be solved in the integrated program, such as insufficient finance support, low quality of service, lack of co-operations between different sectors, etc. Conclusion It is possible and feasible to develop RTIs controlling projects in the family planning system. However, intensive training and close co-operation need to be applied respectively into FP staffs and relative departments.

  19. CUDA programs for solving the time-dependent dipolar Gross-Pitaevskii equation in an anisotropic trap

    CERN Document Server

    Loncar, Vladimir; Bogojevic, Aleksandar; Skrbic, Srdjan; Muruganandam, Paulsamy; Adhikari, Sadhan K

    2016-01-01

    In this paper we present new versions of previously published numerical programs for solving the dipolar Gross-Pitaevskii (GP) equation including the contact interaction in two and three spatial dimensions in imaginary and in real time, yielding both stationary and non-stationary solutions. New versions of programs were developed using CUDA toolkit and can make use of Nvidia GPU devices. The algorithm used is the same split-step semi-implicit Crank-Nicolson method as in the previous version (R. Kishor Kumar et al., Comput. Phys. Commun. 195, 117 (2015)), which is here implemented as a series of CUDA kernels that compute the solution on the GPU. In addition, the Fast Fourier Transform (FFT) library used in the previous version is replaced by cuFFT library, which works on CUDA-enabled GPUs. We present speedup test results obtained using new versions of programs and demonstrate an average speedup of 12 to 25, depending on the program and input size.

  20. Employment-based abstinence reinforcement as a maintenance intervention for the treatment of cocaine dependence: post-intervention outcomes

    Science.gov (United States)

    DeFulio, Anthony; Silverman, Kenneth

    2011-01-01

    Aims Due to the chronicity of cocaine dependence, practical and effective maintenance interventions are needed to sustain long-term abstinence. We sought to assess the effects of long-term employment-based reinforcement of cocaine abstinence after discontinuation of the intervention. Design Participants who initiated sustained opiate and cocaine abstinence during a 6-month abstinence reinforcement and training program worked as data entry operators and were randomly assigned to a group that could work independent of drug use (Control, n = 24), or an abstinence-contingent employment (n = 27) group that was required to provide cocaine- and opiate-negative urine samples to work and maintain maximum rate of pay. Setting A nonprofit data entry business. Participants Unemployed welfare recipients who persistently used cocaine while in methadone treatment. Measurements Urine samples and self-reports were collected every six months for 30 months. Findings During the employment year, abstinence-contingent employment participants provided significantly more cocaine-negative samples than controls (82.7% and 54.2%; P = .01, OR = 4.61). During the follow-up year, the groups had similar rates of cocaine-negative samples (44.2% and 50.0%; P = .93), and HIV-risk behaviors. Participants’ social, employment, economic, and legal conditions were similar in the two groups across all phases of the study. Conclusions Employment-based reinforcement effectively maintains long-term cocaine abstinence, but many patients relapse to use when the abstinence contingency is discontinued, even after a year of abstinence-contingent employment. Relapse could be prevented in many patients by leaving employment-based abstinence reinforcement in place indefinitely, which could be facilitated by integrating it into typical workplaces. PMID:21226886

  1. A National Study of American Indian and Alaska Native Substance Abuse Treatment: Provider and Program Characteristics.

    Science.gov (United States)

    Rieckmann, Traci; Moore, Laurie A; Croy, Calvin D; Novins, Douglas K; Aarons, Gregory

    2016-09-01

    American Indians and Alaska Natives (AIANs) experience major disparities in accessing quality care for mental health and substance use disorders. There are long-standing concerns about access to and quality of care for AIANs in rural and urban areas including the influence of staff and organizational factors, and attitudes toward evidence-based treatment for addiction. We conducted the first national survey of programs serving AIAN communities and examined workforce and programmatic differences between clinics located in urban/suburban (n=50) and rural (n=142) communities. We explored the correlates of openness toward using evidence-based treatments (EBTs). Programs located in rural areas were significantly less likely to have nurses, traditional healing consultants, or ceremonial providers on staff, to consult outside evaluators, to use strategic planning to improve program quality, to offer pharmacotherapies, pipe ceremonies, and cultural activities among their services, and to participate in research or program evaluation studies. They were significantly more likely to employ elders among their traditional healers, offer AA-open group recovery services, and collect data on treatment outcomes. Greater openness toward EBTs was related to a larger clinical staff, having addiction providers, being led by directors who perceived a gap in access to EBTs, and working with key stakeholders to improve access to services. Programs that provided early intervention services (American Society of Addiction Medicine level 0.5) reported less openness. This research provides baseline workforce and program level data that can be used to better understand changes in access and quality for AIAN over time. Copyright © 2016. Published by Elsevier Inc.

  2. The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities.

    Science.gov (United States)

    Legha, Rupinder Kaur; Novins, Douglas

    2012-07-01

    Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.

  3. Do drug treatment variables predict cognitive performance in multidrug-treated opioid-dependent patients? A regression analysis study

    Directory of Open Access Journals (Sweden)

    Rapeli Pekka

    2012-11-01

    Full Text Available Abstract Background Cognitive deficits and multiple psychoactive drug regimens are both common in patients treated for opioid-dependence. Therefore, we examined whether the cognitive performance of patients in opioid-substitution treatment (OST is associated with their drug treatment variables. Methods Opioid-dependent patients (N = 104 who were treated either with buprenorphine or methadone (n = 52 in both groups were given attention, working memory, verbal, and visual memory tests after they had been a minimum of six months in treatment. Group-wise results were analysed by analysis of variance. Predictors of cognitive performance were examined by hierarchical regression analysis. Results Buprenorphine-treated patients performed statistically significantly better in a simple reaction time test than methadone-treated ones. No other significant differences between groups in cognitive performance were found. In each OST drug group, approximately 10% of the attention performance could be predicted by drug treatment variables. Use of benzodiazepine medication predicted about 10% of performance variance in working memory. Treatment with more than one other psychoactive drug (than opioid or BZD and frequent substance abuse during the past month predicted about 20% of verbal memory performance. Conclusions Although this study does not prove a causal relationship between multiple prescription drug use and poor cognitive functioning, the results are relevant for psychosocial recovery, vocational rehabilitation, and psychological treatment of OST patients. Especially for patients with BZD treatment, other treatment options should be actively sought.

  4. Initial feasibility and validity of a prospective memory training program in a substance use treatment population.

    Science.gov (United States)

    Sweeney, Mary M; Rass, Olga; Johnson, Patrick S; Strain, Eric C; Berry, Meredith S; Vo, Hoa T; Fishman, Marc J; Munro, Cynthia A; Rebok, George W; Mintzer, Miriam Z; Johnson, Matthew W

    2016-10-01

    Individuals with substance use disorders have shown deficits in the ability to implement future intentions, called prospective memory. Deficits in prospective memory and working memory, a critical underlying component of prospective memory, likely contribute to substance use treatment failures. Thus, improvement of prospective memory and working memory in substance use patients is an innovative target for intervention. We sought to develop a feasible and valid prospective memory training program that incorporates working memory training and may serve as a useful adjunct to substance use disorder treatment. We administered a single session of the novel prospective memory and working memory training program to participants (n = 22; 13 men, 9 women) enrolled in outpatient substance use disorder treatment and correlated performance to existing measures of prospective memory and working memory. Generally accurate prospective memory performance in a single session suggests feasibility in a substance use treatment population. However, training difficulty should be increased to avoid ceiling effects across repeated sessions. Consistent with existing literature, we observed superior performance on event-based relative to time-based prospective memory tasks. Performance on the prospective memory and working memory training components correlated with validated assessments of prospective memory and working memory, respectively. Correlations between novel memory training program performance and established measures suggest that our training engages appropriate cognitive processes. Further, differential event- and time-based prospective memory task performance suggests internal validity of our training. These data support the development of this intervention as an adjunctive therapy for substance use disorders. (PsycINFO Database Record

  5. The Development and Validation of a Transformational Leadership Survey for Substance Use Treatment Programs

    Science.gov (United States)

    Edwards, Jennifer R.; Knight, Danica K.; Broome, Kirk M.; Flynn, Patrick M.

    2014-01-01

    Directors in substance use treatment programs are increasingly required to respond to external economic and socio-political pressures. Leadership practices that promote innovation can help offset these challenges. Using focus groups, factor analysis, and validation instruments, the current study developed and established psychometrics for the Survey of Transformational Leadership. In 2008, clinical directors were evaluated on leadership practices by 214 counselors within 57 programs in four U.S. regions. Nine themes emerged: integrity, sensible risk, demonstrates innovation, encourages innovation, inspirational motivation, supports others, develops others, delegates tasks, and expects excellence. Study implications, limitations and suggested future directions are discussed. Funding from NIDA. PMID:20509734

  6. Transgenic plant cells lacking mitochondrial alternative oxidase have increased susceptibility to mitochondria-dependent and -independent pathways of programmed cell death.

    Science.gov (United States)

    Robson, Christine A; Vanlerberghe, Greg C

    2002-08-01

    The plant mitochondrial electron transport chain is branched such that electrons at ubiquinol can be diverted to oxygen via the alternative oxidase (AOX). This pathway does not contribute to ATP synthesis but can dampen the mitochondrial generation of reactive oxygen species. Here, we establish that transgenic tobacco (Nicotiana tabacum L. cv Petit Havana SR1) cells lacking AOX (AS8 cells) show increased susceptibility to three different death-inducing compounds (H(2)O(2), salicylic acid [SA], and the protein phosphatase inhibitor cantharidin) in comparison with wild-type cells. The timing and extent of AS8 cell death are very similar among the three treatments and, in each case, are accompanied by the accumulation of oligonucleosomal fragments of DNA, indicative of programmed cell death. Death induced by H(2)O(2) or SA occurs by a mitochondria-dependent pathway characterized by cytochrome c release from the mitochondrion. Conversely, death induced by cantharidin occurs by a pathway without any obvious mitochondrial involvement. The ability of AOX to attenuate these death pathways may relate to its ability to maintain mitochondrial function after insult with a death-inducing compound or may relate to its ability to prevent chronic oxidative stress within the mitochondrion. In support of the latter, long-term treatment of AS8 cells with an antioxidant compound increased the resistance of AS8 cells to SA- or cantharidin-induced death. The results indicate that plants maintain both mitochondria-dependent and -independent pathways of programmed cell death and that AOX may act as an important mitochondrial "survival protein" against such death.

  7. Eight weeks of citicoline treatment does not perturb sleep/wake cycles in cocaine-dependent adults.

    Science.gov (United States)

    Bracken, Bethany K; Penetar, David M; Rodolico, John; Ryan, Elizabeth T; Lukas, Scott E

    2011-06-01

    Citicoline (cytidine-5'-diphosphate) is a mononucleotide composed of ribose, cytosine, pyrophosphate, and choline, and is involved in the biosynthesis of the structural phosopholipids of cell membranes. Treatment with citicoline, improves memory in patients with dementia, and reduces damage to the brain after traumatic brain injury or stroke. Recent research has been conducted to assess whether citicoline is an effective treatment for cocaine dependence. In cocaine-dependent individuals, withdrawal from cocaine is associated with disturbed sleep, which may contribute to the high rate of relapse to cocaine use. Therefore, it is important to know the impact of citicoline on the sleep/wake cycle in these individuals in order to rate its overall efficacy. In this double-blind, placebo-controlled trial, the effects of citicoline treatment on the sleep/wake cycles of cocaine dependent participants were assessed. The results of the current study are reported as part of a larger study, consisting of an eight-week treatment period to assess the efficacy of longer-term treatment with citicoline at decreasing cocaine consumption in cocaine-dependent polydrug using participants. In this non-abstinent, cocaine-dependent population, citicoline had no effect on any of the sleep parameters measured including sleep efficiency, sleep latency, total sleep time, number of waking episodes, time awake per episode, amount of time in bed spent moving, number of sleep episodes, time asleep per episode, and amount of time in bed spent immobile. These data suggest that eight weeks of citicoline administration does not disturb sleep/wake cycles of cocaine-dependent individuals. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. High-dose baclofen for the treatment of alcohol dependence (BACLAD study): a randomized, placebo-controlled trial.

    Science.gov (United States)

    Müller, Christian A; Geisel, Olga; Pelz, Patricia; Higl, Verena; Krüger, Josephine; Stickel, Anna; Beck, Anne; Wernecke, Klaus-Dieter; Hellweg, Rainer; Heinz, Andreas

    2015-08-01

    Previous randomized, placebo-controlled trials (RCTs) assessing the efficacy of the selective γ-aminobutyric acid (GABA)-B receptor agonist baclofen in the treatment of alcohol dependence have reported divergent results, possibly related to the low to medium dosages of baclofen used in these studies (30-80mg/d). Based on preclinical observations of a dose-dependent effect and positive case reports in alcohol-dependent patients, the present RCT aimed to assess the efficacy and safety of individually titrated high-dose baclofen for the treatment of alcohol dependence. Out of 93 alcohol-dependent patients initially screened, 56 were randomly assigned to a double-blind treatment with individually titrated baclofen or placebo using dosages of 30-270mg/d. The multiple primary outcome measures were (1) total abstinence and (2) cumulative abstinence duration during a 12-week high-dose phase. More patients of the baclofen group maintained total abstinence during the high-dose phase than those receiving placebo (15/22, 68.2% vs. 5/21, 23.8%, p=0.014). Cumulative abstinence duration was significantly higher in patients given baclofen compared to patients of the placebo group (mean 67.8 (SD 30) vs. 51.8 (SD 29.6) days, p=0.047). No drug-related serious adverse events were observed during the trial. Individually titrated high-dose baclofen effectively supported alcohol-dependent patients in maintaining alcohol abstinence and showed a high tolerability, even in the event of relapse. These results provide further evidence for the potential of baclofen, thereby possibly extending the current pharmacological treatment options in alcohol dependence.

  9. The effectiveness of patient navigation programs for adult cancer patients undergoing treatment: a systematic review.

    Science.gov (United States)

    Tho, Poh Chi; Ang, Emily

    2016-02-01

    Advancements in technology and medical treatment have made cancer care treatment more complex. With the current trend of sub-specialization in health care, cancer patients commonly receive care from multiple specialists and have wider treatment options. In view of this, there is a need to coordinate care and integrate information to enhance care and quality of outcomes for patients. Since the successful implementation of programs for increasing the survival rate of breast cancer patients at Harlem Hospital Center, New York, USA, patient navigation programs have been widely introduced in healthcare settings. Some literature has identified nurses as a primary candidate in assuming the role of a navigator. However, there is a need to further explore the effectiveness of patient navigation programs for their effectiveness in improving quality of life, and patient satisfaction and outcomes during the commencement of cancer treatment. The objective of this review was to synthesize the best available evidence on the effectiveness of patient navigation programs in adult cancer patients undergoing treatments such as radiotherapy and/or chemotherapy. This review considered studies that included adults aged 18 years and over, diagnosed with any type of cancer and undergoing treatment in an acute care hospital setting, including inpatient and outpatient/ambulatory care.This review considered studies that evaluated nurse-led patient navigation programs versus no patient navigation program or non-structured care coordination.A patient navigation program includes patient education, psychosocial support, and care coordination.This review considered randomized controlled trials and quasi-experimental studies.The review focused on the effects of patient navigator program clinical/patient outcomes. The review included studies on patient wellbeing and clinical outcomes, but excluded studies that had examined the impact of these programs on efficiency-related outcomes, such as length

  10. Acetylation-induced TDP-43 pathology is suppressed by an HSF1-dependent chaperone program.

    Science.gov (United States)

    Wang, Ping; Wander, Connor M; Yuan, Chao-Xing; Bereman, Michael S; Cohen, Todd J

    2017-07-19

    TDP-43 pathology marks a spectrum of multisystem proteinopathies including amyotrophic lateral sclerosis, frontotemporal lobar degeneration, and sporadic inclusion body myositis. Surprisingly, it has been challenging to recapitulate this pathology, highlighting an incomplete understanding of TDP-43 regulatory mechanisms. Here we provide evidence supporting TDP-43 acetylation as a trigger for disease pathology. Using cultured cells and mouse skeletal muscle, we show that TDP-43 acetylation-mimics promote TDP-43 phosphorylation and ubiquitination, perturb mitochondria, and initiate degenerative inflammatory responses that resemble sporadic inclusion body myositis pathology. Analysis of functionally linked amyotrophic lateral sclerosis proteins revealed recruitment of p62, ubiquilin-2, and optineurin to TDP-43 aggregates. We demonstrate that TDP-43 acetylation-mimic pathology is potently suppressed by an HSF1-dependent mechanism that disaggregates TDP-43. Our study illustrates bidirectional TDP-43 processing in which TDP-43 aggregation is targeted by a coordinated chaperone response. Thus, activation or restoration of refolding mechanisms may alleviate TDP-43 aggregation in tissues that are uniquely susceptible to TDP-43 proteinopathies.TDP-43 aggregation is linked to various diseases including amyotrophic lateral sclerosis. Here the authors show that acetylation of the protein triggers TDP-43 pathology in cultured cells and mouse skeletal muscle, which can be cleared through an HSF1-dependent chaperone mechanism that disaggregates the protein.

  11. Substance use and Dependency Problems, Psychotherapeutic Approaches and Special Treatment Approaches for Girls and Women

    NARCIS (Netherlands)

    Vogt, I.

    2010-01-01

    Evidenced-based research shows that we can draw on a number of efficient treatments for substance use problems. Best researched and evaluated are treatment approaches which are derived from cognitive behavior therapy (CBT). Dialectic behaviour therapy is most useful for the treatment of women (and m

  12. Reliability and validity of the Treatment Outcome Profile among patients attending methadone maintenance treatment programs in Kunming, China.

    Science.gov (United States)

    Wang, Mei; Shen, Jiucheng; Liu, Xianling; Deng, Yuan; Li, Jiahua; Finch, Emily; Wolff, Kim

    2017-06-01

    Substance misuse has been a major health and social issue worldwide and has become an important public health issue in China over the past two decades. Methadone maintenance treatment (MMT) has been proved worldwide by large bodies of research to be one of the most effective practices for illicit drug users. The Treatment Outcome Profile (TOP) was developed in 2007 by the UK National Treatment Agency (NTA). It has been proved to be a reliable instrument for outcome measure. This study aim to develop the Chinese version of the Treatment Outcome Profile (TOP), and to assess whether TOP is a reliable outcome measure that can be recommended for use in Chinese MMT program. The Chinese version of TOP was translated and revised based on the English version of TOP. Psychometric properties of TOP were evaluated through face-to-face interviews in 197 patients who had been attending methadone maintenance treatment clinics in Kunming city, Yunnan Institute for Drug Abuse, for less than three months. Patients were interviewed by 3 trained interviewers. Reliability and validity of the instrument were analyzed by measures including test-retest and inter-rater reliability, concurrent validity and change sensitivity. Concurrent validity was assessed by comparing the scores from TOP with scores obtained from validated clinometric instruments. Self-reported opiate use was compared with results of urine analysis. Change sensitivity was judged by t-tests and chi-square tests. About 67% of the 197 interviewers were male and 33% were female. Test-retest reliability of TOP scores (after 10 days interval) were good (K=0.65 to 0.95), inter-rater correlations (ICC) ranged from 0.7 to 0.9, and the criterion validity ranged from 0.72 to 0.88. TOP covers a large scope of problems encountered by drug users needed for treatment. The Chinese version of TOP is a reliable and valid assessment tool. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems.

    Science.gov (United States)

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2009-01-01

    We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M(age) = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association: Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed.

  14. Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2013-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD, and alcohol dependence . Objective: The objective of this study is to evaluate the efficacy of

  15. Prostaglandin E1 treatment in ductus dependent congenital cardiac malformation. A review of the treatment of 34 neonates

    DEFF Research Database (Denmark)

    Høst, A; Halken, S; Kamper, J

    1988-01-01

    Thirty-four sick neonates with major duct dependent cardiac defects were given short term (1 h-408 h) intravenous infusions of prostaglandin E1 (alprostadil) in doses varying between 0.1 micrograms/kg/min (starting dose) and 0.01 micrograms/kg/min. The aim of the study was to establish an effecti...

  16. 76 FR 47518 - Energy Conservation Program: Treatment of “Smart” Appliances in Energy Conservation Standards and...

    Science.gov (United States)

    2011-08-05

    ... Parts 430 and 431 Energy Conservation Program: Treatment of ``Smart'' Appliances in Energy Conservation... Energy, Building Technologies Program, Mailstop EE-2J, Energy Conservations Standards: Treatment of Smart... INFORMATION: In support of its Energy Conservation Standards Rulemakings, DOE conducts in-depth technical...

  17. [Effectiveness of an inpatient multimodal psychiatric-psychotherapeutic program for the treatment of job burnout].

    Science.gov (United States)

    Schwarzkopf, Kathleen; Conrad, Nathalie; Straus, Doris; Porschke, Hildburg; von Känel, Roland

    2016-03-16

    We studied the clinical course and long-term effects of inpatient treatment in 723 patients with job burnout referred with an ICD-10 F diagnosis and Z73.0 code («overwhelming exhaustion») to a Swiss hospital specialized in the treatment of job stress-related disorders. Patients were characterized in terms of age, gender, socioeconomic status. Self-rated psychological measures related to general and burnout-specific symptoms (i. e., emotional exhaustion, depersonalization, and diminished personal accomplishments) were applied before and after a six-week treatment program, as well as at 15 months after hospital discharge in 232 patients. The results show that the multimodal inpatient psychiatric-psychotherapeutic treatment was successful with a sustainable effect on psychological well-being (>90 %), including improvements regarding emotional exhaustion, depersonalization and personal accomplishments as well as professional reintegration in 71 % of cases.

  18. Analysis of data from radioactive wastes treatment process and implementation of a data management applied program

    Energy Technology Data Exchange (ETDEWEB)

    Jeo, H. S.; Son, J. S.; Kim, T. K.; Kang, I. S.; Lee, Y. H [KAERI, Taejon (Korea, Republic of)

    2003-10-01

    As for the generated radioactive waste, a nuclide and a form are various, and by small quantity occurs the irregular times in KAERI. Record management of a radioactive waste personal history is an important element in disposal. A data collection of a liquid / solid radioactive waste treatment process of a research organization became necessary while developing the RAWMIS which it can generate personal history management for efficient management of a waste, documents, all kinds of statistics. This paper introduces an input and output application program design to do to database with data in the results and a stream process of a treatment that analyzed the waste occurrence present situation and data by treatment process. Data on the actual treatment process that is not limited experiment improve by a document, human traces, saving of material resources and improve with efficiency of tracking about a radioactive waste and a process and give help to radioactive waste material valance and inventory study.

  19. Pyridoxine-Dependent Seizures: A Family Phenotype that Leads to Severe Cognitive Deficits, Regardless of Treatment Regime

    Science.gov (United States)

    Rankin, Peter M; Harrison, Sue; Chong, W. K.; Boyd, Stewart; Aylett, Sarah E.

    2007-01-01

    The neuropsychological and clinical histories of three male siblings affected by pyridoxine-dependent seizures with known homozygous antiquitin mutations are presented. Neuropsychological evaluation is reported from when the siblings were 11, 9, and 7 years of age. Two of the siblings had received early pyridoxine treatment (antenatal, 2-4 wks…

  20. Effects of daily treatment with citicoline: a double-blind, placebo-controlled study in cocaine-dependent volunteers.

    Science.gov (United States)

    Licata, Stephanie C; Penetar, David M; Ravichandran, Caitlin; Rodolico, John; Palmer, Christopher; Berko, Jeff; Geaghan, Thomas; Looby, Alison; Peters, Erica; Ryan, Elizabeth; Renshaw, Perry F; Lukas, Scott E

    2011-03-01

    Many pharmacotherapies for treating cocaine dependence are aimed at reducing drug effects, alleviating craving, and preventing relapse. We demonstrated previously that citicoline, a compound used to repair neuronal damage in stroke and brain injury, is safe in cocaine-abusing volunteers. This study assessed the effectiveness of an 8-week citicoline treatment period and 4-week follow-up in cocaine-dependent individuals. Twenty-nine healthy nontreatment-seeking, cocaine-dependent male and female volunteers were randomized in this double-blind, placebo-controlled study, 18 of whom completed the treatment period of the study. Participants took citicoline (500 mg twice daily) or matched placebo each day and recorded the measures of craving and drug use. Participants visited the laboratory twice a week for urine screens and to attend weekly group therapy sessions. Citicoline had no effect on cocaine craving or total use. Although the current preliminary results from this small trial suggest that citicoline is not an effective treatment for heavy cocaine users, further investigation on efficacy citicoline as a treatment for substance dependence in other settings may be warranted.

  1. Predictors of Abstinence: National Institute of Drug Abuse Multisite Buprenorphine/Naloxone Treatment Trial in Opioid-Dependent Youth

    Science.gov (United States)

    Subramaniam, Geetha A.; Warden, Diane; Minhajuddin, Abu; Fishman, Marc J.; Stitzer, Maxine L.; Adinoff, Bryon; Trivedi, Madhukar; Weiss, Roger; Potter, Jennifer; Poole, Sabrina A.; Woody, George E.

    2011-01-01

    Objective: To examine predictors of opioid abstinence in buprenorphine/naloxone (Bup/Nal)-assisted psychosocial treatment for opioid-dependent youth. Method: Secondary analyses were performed of data from 152 youth (15-21 years old) randomly assigned to 12 weeks of extended Bup/Nal therapy or up to 2 weeks of Bup/Nal detoxification with weekly…

  2. A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

    Science.gov (United States)

    Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

    2016-01-01

    Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

  3. Effect of Stabilization Heat Treatment on Time-Dependent Polarization Losses in Sintered Nd-Fe-B Permanent Magnets

    Directory of Open Access Journals (Sweden)

    Tuominen S.

    2013-01-01

    Full Text Available Some companies in the motor and generator industry utilizing sintered NdFeB magnets have adopted pre-ageing heat treatment in order to improve the stability of the magnets. The parameters of this stabilization heat treatment are based mainly on assumptions rather than on any published research results. In this work, the effects of pre-ageing treatment on the time-dependent polarization losses of two different types of commercial sintered NdFeB magnets were studied. The material showing the squarer J(H curve did not benefit from the pre-ageing treatment, since it seems to be stable under a certain critical temperature. In contrast, a stabilizing effect was observed in the material showing rounder J(H curve. After the stabilization heat treatment, the polarization of the magnets was found to be at lower level, but unchanged over a certain period of time. The length of this period depends on the temperature and the duration of the pre-ageing treatment. In addition, our analysis reveals that the stabilization heat treatment performed in an open circuit condition does not stabilize the magnet uniformly.

  4. Parameters of hemodialysis adequacy and patients’ survival depending on treatment modalities

    Directory of Open Access Journals (Sweden)

    Đurić Petar S.

    2015-01-01

    Full Text Available Introduction. Retrospective studies showed that hemodiafiltration was associated with a reduced risk of mortality compared with standard hemodialysis in the patients with end-stage renal disease. Recently, a few prospective randomized clinical trials found no advantage in survival with hemodiafiltration as compared with high-flux hemodialysis and low-flux hemodialysis. The aim of this study was to compare the parameters of hemodialysis adequacy and two-year survival of patients depending on the modality of hemodialysis. Material and Methods. A total of 159 hemodialysis patients were divided into 3 groups according to the type of hemodialysis treatment: group A - lowflux hemodialysis, group B - high-flux hemodialysis, and group C - hemodiafiltration. All patients had the same duration of hemodialysis sessions. The analysis included average one-year biochemical parameters, and two-year survival of patients. Results. The patients on hemodiafiltration were significantly younger, they had longer dialysis vintage and higher index of dialysis adequancy as compared with the patients on low-flux hemodialysis and high-flux hemodialysis, but without a difference between the two latter groups. Compared to the patients on low-flux hemodialysis, the patients on hemodiafiltration and high-flux hemodialysis had significantly higher hemoglobin value with less frequent erythropoietin stimulating agent use. According to Kaplan-Meier survival analysis, the patients on hemodiafiltration and high-flux hemodialysis had significantly better two-year survival than the patients on low-flux hemodialysis. Cox proportional hazards model confirmed that high-flux hemodialysis caused a significantly lower relative risk of mortality (56% reduction compared to low-flux hemodialysis (hazard ratio 0.44; P=0.026, and hemodiafiltration caused a 58% reduction in the relative risk of mortality compared to low-flux dialysis (hazard ratio 0.42; P=0.105, but without a statistical

  5. Baclofen as relapse prevention in the treatment of gamma-hydroxybutyrate dependence: a case series

    NARCIS (Netherlands)

    Kamal, R.M.; Loonen, A.J.; Dijkstra, B.A.; Jong, C.A.J. de

    2015-01-01

    In the last decade, gamma-hydroxybutyrate (GHB) abuse and dependence have increased. It has been reported that GHB dependence has a high rate of relapse, serious complications of intoxication, and a potentially life-threatening withdrawal syndrome. Nevertheless, in clinical practice, there is no kno

  6. Mending the Broken Circle: Treatment of Substance Dependence among Native Americans.

    Science.gov (United States)

    Garrett, Michael Tlanusta; Carroll, Jane J.

    2000-01-01

    Issues surrounding substance dependence of Native Americans are examined through the cultural concept of the Broken Circle. Traditional cultural views of wellness and healing are described. Underlying factors in substance dependence of Native Americans are presented along with practical counseling recommendations and implications for treatment…

  7. Dependence of Boiling Histotripsy Treatment Efficiency on HIFU Frequency and Focal Pressure Levels.

    Science.gov (United States)

    Khokhlova, Tatiana D; Haider, Yasser A; Maxwell, Adam D; Kreider, Wayne; Bailey, Michael R; Khokhlova, Vera A

    2017-09-01

    Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU)-based method of mechanical tissue fractionation that utilizes millisecond-long bursts of HIFU shock waves to cause boiling at the focus in milliseconds. The subsequent interaction of the incoming shocks with the vapor bubble mechanically lyses surrounding tissue and cells. The acoustic parameter space for BH has been investigated previously and an inverse dependence between the HIFU frequency and the dimensions of a BH lesion has been observed. The primary goal of the present study was to investigate in more detail the ablation rate and reliability of BH in the frequency range relevant to treatment of deep abdominal tissue targets (1-2 MHz). The second goal was to investigate the effect of focal peak pressure levels and shock amplitude on BH lesion formation, given a constant duty factor, a constant ratio of the pulse duration to the time to reach boiling and a constant number of BH pulses. A custom-built 12-element sector array HIFU transducer with F-number = 1.05 was used in all experiments. BH pulses at 5 different frequencies (1, 1.2, 1.5, 1.7 and 1.9 MHz) were delivered to optically transparent polyacrylamide gel phantoms and ex vivo bovine liver and myocardium tissue to observe cavitation and boiling bubble activity with high-speed photography and B-mode ultrasound imaging, correspondingly. In gel phantoms, a cavitation bubble cloud was shown to form prefocally and to shield the focus in all exposures at 1 and 1.2 MHz and in the highest amplitude exposures at 1.5-1.7 MHz; shielding was not observed at 1.9 MHz. In ex vivo tissue, this shielding effect was observed in 25% of exposures when peak negative in situ pressure exceeded 10.2 MPa at 1 MHz and 14.5 MPa at 1.5 MHz. When shielding occurred, the exposures resulted in mild tissue disruption in the prefocal region, but not liquefaction. The dimensions of liquefied lesions followed the inverse proportionality trend with

  8. FIRO-B scores and success in a positive peer-culture residential treatment program.

    Science.gov (United States)

    Lee, R E

    1996-02-01

    FIRO-B Wanted Inclusion, Wanted Affection, and Total scores discriminated between 28 adolescent boys who would be successful graduates of a positive peer-culture residential program and 29 who would not. Successful graduates had higher mean scores on these scales. Successful and unsuccessful residents did not differ in scores on Exner Rorschach Experience Balance, Experienced Stimulation, or Adjusted D. Likewise they did not differ in Verbal IQ or age. Openness to social relationships may be an important variable in assessing for whom group-based treatment will work. Where the capacity for relatedness is not present, staff in a group-based program may have to recognize and treat this if the program is to succeed.

  9. The potential use of genetics to increase the effectiveness of treatment programs for criminal offenders.

    Science.gov (United States)

    Beaver, Kevin M; Jackson, Dylan B; Flesher, Dillon

    2014-01-01

    During the past couple of decades, the amount of research examining the genetic underpinnings to antisocial behaviors, including crime, has exploded. Findings from this body of work have generated a great deal of information linking genetics to criminal involvement. As a partial result, there is now a considerable amount of interest in how these findings should be integrated into the criminal justice system. In the current paper, we outline the potential ways that genetic information can be used to increase the effectiveness of treatment programs designed to reduce recidivism among offenders. We conclude by drawing attention to how genetic information can be used by rehabilitation programs to increase program effectiveness, reduce offender recidivism rates, and enhance public safety.

  10. Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): A Pilot Study in Alcohol-dependent Women.

    Science.gov (United States)

    Persson, Anna; Back, Sudie E; Killeen, Therese K; Brady, Kathleen T; Schwandt, Melanie L; Heilig, Markus; Magnusson, Åsa

    Posttraumatic stress disorder (PTSD) and substance use disorders are highly comorbid. Effective treatments are largely lacking. This pilot study evaluated the safety and feasibility of a novel intervention, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), in preparation for a randomized controlled trial. Twenty-two treatment-seeking women with current DSM-IV-TR PTSD and alcohol dependence (AD) were recruited. Participants received COPE. Safety and feasibility were evaluated, as were efficacy-related outcomes: PTSD and depression symptom severity, alcohol use, craving, and dependence severity. No adverse events occurred. COPE was implemented in routine clinical practice. Among the assessed women, 95.8% were eligible to participate. Treatment attendance and completion were higher than in previous studies. Post treatment, all efficacy-related outcomes, including PTSD and depression symptom severity, alcohol use, craving, and dependence severity, were significantly reduced. COPE was safe and feasible to use. Concerns that trauma-focused, exposure-based therapy might promote relapse in this population appear unwarranted. Our findings provide initial evidence suggestive of COPE efficacy for comorbid PTSD and AD in women. These results provide a strong rationale for investigating the efficacy of COPE for comorbid PTSD and AD in women in a randomized controlled trial.

  11. Treatment Programs for Students With Attention Deficit Hyperactivity Disorder: A Meta-Analysis Study

    OpenAIRE

    Mihandoost, Zeinab

    2015-01-01

    Context: The aim of this study was to determine the experimental evidence of treatment/intervention programs for deficits in social skills, attention, and behavioral disorder in children and adolescents with attention deficit hyperactivity disorder (ADHD). Evidence Acquisition: Meta-analysis procedures were employed to investigate whether children and adolescents with ADHD exhibit deficits in attention and social skills. A total of 17 empirical research studies published between 2000 and 2013...

  12. Effectiveness of education programs in the treatment of patients with heart failure

    OpenAIRE

    Natalya Zagorulya; Gulnar Zhussupova

    2010-01-01

    The paper describes efficiency of education program targeted to patientsin “School for patients with congestive heart failure”. During 6 months20 patients proceeding standard therapy were being simultaneouslyeducated on topics related to heart failure. These topics covered causesof chronic heart failure (CHF) formation, basic clinical CHF displays,the role of medicamentous and non-medicamentous CHF treatment,significance of self-control with CHF. The screening group was similarto baseline (wh...

  13. A double-blind, placebo-controlled pilot trial of acamprosate for the treatment of cocaine dependence.

    Science.gov (United States)

    Kampman, Kyle M; Dackis, Charles; Pettinati, Helen M; Lynch, Kevin G; Sparkman, Thorne; O'Brien, Charles P

    2011-03-01

    Acamprosate is a medication shown to be effective for the treatment of alcohol dependence. Although the exact mechanism of action of acamprosate is unknown, evidence suggests that it decreases excitatory amino acid activity by post-synaptic inhibition of the NMDA subtype of glutamate receptors. It is possible that the activity of acamprosate via modulating glutamatergic activity could also reduce craving for cocaine and impact abstinence in cocaine dependence. Therefore, we conducted a double-blind placebo-controlled pilot trial of acamprosate for the treatment of cocaine dependence. Sixty male and female cocaine dependent patients were included in a nine week double-blind, placebo-controlled trial. After a one-week baseline, patients were randomized to receive acamprosate 666 mg three times daily or identical placebo tablets for eight weeks. The primary outcome measure was cocaine use as determined by twice weekly urine drug screens. Thirty-six patients (60%) completed the trial, with no significant between-group difference in treatment retention. Percent cocaine positive urine drug screens did not differ between the two groups. Acamprosate was no better than placebo in reducing cocaine craving, reducing cocaine withdrawal symptoms, or improving measures of drug use severity from the Addiction Severity Index. Adverse events in this trial were generally mild and were evenly distributed between the two groups. Acamprosate was well tolerated but was no more efficacious than placebo in promoting abstinence from cocaine in cocaine dependent patients. Acamprosate does not appear to be a promising medication for the treatment of cocaine dependence. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. A structural model of treatment program and individual counselor leadership in innovation transfer.

    Science.gov (United States)

    Joe, George W; Becan, Jennifer E; Knight, Danica K; Flynn, Patrick M

    2017-03-23

    A number of program-level and counselor-level factors are known to impact the adoption of treatment innovations. While program leadership is considered a primary factor, the importance of leadership among clinical staff to innovation transfer is less known. Objectives included explore (1) the influence of two leadership roles, program director and individual counselor, on recent training activity and (2) the relationship of counselor attributes on training endorsement. The sample included 301 clinical staff in 49 treatment programs. A structural equation model was evaluated for key hypothesized relationships between exogenous and endogenous variables related to the two leadership roles. The importance of organizational leadership, climate, and counselor attributes (particularly counseling innovation interest and influence) to recent training activity was supported. In a subset of 68 counselors who attended a developer-led training on a new intervention, it was found that training endorsement was higher among those with high innovation interest and influence. The findings suggest that each leadership level impacts the organization in different ways, yet both can promote or impede technology transfer.

  15. VNAP2: a computer program for computation of two-dimensional, time-dependent, compressible, turbulent flow

    Energy Technology Data Exchange (ETDEWEB)

    Cline, M.C.

    1981-08-01

    VNAP2 is a computer program for calculating turbulent (as well as laminar and inviscid), steady, and unsteady flow. VNAP2 solves the two-dimensional, time-dependent, compressible Navier-Stokes equations. The turbulence is modeled with either an algebraic mixing-length model, a one-equation model, or the Jones-Launder two-equation model. The geometry may be a single- or a dual-flowing stream. The interior grid points are computed using the unsplit MacCormack scheme. Two options to speed up the calculations for high Reynolds number flows are included. The boundary grid points are computed using a reference-plane-characteristic scheme with the viscous terms treated as source functions. An explicit artificial viscosity is included for shock computations. The fluid is assumed to be a perfect gas. The flow boundaries may be arbitrary curved solid walls, inflow/outflow boundaries, or free-jet envelopes. Typical problems that can be solved concern nozzles, inlets, jet-powered afterbodies, airfoils, and free-jet expansions. The accuracy and efficiency of the program are shown by calculations of several inviscid and turbulent flows. The program and its use are described completely, and six sample cases and a code listing are included.

  16. Arsenic Attenuates GLI Signaling, Increasing or Decreasing its Transcriptional Program in a Context-Dependent Manner.

    Science.gov (United States)

    Li, Bin; Giambelli, Camilla; Tang, Bo; Winterbottom, Emily; Long, Jun; Jin, Ke; Wang, Zhiqiang; Fei, Dennis Liang; Nguyen, Dao M; Athar, Mohammad; Wang, Baolin; Subbarayan, Pochi R; Wang, Lily; Rai, Priyamvada; Ardalan, Bach; Capobianco, Anthony J; Robbins, David J

    2016-02-01

    The metalloid arsenic is a worldwide environmental toxicant, exposure to which is associated with many adverse outcomes. Arsenic is also an effective therapeutic agent in certain disease settings. Arsenic was recently shown to regulate the activity of the Hedgehog (HH) signal transduction pathway, and this regulation of HH signaling was proposed to be responsible for a subset of arsenic's biologic effects. Surprisingly, these separate reports proposed contradictory activities for arsenic, as either an agonist or antagonist of HH signaling. Here we provide in vitro and in vivo evidence that arsenic acts as a modulator of the activity of the HH effector protein glioma-associated oncogene family zinc finger (GLI), activating or inhibiting GLI activity in a context-dependent manner. This arsenic-induced modulation of HH signaling is observed in cultured cells, patients with colorectal cancer who have received arsenic-based therapy, and a mouse colorectal cancer xenograft model. Our results show that arsenic activates GLI signaling when the intrinsic GLI activity is low but inhibits signaling in the presence of high-level GLI activity. Furthermore, we show that this modulation occurs downstream of primary cilia, evidenced by experiments in suppressor of fused homolog (SUFU) deficient cells. Combining our findings with previous reports, we present an inclusive model in which arsenic plays dual roles in GLI signaling modulation: when GLIs are primarily in their repressor form, arsenic antagonizes their repression capacity, leading to low-level GLI activation, but when GLIs are primarily in their activator form, arsenic attenuates their activity.

  17. LRH-1-dependent programming of mitochondrial glutamine processing drives liver cancer

    Science.gov (United States)

    Xu, Pan; Oosterveer, Maaike H.; Stein, Sokrates; Demagny, Hadrien; Ryu, Dongryeol; Moullan, Norman; Wang, Xu; Can, Emine; Zamboni, Nicola; Comment, Arnaud; Auwerx, Johan; Schoonjans, Kristina

    2016-01-01

    Various tumors develop addiction to glutamine to support uncontrolled cell proliferation. Here we identify the nuclear receptor liver receptor homolog 1 (LRH-1) as a key regulator in the process of hepatic tumorigenesis through the coordination of a noncanonical glutamine pathway that is reliant on the mitochondrial and cytosolic transaminases glutamate pyruvate transaminase 2 (GPT2) and glutamate oxaloacetate transaminase 1 (GOT1), which fuel anabolic metabolism. In particular, we show that gain and loss of function of hepatic LRH-1 modulate the expression and activity of mitochondrial glutaminase 2 (GLS2), the first and rate-limiting step of this pathway. Acute and chronic deletion of hepatic LRH-1 blunts the deamination of glutamine and reduces glutamine-dependent anaplerosis. The robust reduction in glutaminolysis and the limiting availability of α-ketoglutarate in turn inhibit mTORC1 signaling to eventually block cell growth and proliferation. Collectively, these studies highlight the importance of LRH-1 in coordinating glutamine-induced metabolism and signaling to promote hepatocellular carcinogenesis. PMID:27298334

  18. The use of recurrent signals about adaptation for subsequent saccade programming depends on object structure.

    Science.gov (United States)

    Doré-Mazars, Karine; Vergilino-Perez, Dorine; Collins, Thérèse; Bohacova, Katarina; Beauvillain, Cécile

    2006-10-03

    Executing sequences of accurate saccadic eye movements supposes the use of signals carrying information about the first saccade for updating the predetermined motor plan of the subsequent saccades. The present study examines the signals used in planning a second saccade when subjects made two successive saccades towards one long or two short peripheral objects displayed before the first saccade execution. Different first eye movement signals could be used: desired eye movement signals, representing the movement necessary for attaining the intended target, or actual eye movement signals, representing the movement actually executed. Experimental dissociation of desired and actual eye movement signals is made possible by adaptive modifications of the first saccade, obtained by transfer of single saccade adaptation, during which the motor vector was progressively modified in response to the systematic intra-saccadic step of a single target. Whether the second saccade used the actual eye movement signal to compensate or not for the adaptive changes in the first saccade depended on which object properties were relevant for saccade planning. Compensation was observed for saccades that aimed for a new object (between-object saccades) because adaptation modifies relative object location. No compensation was observed for saccades that explored an extended object (within-object saccades). Implications for the on-line control of subsequent eye movements are discussed.

  19. The Effect of Modified "Aggression Replacement Training" Program on Self-efficacy of Adolescents with Insulin-dependent Diabetes

    Directory of Open Access Journals (Sweden)

    Seyed Reza Mazlom

    2015-06-01

    Full Text Available Background: Self-efficacy is a crucial factor in controlling adolescents with insulin-dependent diabetes mellitus (IDDM. Subsequently the negative behavioral reactions such as aggression adversely affect on self-efficacy. Therefore, interventions are essential to reduce the aggression and to improve the self- efficacy in these patients. Aim: To determine the efficacy of the modified "aggression replacement training" program on self-efficacy of adolescents with insulin-dependent diabetes. Methods: In this clinical trial, 70 adult subjects with IDDM who were referred to Parsian Diabetes clinic of Mashhad in 2014 were divided into two groups of intervention and control. The intervention program, including three aspects including: anger control training, social skills training and moral reasoning training was performed in five sessions, each 1.5-2 hours. A five-day interval was between the sessions and each group consisted of 8-10 individuals. The self-management standard questionnaire of “insulin-dependent diabetes management self-efficacy scale (IDMSE” was filled before the intervention and two months afterwards. Data were analyzed using SPSS version 11.5 with paired and Independent t-tests. Results: In this study, 38.5 and 61.5 percent of the subjects were boys and girls, respectively with total mean age of 15.9±2. The self-efficacy of the subjects before the intervention was not significantly different within the groups (p=0/57. Nevertheless in post-intervention assessment, the self-efficacy of the Intervention group significantly increased (49.0±11.1 compared to the control group (33.7±5.5 (p

  20. Mayor Erythropoietic Response after Deferasirox Treatment in a Transfusion-Dependent Anemic Patient with Primary Myelofibrosis

    Science.gov (United States)

    Lisette, Del Corso; Enrico, Balleari; Eleonora, Arboscello; Riccardo, Ghio; Manlio, Mencoboni; Omar, Racchi

    2013-01-01

    Primary myelofibrosis (PMF) is a myeloproliferative neoplasm frequently complicated by transfusion dependent anemia. Both anemia and transfusion-dependence are associated with a poor outcome, at least in part because of toxic effects of iron overload (IOL). Iron-chelating therapy (ICT) is increasingly used in order to prevent IOL in this setting. Here, we describe the case of a 73-year-old man affected by PMF and severe transfusion-dependent anemia who experienced a dramatic erythroid response after being treated with deferasirox to prevent IOL. PMID:24307957

  1. Mayor erythropoietic response after deferasirox treatment in a transfusion-dependent anemic patient with primary myelofibrosis.

    Science.gov (United States)

    Lisette, Del Corso; Enrico, Balleari; Eleonora, Arboscello; Riccardo, Ghio; Manlio, Mencoboni; Omar, Racchi

    2013-01-01

    Primary myelofibrosis (PMF) is a myeloproliferative neoplasm frequently complicated by transfusion dependent anemia. Both anemia and transfusion-dependence are associated with a poor outcome, at least in part because of toxic effects of iron overload (IOL). Iron-chelating therapy (ICT) is increasingly used in order to prevent IOL in this setting. Here, we describe the case of a 73-year-old man affected by PMF and severe transfusion-dependent anemia who experienced a dramatic erythroid response after being treated with deferasirox to prevent IOL.

  2. Mayor Erythropoietic Response after Deferasirox Treatment in a Transfusion-Dependent Anemic Patient with Primary Myelofibrosis

    Directory of Open Access Journals (Sweden)

    Del Corso Lisette

    2013-01-01

    Full Text Available Primary myelofibrosis (PMF is a myeloproliferative neoplasm frequently complicated by transfusion dependent anemia. Both anemia and transfusion-dependence are associated with a poor outcome, at least in part because of toxic effects of iron overload (IOL. Iron-chelating therapy (ICT is increasingly used in order to prevent IOL in this setting. Here, we describe the case of a 73-year-old man affected by PMF and severe transfusion-dependent anemia who experienced a dramatic erythroid response after being treated with deferasirox to prevent IOL.

  3. Achieving full compliance with standards for assertive community treatment programs in Ontario: does sponsoring agency type matter?

    Science.gov (United States)

    Randall, Glen E; Wakefield, Patricia A

    2010-01-01

    Assertive Community Treatment (ACT) programs provide community-based services for individuals with severe mental illness. In Ontario, these programs are funded by the Ministry of Health and Long-Term Care and administered through sponsoring agencies (hospitals, mental health facilities, and "other" community-based organizations). This article reports on the results of a survey of ACT programs and investigates the relationship between sponsoring agency type and ACT program operations. Findings and implications for policy makers and administrators are discussed.

  4. Integrated intensive proprioceptive and visuomotor rehabilitation program for treatment of spastic diplegic Children

    Directory of Open Access Journals (Sweden)

    Fathy A. Elshazly

    2016-08-01

    Full Text Available Although so many rehabilitation programs have been addressed for rehabilitation of diplegic children, it still a challenging task to attain a satisfactory functional recovery. The purpose of the study was to investigate the efficacy of an intensive proprioceptive and visuomotor training program in the treatment of diplegic children in term of spatiotemporal gait parameters, postural stability, and quality of life. In a prospective randomized controlled trial, convenient sample of forty ambulant diplegic children were randomly distributed to either control (n=20 or study (n=20 groups; the control group received a traditional rehabilitation program for 1 hour, 5 times/week for 3 successive months, while the study group received the same program with intensive proprioceptive and visuomotor integration. Vicon 3D motion analysis system, Technobody balance system and Pediatric Quality of life Inventory were used to measure spatiotemporal gait parameters, stability indices and quality of life respectively. all parameters were similar in both groups at inception (p˃0.05. Children within both groups showed improvement of gait function, postural stability and quality of life (p˂0.05 and the integrated proprioceptive and visuomotor rehabilitation program achieved better gain (p˂0.05. Integrated proprioceptive and visuomotor rehabilitation might improve gait function, postural stability, and quality of life in diplegic children.

  5. Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer.

    Science.gov (United States)

    Amodeo, Maryann; Storti, Susan A; Larson, Mary Jo

    2010-05-01

    Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001 ; Roman and Johnson, 2002 ; Willenbring et al., 2004 ). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported practice (ESP) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors' perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors was also difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified.

  6. Forest canopy reduction and breeding bird responses: treatment-and temporal-dependent patterns

    Science.gov (United States)

    Brandie K. Stringer; Yong Wang; Callie J. Schweitzer

    2015-01-01

    We examined the effects of oak regeneration forest management treatments on territorial density of breeding forest birds. The study area was located on the southern end of the mid-Cumberland Plateau in northern Jackson County, AL. Fifteen 4-ha stands were treated in 2001 with one of five target overstory retention (percentage) treatments: 0 (clearcut); 25; 50; 75; and...

  7. Successful treatment of polydipsia, water intoxication, and delusional jealousy in an alcohol dependent patient with clozapine.

    Science.gov (United States)

    Margetić, Branimir; Aukst-Margetić, Branka; Zarković-Palijan, Tija

    2006-09-30

    The beneficial effect of clozapine on polydipsia and water intoxication in patients with schizophrenia has been demonstrated many times. The authors report a successful clozapine treatment of polydipsia, intermittent water intoxication, and delusional jealousy of an alcoholic. This is a rare case of clozapine treatment of a non-schizophrenic patient affected by polydipsia.

  8. Clinical, Biochemical, and Molecular Studies and Treatment of Pyridoxine-Dependent Epilepsy

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2013-03-01

    Full Text Available Researchers at Autonomous University of Madrid, and other centers in Spain studied the clinical, biochemical, and genetic spectrum of pyridoxine-dependent epilepsy (PDE in 12 patients with the clinically proven diagnosis.

  9. Antibiotic treatment affects intestinal permeability and gut microbial composition in Wistar rats dependent on antibiotic class

    DEFF Research Database (Denmark)

    Tulstrup, Monica Vera-Lise; Christensen, Ellen Gerd; Carvalho, Vera;

    (AMX), cefataxime (CTX), vancomycin (VAN), metronidazole (MTZ), or water (CON) daily for 10-11 days. Bacterial composition, alpha diversity and cecum short chain fatty acid levels were significantly affected by AMX, CTX and VAN, and varied among antibiotic treatments. A general decrease in diversity...... in microbiota composition or function were observed following MTZ treatment. Permeability to 4 kDa FITC-dextran was decreased after CTX and VAN treatment and increased following MTZ treatment. Plasma haptoglobin levels were increased by both AMX and CTX but no changes in expression of host tight junction genes...... were found in any treatment group. Antibiotic induced changes in microbiota could be linked to intestinal permeability, although changes in permeability did not always result from major changes in microbiota and vice versa....

  10. Supporting Mothers’ Engagement in a Community-Based Methadone Treatment Program

    Directory of Open Access Journals (Sweden)

    Nicole Letourneau

    2013-01-01

    Full Text Available Unmanaged maternal opioid addiction poses health and social risks to both mothers and children in their care. Methadone maintenance treatment (MMT is a targeted public health service to which nurses and other allied health professionals may refer these high risk families for support. Mothers participating in MMT to manage their addiction and their service providers were interviewed to identify resources to maximize mothers’ engagement in treatment and enhance mothers’ parenting capacity. Twelve mothers and six service providers were recruited from an outpatient Atlantic Canadian methadone treatment program. Two major barriers to engagement in MMT were identified by both mothers and service providers including (1 the lack of available and consistent childcare while mothers attended outpatient programs and (2 challenges with transportation to the treatment facility. All participants noted the potential benefits of adding supportive resources for the children of mothers involved in MMT and for mothers to learn how to communicate more effectively with their children and rebuild damaged mother-child relationships. The public health benefits of integrating parent-child ancillary supports into MMT for mothers are discussed.

  11. Causation of drug abuse and treatment strategy: a comparison of counselors' perceptions of faith-based and secular drug treatment programs.

    Science.gov (United States)

    Chu, Doris C; Sung, Hung-En

    2014-04-01

    Many offenders participate in drug abuse treatment programs while in prison or on probation or parole. Among other benefits, this treatment may lessen the risk of recidivism. Thus, understanding counselor treatment philosophy is important as their attitudes toward treatment can be influential in the strategies they use and ultimately affect treatment outcomes. Analyzing data from 110 drug abuse treatment counselors, this study compared counselors' perceptions of causation of drug abuse and treatment strategy between faith-based and secular treatment programs. It was found that counselors from faith-based programs were more likely to endorse religious models and less prone to support disease models as an explanation of drug use. With regard to treatment strategy, counselor's group affiliation was not predictive of a focus on either a client religious need or a medical treatment model. Nevertheless, the extent of counselor's religiosity was correlated with tackling clients' religious needs as a treatment strategy. On the other hand, certified (licensed) counselors were found to be more supportive of the medical model as a treatment approach. Limitations of the current study and policy implications are discussed.

  12. Improving China's antiretroviral treatment program: assessing current and future performance using the principals of ethics

    Institute of Scientific and Technical Information of China (English)

    YIN Wen-yuan; ZHANG Fu-jie; Naomi Juniper; WU Zun-you

    2009-01-01

    @@ The global commitment to providing antiretroviral therapy (ART) to people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in low-income countries has raised hope that the increasing momentum in the fight against the worldwide HIV/AIDS pandemic will be sufficient to control it. However, improved availability of subsidized antiretroviral (ARV) treatments in low-income countries raises complex ethical issues.1,2 In many resource-constrained countries the number of individuals infected with HIV in need of treatment far exceeds the supply of ARV medication. Resource allocation decisions can be made on the basis of many epidemiological,ethical, or preferential treatment priority criteria,Healthcare systems and funding in low-income countries are limited, requiring a step-by-step aipproach to scalingup programs to reach their stated aims.

  13. Distance Traveled and Cross-State Commuting to Opioid Treatment Programs in the United States

    Directory of Open Access Journals (Sweden)

    Andrew Rosenblum

    2011-01-01

    Full Text Available This study examined commuting patterns among 23,141 methadone patients enrolling in 84 opioid treatment programs (OTPs in the United States. Patients completed an anonymous one-page survey. A linear mixed model analysis was used to predict distance traveled to the OTP. More than half (60% the patients traveled <10 miles and 6% travelled between 50 and 200 miles to attend an OTP; 8% travelled across a state border to attend an OTP. In the multivariate model (n=17,792, factors significantly (P<.05 associated with distance were, residing in the Southeast or Midwest, low urbanicity, area of the patient's ZIP code, younger age, non-Hispanic white race/ethnicity, prescription opioid abuse, and no heroin use. A significant number of OTP patients travel considerable distances to access treatment. To reduce obstacles to OTP access, policy makers and treatment providers should be alert to patients' commuting patterns and to factors associated with them.

  14. Distance Traveled and Cross-State Commuting to Opioid Treatment Programs in the United States

    Science.gov (United States)

    Rosenblum, Andrew; Cleland, Charles M.; Fong, Chunki; Kayman, Deborah J.; Tempalski, Barbara; Parrino, Mark

    2011-01-01

    This study examined commuting patterns among 23,141 methadone patients enrolling in 84 opioid treatment programs (OTPs) in the United States. Patients completed an anonymous one-page survey. A linear mixed model analysis was used to predict distance traveled to the OTP. More than half (60%) the patients traveled <10 miles and 6% travelled between 50 and 200 miles to attend an OTP; 8% travelled across a state border to attend an OTP. In the multivariate model (n = 17,792), factors significantly (P < .05) associated with distance were, residing in the Southeast or Midwest, low urbanicity, area of the patient's ZIP code, younger age, non-Hispanic white race/ethnicity, prescription opioid abuse, and no heroin use. A significant number of OTP patients travel considerable distances to access treatment. To reduce obstacles to OTP access, policy makers and treatment providers should be alert to patients' commuting patterns and to factors associated with them. PMID:21776440

  15. Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

    Science.gov (United States)

    Attia, Evelyn; Blackwood, Kristy L; Guarda, Angela S; Marcus, Marsha D; Rothman, David J

    2016-06-01

    Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.

  16. Comparison of self-reported benzodiazepine use and urinalysis among consecutive treatment seekers at a tertiary care drug dependence treatment centre.

    Science.gov (United States)

    Pattanayak, Raman Deep; Jain, Raka; Ray, Rajat

    2010-01-01

    Information provided by drug dependent patients might be incomplete and/or discrepant. Benzodiazepines are frequently abused, but not necessarily reported, even bythe treatment seeking population. The study aims to compare the self reported benzodiazepine use with a quick and effective urinalysis method. A total of 51 consecutive adult patients were included after an informed consent during their first visit to a tertiary care drug dependence treatment centre. The socio-demographic and clinical details were recorded on a semi-structured proforma. Patients were specifically asked for ever, current and recent benzodiazepine use and thereafter ten ml urine sample was collected to perform urinalysis with cassette test for benzodiazepines. The sample, predominantly males, had a mean age of 37.86 +/-10.46 years. The common primary drugs of use were heroin (52.9%), alcohol (23.5%) and other opioids (21.6%). Drug use was uninterrupted in most of users (72.5%) and ranged from one to forty years. The recent benzodiazepine use was reported by 21.6% of all users whereas urinalysis by cassette test was positive in 50.9% of the treatment seekers. Denial among users was 69.2% and denial among negative self report was 45%. A poor level of agreement (K) was found between results of self-report and urinalysis for all the treatment seekers. Self report of benzodiazepine use is highly questionable among treatment seekers. The urinalysis with cassette test is a quick objective method which is recommended for routine screening.

  17. Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

    Science.gov (United States)

    Smyth, Daniel; Francheville, Jordan W; Rankin, Robin; Beck, Jeremy; Hoare, Connie; Materniak, Stefanie; German, Greg; Barrett, Lisa; Bunimov-Wall, Natalie

    2017-01-01

    The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: 1) Treatment effectiveness using intention-to-treat analysis; and 2) Patient treatment experience assessed using demographics, adverse events, and medication adherence. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.

  18. Benzodiazepine dependence and its prevention and treatment%苯二氮类药物依赖及其防治

    Institute of Scientific and Technical Information of China (English)

    李林艳; 徐建

    2012-01-01

    Benzodiazepines are mainly used to treat anxiety and insomnia. Prolonged use: of benzodiazepines can lead to physical and psychological dependence. The: mechanism of benzodiazepine dependence is related to central neurotransmitters such as ?-aminobutyric acid and glutamate acid. The risk factors for benzodiazepine dependence include drug selection, drug administration, and individual difference. The clinical manifestations of benzodiazepine dependence are increased tolerance to the drug, withdrawal symptoms, and psychological dependence. The treatment strategies for benzodiazepine dcpc;ndc;ncc include the drug withdrawal, adjuvant treatment with drug, substitntivc trcatmcnt, combincd thcrapy of Chinese and wcstcrn mcdicinc, and psychotherapy.%苯二氮类药物(BZD)主要用于治疗焦虑和失眠,长期使用可导致躯体及精神依赖.BZD依赖的发生机制与γ-氨基丁酸和谷氨酸等中枢神经递质有关.药物选择、给药方法 和个体差异是BZD依赖的影响因素.BZD依赖表现为药物耐受性增加、戒断症状和心理依赖.BZD依赖的治疗包括停药、药物辅助治疗、替代治疗、中西医结合治疗和心理治疗.

  19. Drug-dependent inpatients reporting continuous absence of spontaneous drug craving for the main substance throughout detoxification treatment.

    Science.gov (United States)

    De Los Cobos, José Pérez; Siñol, Núria; Trujols, Joan; Bañuls, Enrique; Batlle, Fanny; Tejero, Antoni

    2011-07-01

    Drug craving is considered to be an essential component of substance dependence. We aimed to characterise drug-dependent inpatients reporting continuous absence of subjective spontaneous drug craving. This is a 3 year chart-review study designed to compare drug-dependent inpatients who did not report craving everyday (non-cravers) and their counterparts who did (cravers). All participants were recruited consecutively and completed a 14 day detoxification treatment. Craving was defined as a desire to use the main detoxification substance. This substance was chosen by patients, who completed a craving visual analogue scale, the Beck Depression Inventory and the State-Trait Anxiety Inventory daily. The Temperament and Character Inventory and the Addiction Severity Index were also used. Of the 195 patients who completed the detoxification treatment, 45 (23.1%) were non-cravers and 32 (16.4%) were cravers. The main detoxification substances were alcohol, benzodiazepines, cannabis, cocaine, heroin and methadone. Non-cravers named methadone as the main detoxification substance more frequently than cravers, and benzoylecgonine was less frequently present in their urine at treatment entry. A decreased score on the Temperament and Character Inventory dimension of harm avoidance (i.e. trait anxiety) was the only independent predictor of absence of craving (odds ratio = 1.16, 95% confidence interval = 1.03-1.31). During admission, non-cravers had lower Beck Depression Inventory and State-Trait Anxiety Inventory scores than cravers. These differences were not accounted for by pharmacological treatment. Drug -dependent inpatients who report absence of craving are characterised by relatively low levels of depression and anxiety throughout detoxification treatment, and relatively low levels of trait anxiety. © 2010 Australasian Professional Society on Alcohol and other Drugs.

  20. The Adolescent Behavioral Activation Program: Adapting Behavioral Activation as a Treatment for Depression in Adolescence.

    Science.gov (United States)

    McCauley, Elizabeth; Gudmundsen, Gretchen; Schloredt, Kelly; Martell, Christopher; Rhew, Isaac; Hubley, Samuel; Dimidjian, Sona

    2016-01-01

    This study aimed to examine implementation feasibility and initial treatment outcomes of a behavioral activation (BA) based treatment for adolescent depression, the Adolescent Behavioral Activation Program (A-BAP). A randomized, controlled trial was conducted with 60 clinically referred adolescents with a depressive disorder who were randomized to receive either 14 sessions of A-BAP or uncontrolled evidenced-based practice for depression. The urban sample was 64% female, predominantly Non-Hispanic White (67%), and had an average age of 14.9 years. Measures of depression, global functioning, activation, and avoidance were obtained through clinical interviews and/or through parent and adolescent self-report at preintervention and end of intervention. Intent-to-treat linear mixed effects modeling and logistic regression analysis revealed that both conditions produced statistically significant improvement from pretreatment to end of treatment in depression, global functioning, and activation and avoidance. There were no significant differences across treatment conditions. These findings provide the first step in establishing the efficacy of BA as a treatment for adolescent depression and support the need for ongoing research on BA as a way to enhance the strategies available for treatment of depression in this population.

  1. A framework for conducting a national study of substance abuse treatment programs serving American Indian and Alaska native communities.

    Science.gov (United States)

    Novins, Douglas K; Moore, Laurie A; Beals, Janette; Aarons, Gregory A; Rieckmann, Traci; Kaufman, Carol E

    2012-09-01

    Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research. We developed a framework for studying these substance abuse treatment programs (n ≈ 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve. Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research. This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies.

  2. Evaluation of Jump into Action: A Program to Reduce the Risk of Non-Insulin Dependent Diabetes Mellitus in School Children on the Texas-Mexico Border.

    Science.gov (United States)

    Holcomb, J. David; Lira, Juanita; Kingery, Paul M.; Smith, D. W.; Lane, Dorothy; Goodway, Jackie

    1998-01-01

    Evaluated Jump into Action, a non-insulin dependent diabetes mellitus (NIDDM)-prevention program that encouraged students to eat well and exercise regularly to reduce NIDDM risks. Surveys of predominantly Hispanic fifth graders and their teachers at Texas-Mexico border schools indicated that the program increased NIDDM-prevention knowledge and…

  3. Successful treatment of dwarfism secondary to long-term steroid therapy in steroid-dependent nephrotic syndrome.

    Science.gov (United States)

    Sun, Linlin; Chen, Dongping; Zhao, Xuezhi; Xu, Chenggang; Mei, Changlin

    2010-01-01

    Prolonged steroid therapy is generally used for steroid-dependent nephrotic syndrome in pediatric patients. However, dwarfism secondary to a long-term regimen and its successful reverse is rarely reported. The underlying mechanism of dwarfism is still poorly understood, as both long-term steroid use and nephrotic syndrome may interact or independently interfere with the process of growth. Here, we present a 17-year-old patient with dwarfism and steroid-dependent nephrotic syndrome and the successful treatment by recombinant human growth factor and cyclosporine A with withdrawal of steroid. We also briefly review the current understanding and the management of dwarfism in pediatric patients with nephrotic syndrome.

  4. Treatment of steroid dependant cases of recurrent lepra reaction with a combination of thalidomide and clofazimine.

    Science.gov (United States)

    Ramu, G; Girdhar, A

    1979-10-01

    22 Adult Male Lepromatous patients suffering from recurrent lepra reaction have been allotted to either a regimen of combined treatment with Clofazimine and Thalidomide alone. The initial dosage of either of the drugs was 300 mg daily administered in divided doses of 100 mg three times a day. The preliminary assessment of the ongoing study, indicates that the combined treatment controls the reactional state more rapidly than monotherapy with Thalidomide alone. Results of treatment as regards relief of neuritis and arthritis are particularly gratifying. Four month.ases relapsed into reactional status from 2 days to 15 days. 5 cases on the combined therapy relapsed from one to three months. Three other cases required six months and three cases 8 months treatment before clofazimine could be withdrawn. It would appear that a maintenance therapy of 6 months with flofazimine would be necessary for maintaining the control of reactional episodes while employing this combined therapy.

  5. Treatment with Mycophenolat Mofetil of Steroid-Dependent Asthma—One Case of Severe Asthma

    Directory of Open Access Journals (Sweden)

    V. Backer

    2009-01-01

    Full Text Available Background. Some patients with severe nonallergic asthma can be difficult to treat with conventional therapy. Mycophenolat Mofetil (MMF is an immunosuppressive drug with multiple mechanisms. There is theoretical support of specific effect of MMF on severe asthma, in “difficult to treat” patients. The aim of the present case was to explore whether MMF had an effect in one case of severe refractory asthma. The patient. This case deals with one patient with very severe nonallergic treatment refractory asthma who experienced treatment failure on ordinary antiasthmatic treatment and severe adverse events to conventional immunosupressive treatment. She was then treated with MMF. Results. The patient experienced a gain in FEV1 and a reduction in the need for oral glucocorticosteroids as well as seldom need of when needed bronchodilator both during daytime and night. It therefore seems very interesting to examine the use of MMF for severe refractory asthma with further clinical studies and basic cellular trials.

  6. Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment

    NARCIS (Netherlands)

    Schulte, M.H.J.; Cousijn, J.; den Uyl, T.E.; Goudriaan, A.E.; van den Brink, W.; Veltman, D.J.; Schilt, T.; Wiers, R.W.

    2014-01-01

    Background: Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding

  7. Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment

    NARCIS (Netherlands)

    Schulte, Mieke H J; Cousijn, Janna; den Uyl, Tess E; Goudriaan, Anna E; van den Brink, Wim; Veltman, Dick J; Schilt, Thelma; Wiers, Reinout W

    2014-01-01

    BACKGROUND: Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding

  8. Dependence of the elastic strain coefficient of copper on the pre-treatment

    Science.gov (United States)

    Kuntze, Wilhelm

    1950-01-01

    The effect of various pre-treatments on the elastic strain coefficient (alpha) (defined as the reciprocal of the modulus of elasticity E) (Epsilon) and on the mechanical hysteresis of copper has been investigated. Variables comprising the pre-treatments were pre-straining by stretching in a tensile testing machine and by drawing through a die, aging at room and elevated temperatures and annealing. The variation of the elastic strain coefficient with test stress was also investigated.

  9. Maintaining Treatment Fidelity of Mindfulness-Based Relapse Prevention Intervention for Alcohol Dependence: A Randomized Controlled Trial Experience

    Directory of Open Access Journals (Sweden)

    Aleksandra E. Zgierska

    2017-01-01

    Full Text Available Background. Treatment fidelity is essential to methodological rigor of clinical trials evaluating behavioral interventions such as Mindfulness Meditation (MM. However, procedures for monitoring and maintenance of treatment fidelity are inconsistently applied, limiting the strength of such research. Objective. To describe the implementation and findings related to fidelity monitoring of the Mindfulness-Based Relapse Prevention for Alcohol Dependence (MBRP-A intervention in a 26-week randomized controlled trial. Methods. 123 alcohol dependent adults were randomly assigned to MM (MBRP-A and home practice, adjunctive to usual care; N=64 or control (usual care alone; N=59. Treatment fidelity assessment strategies recommended by the National Institutes of Health Behavior Change Consortium for study/intervention design, therapist training, intervention delivery, and treatment receipt and enactment were applied. Results. Ten 8-session interventions were delivered. Therapist adherence and competence, assessed using the modified MBRP Adherence and Competence Scale, were high. Among the MM group participants, 46 attended ≥4 sessions; over 90% reported at-home MM practice at 8 weeks and 72% at 26 weeks. They also reported satisfaction with and usefulness of MM for maintaining sobriety. No adverse events were reported. Conclusions. A systematic approach to assessment of treatment fidelity in behavioral clinical trials allows determination of the degree of consistency between intended and actual delivery and receipt of intervention.

  10. Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Program.

    Science.gov (United States)

    Tannuri, Uenis; Barros, Fabio de; Tannuri, Ana Cristina Aoun

    2016-09-01

    The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel. This set of procedures constitutes what is called an Intestinal Rehabilitation Program. This therapy was used in 16 children in periods ranging from 8 months to 7.5 years, with survival in 75% of the cases. Finally, the last resort to be used in children with complete resection of the small bowel is an intestinal transplant. However, to date there is no record of a Brazilian child that has survived this procedure, despite it being attempted in seven patients. We conclude that the results of the intestinal rehabilitation program are encouraging for the continuation of this type of treatment and stimulate the creation of the program in other pediatric care institutions.

  11. Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Uenis Tannuri

    Full Text Available Summary The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel. This set of procedures constitutes what is called an Intestinal Rehabilitation Program. This therapy was used in 16 children in periods ranging from 8 months to 7.5 years, with survival in 75% of the cases. Finally, the last resort to be used in children with complete resection of the small bowel is an intestinal transplant. However, to date there is no record of a Brazilian child that has survived this procedure, despite it being attempted in seven patients. We conclude that the results of the intestinal rehabilitation program are encouraging for the continuation of this type of treatment and stimulate the creation of the program in other pediatric care institutions.

  12. Reduced albuminuria during early and aggressive antihypertensive treatment of insulin-dependent diabetic patients with diabetic nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Andersen, A R; Smidt, U M

    1981-01-01

    nephropathy. Mean age of the patients was 30 yr. All patients had a diastolic blood pressure greater than or equal to 95 mm Hg. Metoprolol, hydralazine, and furosemide or thiazide were used as antihypertensives. During the 12-mo treatment period, BP decreased from 151/104 to 133/85 mm Hg (P less than 0...... hypertension is an early feature of diabetic nephropathy in young insulin-dependent patients. Early and aggressive treatment of that condition decreases albuminuria, probably due to reduced intraglomerular filtration pressure. Whether sustained reduction in arterial blood pressure to near-normal levels during...

  13. SGOTL: A Computer Program for Modeling High-Resolution, Height-Dependent Gravity Effect of Ocean Tide Loading

    Directory of Open Access Journals (Sweden)

    Cheinway Hwang Jiu-Fu Huang

    2012-01-01

    Full Text Available SGOTL, a computer package coded in FORTRAN, has been developed to model the gravity effect due to ocean tide loading (OTL, especially for a coastal station with large ocean tides. SGOTL uses a regional and a global tide model to account separately for near (inner and far (outer zone contributions, and optimizes an inner-zone region and grid interval for numerical convolution. Height dependent Green¡¦s functions for Newtonian and elastic effects are developed. The coastline is defined by the full-resolution GMT shoreline, and optionally a digital elevation model (DEM. A case study using gravity observations at the Hsinchu superconducting gravity station and some offshore islands around the Taiwan Strait suggests that SGOTL outperforms some selected global OTL programs and achieves an accuracy of 0.1 μGal for 8 leading tidal constituents.

  14. Treatment-dependent and treatment-independent risk factors associated with the risk of diabetes-related events

    DEFF Research Database (Denmark)

    Wilke, Thomas; Mueller, Sabrina; Groth, Antje

    2015-01-01

    BACKGROUND: The aim of this study was to analyse which factors predict the real-world macro-/microvascular event, hospitalisation and death risk in patients with type 2 diabetes mellitus. Furthermore, we aimed to investigate whether there exists both an under- and over-treatment risk...... of these patients. METHODS: We used a German claims/clinical data set covering the years 2010-12. Diabetes-related events were defined as (1) macro-, (2) microvascular events leading to inpatient hospitalisation, (3) other hospitalisations with type 2 diabetes mellitus as main diagnosis, (4) all-cause death and (5......) a composite outcome including all event categories 1-4. Factors associated with event risk were analysed by a Kaplan-Meier curve analysis and by multivariable Cox regression models. RESULTS: 229,042 patients with type 2 diabetes mellitus (mean age 70.2 years; mean CCI 6.03) were included. Among factors...

  15. Cigarette dependence and depressive symptoms as predictors of smoking status at five-year follow-up after a workplace smoking cessation program.

    Science.gov (United States)

    Nieva, Gemma; Comín, Marina; Valero, Sergi; Bruguera, Eugeni

    2017-10-01

    Workplace smoking cessation interventions increase quit rates compared to no treatment or minimal interventions. However, most studies report data up to one year. This study aims to evaluate long-term effects of a worksite smoking cessation intervention based on cognitive behavioral cessation groups combined with first-line medications, and determine to what extent cigarette dependence (FTCD) and depressive symptoms may influence results at five-year follow-up. Participants were invited to answer a short survey five years after starting the program. A total of 90.4% (n=227) of those who had attended at least one treatment session and were alive, completed the survey. At the five-year follow-up, 29.5% participants reported continuous abstinence. Low scores in the FTCD and low depressive symptoms at baseline predicted continuous abstinence. Three out of four continuous abstainers at twelve months remained abstinent at the five-year follow-up. The study shows that workplace smoking cessation interventions have long-term effects and supports the traditional one-year follow-up period to assess smoking cessation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Uso potencial dos anticonvulsivantes no tratamento ambulatorial da dependência de álcool Potential use of the anticonvulsants in the outpatient treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Luís André Castro

    2006-01-01

    Full Text Available Atualmente três medicações (dissulfiram, naltrexona e acamprosato são aprovadas pela Food and Drug Administration (FDA para tratar a dependência de álcool. As drogas anticonvulsivantes clássicas são raramente empregadas como alternativa por causa dos seus efeitos colaterais, mas a sua última geração pode ser útil. Os anticonvulsivantes podem ser uma alternativa aos benzodiazepínicos (BZD e a outros tratamentos farmacológicos na prevenção de complicações na desintoxicação por apresentarem ausência de propriedades aditivas e um melhor perfil de efeitos adversos do que os anticonvulsivantes clássicos. Anticonvulsivantes como carbamazepina, ácido valpróico, gabapentina e topiramato demonstraram-se excelentes tratamentos para síndrome de abstinência do álcool e prevenção de recaídas. Embora nenhum desses agentes tenha sido aprovado pela FDA, existe uma crescente evidência na literatura que apóia o seu uso.Currently three medications (disulfiram, naltrexone and acamprosate are approved by the FDA to treat alcohol dependence by the FDA. The classical anticonvulsive drugs are rarely employed as an alternative because of their side effects, but the latest generation of anticonvulsants could be useful. The anticonvulsants can be a alternative to BZD and other pharmacological treatments in the prevention of complications during the detoxification therapy, because of the absence of addictive properties and a better adverse effects profile than classical anticonvulsant drugs. Anticonvulsants such as carbamazepine, valproic acid, gabapentin and topiramate have shown to be excellent treatment for alcohol withdrawal and for the prevention of alcohol relapse. Although none of these agents have been approved by the FDA yet, there is growing evidence in the literature to support their use.

  17. Dual diagnosis capability in mental health and addiction treatment services: an assessment of programs across multiple state systems.

    Science.gov (United States)

    McGovern, Mark P; Lambert-Harris, Chantal; Gotham, Heather J; Claus, Ronald E; Xie, Haiyi

    2014-03-01

    Despite increased awareness of the benefits of integrated services for persons with co-occurring substance use and psychiatric disorders, estimates of the availability of integrated services vary widely. The present study utilized standardized measures of program capacity to address co-occurring disorders, the dual diagnosis capability in addiction treatment and dual diagnosis capability in mental health treatment indexes, and sampled 256 programs across the United States. Approximately 18 % of addiction treatment and 9 % of mental health programs met criteria for dual diagnosis capable services. This is the first report on public access to integrated services using objective measures.

  18. Correlates of Nine-Month Retention following Interim Buprenorphine-Naloxone Treatment in Opioid Dependence: A Pilot Study

    Directory of Open Access Journals (Sweden)

    A. Håkansson

    2016-01-01

    Full Text Available Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT in opioid-dependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent (n=30. While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT (p=0.09, urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout (p<0.01, in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout.

  19. Is prosthodontic treatment age-dependent in patients 60 years and older in Public Dental Services?

    Science.gov (United States)

    Hiltunen, K; Vehkalahti, M M; Mäntylä, P

    2015-06-01

    Prosthodontic treatment is a common procedure for the elderly as tooth loss is a reality in old age. Dentists take care of increasingly older patients with physiological age manifesting as cognitive impairment, frailty or multiple chronic diseases or who have side effects of medicines. We evaluated how patients' age affects prosthodontic treatment choice and whether we could identify the age when a change in practice occurs. In addition, we determined how common the treatment method of fixed prostheses is among patients aged 60 years or over in Public Dental Services (PDS) and how common rehabilitation of dentition with new dentures is compared with repair of existing dentures. Our data cover all patients aged 60 years and older (n = 130,060) treated in Helsinki PDS in 2007-2012. Data were aggregated into seven groups: 60-64, 65-69, 70-74, 75-79, 80-84, 85-89, and 90 years and over. During the 6-year period, the mean annual number of the population was about 114,000 and the mean annual number of patients treated with prosthodontics 1700. Prosthodontic treatment choices (repair, removable prosthodontics, fixed prostheses, fibre-reinforced composite fixed prostheses) vary by age; the older the patient, the rarer fixed or fibre-reinforced composite fixed prostheses and removable prostheses and the more frequent repairs (P < 0.001). Denture repair was virtually the only treatment that patients over 90 years received. Based on our results, the age at which prosthodontic treatment practices in PDS change is around 70 years. Beyond this age, fixed prosthodontic treatment modalities are very rare and repairs are more common.

  20. Antiretroviral treatment knowledge and stigma--implications for programs and HIV treatment interventions in rural Tanzanian populations.

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    Abela Mpobela Agnarson

    Full Text Available OBJECTIVE: To analyse antiretroviral treatment (ART knowledge and HIV- and ART-related stigma among the adult population in a rural Tanzanian community. DESIGN: Population-based cross-sectional survey of 694 adults (15-49 years of age. METHODS: Latent class analysis (LCA categorized respondents' levels of ART knowledge and of ART-related stigma. Multinomial logistic regression assessed the association between the levels of ART knowledge and HIV- and ART-related stigma, while controlling for the effects of age, gender, education, marital status and occupation. RESULTS: More than one-third of men and women in the study reported that they had never heard of ART. Among those who had heard of ART, 24% were east informed about ART, 8% moderately informed, and 68% highly informed. Regarding ART-related stigma, 28% were least stigmatizing, 41% moderately stigmatizing, and 31% highly stigmatizing toward persons taking ART. Respondents that had at least primary education were more likely to have high levels of knowledge about ART (OR 3.09, 95% CI 1.61-5.94. Participants highly informed about ART held less HIV- and ART-related stigma towards ART patients (OR 0.26, 95% CI 0.09-0.74. CONCLUSION: The lack of ART knowledge is broad, and there is a strong association between ART knowledge and individual education level. These are relevant findings for both HIV prevention and HIV treatment program interventions that address ART-related stigma across the entire spectrum of the community.