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Biomedical subjects

A J Swanson

Publications and source records attributed to A J Swanson.

15 recordsLinked to original sources
PubMed2001

The Key Extended Entry Program (KEEP): a methadone treatment program for opiate-dependent inmates.

The Key Extended Entry Program (KEEP) is the only known methadone treatment program for incarcerated opiate-dependent inmates in the United States. Initiated in 1987, KEEP performs approximately 18,000 detoxifications and 4,000 admissions for methadone treatment per year. Of those methadone treatment patients discharged to the community, mostly to outpatient KEEP programs, 74-80% report to their designated program. Recidivism rates reveal that 79% of KEEP patients were incarcerated again only once or twice during a recent 11-year period. Finally, KEEP data point to the importance of dedicating slots in the community for released inmates and maintaining them on sufficient blocking doses to eliminate the craving for heroin. About 6% of KEEP patients, some with mental illness have a high incidence of recidivism.

Female↗
PubMed1999

Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients.

The effect of motivational interviewing on outpatient treatment adherence among psychiatric and dually diagnosed inpatients was investigated. Subjects were 121 psychiatric inpatients, 93 (77%) of whom had concomitant substance abuse/dependence disorders, who were randomly assigned to: a) standard treatment (ST), including pharmacotherapy, individual and group psychotherapy, activities therapy, milieu treatment, and discharge planning; or b) ST plus motivational interviewing (ST+MI), which involved 15 minutes of feedback on the results of a motivational assessment early in the hospitalization, and a 1-hour motivational interview just before discharge. Interviewers utilized motivational techniques described in Miller and Rollnick (1991), such as reflective listening, discussion of treatment obstacles, and elicitation of motivational statements. Results indicated that the proportion of patients who attended their first outpatient appointment was significantly higher for the ST+MI group (47%) than for the ST group (21%; chi2 = 8.87, df = 1, p<.01) overall, and for dually diagnosed patients (42% for ST+MI vs. 16% for ST only; chi2 = 7.68, df = 1, p<.01). Therefore, brief motivational interventions show promise in improving outpatient treatment adherence among psychiatric and dually diagnosed patients.

Adult↗
PubMed1990

Aggressive children in a day treatment program: changed outcome and possible explanations.

An earlier study (Gabel, Finn & Ahmad, 1988) of severely disturbed children treated in a day hospital program, found that outcome was particularly poor for children with preadmission histories of severe aggressive/destructive behavior. The study reported here compares the outcome in a more recent group of children treated in the same setting with the earlier group's outcome. The recent group of children, like the earlier one, was made up of youngsters who were often from dysfunctional and abusive families. Outcome for aggressive children, including aggressive children with histories of suspected child abuse/maltreatment, was significantly improved. Possible reasons for this improvement in outcome in terms of programmatic changes that had occurred are discussed.

Aggression↗
PubMed1990

Outcome in children's day treatment: relationship to preadmission variables.

Outcome in children's day treatment has been studied infrequently. There is little information available to suggest which types of children may or may not benefit from day treatment services. In an earlier study, Gabel et al. (1988) found that preadmission factors related to parental/family dysfunction (i.e., suspected child abuse/maltreatment and parental substance abuse) and preadmission factors related to child dysfunction (i.e., suicidality and severe aggressive/destructive behavior) correlated with poor outcome in day treatment by the criterion of a recommended out-of-home placement on discharge. Of these factors, severe aggressive/destructive behavior was most important in predicting outcome. In this study, discharges from two additional centers were reviewed to determine if these findings could be generalized. There is support for the earlier results when the three centers' discharges are considered as a whole but not when the two new centers' discharges are considered separately. Reasons for these findings are discussed. Further study of these preadmission variables, especially severe aggressive/destructive behavior, as possible predictors of poor outcome in children's day treatment, seems warranted.

Aggression↗
PubMed1990

A long-term follow-up study of total meniscectomy in children.

The long-term effects of single meniscectomy in 89 children have been analyzed at an average of 16.8 years after surgery. Seventy-four percent were pleased with the outcome, but only 52% or 58% had objectively satisfactory results according to the two scoring systems used. Significantly poorer results were achieved with lateral meniscectomies. The range of movement was significantly decreased after lateral meniscectomy. Minor instabilities were recorded in 45% of the patients and major instabilities in 15%. Anteroposterior and rotatory instabilities were objectively measured, and a significant increase was noted in knees that had lateral meniscectomy. Grade I gonarthrosis was recorded in 39% of the surgically treated knees and Grades II and III gonarthroses in 9%. The joint space was significantly reduced in all knees irrespective of the injured compartment.

Adolescent↗
PubMed1987

Manic depressive psychosis with mental retardation and flexion deformities: a clinical and cytogenetic study.

Five mentally handicapped patients are described in whom a bipolar manic depressive psychosis was associated with flexion deformities, involving principally the fingers. The effect of increasing degrees of retardation on the clinical presentation of the affective psychosis is discussed. Surgical treatment of the flexion deformity brought about considerable improvement in one patient. These five patients were further investigated cytogenetically using high resolution banding techniques. The results obtained were interesting but inconclusive. There would seem to be a definite place for further cytogenetic investigations of some of the more distinctive psychotic disorders using this technique.

Bipolar Disorder↗
PubMed1983

Haemarthrosis of the knee joint.

One hundred and twenty knee injuries diagnosed as traumatic haemarthrosis were reviewed. All were initially treated by aspiration and splintage. None had major ligamentous or major bony injury clinically or radiographically when first seen. The incidence of anterior cruciate damage was 17 per cent and that of crack fracture was 29 per cent. Many of those aged under thirty had anterior cruciate damage. Those over thirty commonly had crack fractures. Sixty-five per cent of the patients had no symptom when reviewed. A total of 9.9 per cent needed further operations. The younger patients, especially those with an injury from sport, should be referred to a specialist knee clinic for further management.

Adolescent↗
PubMed1983

Fractured neck of femur. Pattern of incidence and implications.

Projected figures for the 1975 incidence of fracture neck of femur in Dundee are compared with the actual figures. Analysis of the incidence in 1952, 1975 and 1980, relating it to age and other factors, shows both an increase in the true incidence and a marked rise in the total number over the period. The length of stay in an Orthopaedic ward is considerably increased if the patient then has to be admitted to a long-stay bed. This length of inpatient stay and the increased incidence continues to raise the demand on acute Orthopaedic female beds.

Age Factors↗
PubMed1983

The incidence of prepatellar neuropathy following medial meniscectomy.

The frequency of lasting prepatellar dysesthesia following medial meniscectomy has been under-estimated. Analysis of 87 patients undergoing medial meniscectomy in a prospective study with a minimum follow-up period of six months showed dysesthesia in 63.2% immediately after operation. The condition persisted in 44.4% at six months. Female patients had a higher incidence of dysesthesia than male patients and had a slower recovery rate. Numbness had a less favorable prognosis than paresthesia.

Female↗