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Biomedical subjects

B C Wallace

Publications and source records attributed to B C Wallace.

14 recordsLinked to original sources
PubMed1998

Milk leakage in nonlactating women: a randomized clinical trial evaluating a polyvinyl chloride device versus disposable breast pads.

A randomized clinical trial was carried out to evaluate the safety and helpfulness of the LactaPrev System (LPS) compared with disposable pads for milk leakage management for postpartum, nonlactating women (those who do not breastfeed). Fifty-five women completed the single-blind, randomized trial. Participants wore each device on each breast concurrently. Assignment of the LPS or pad to each breast was done randomly. Fifty-eight percent of participants preferred the LPS. The longer the participation in the study, which correlated with the duration of milk leakage, the greater the preference (p = 0.05). Preference was related to bra size (p = 0.05). The smaller the bra size, the greater the preference for the LPS. There was no greater incidence of complications from the LPS compared with the disposable breast pad.

Adolescent↗
PubMed1997

Managing milk leakage in breastfeeding women: a clinical trial evaluating a polyvinyl chloride device versus disposable nursing pads.

The object of this clinical trial was to evaluate the effectiveness and to investigate possible problems associated with the use of a polyvinyl chloride (PVC) device ("blis") compared to a disposable nursing pad, for controlling milk leakage among nursing mothers. Seventy-one women completed the single blind, paired comparison, randomized trial. Among the 28 women having a strong early preference, 21 opted for the PVC device (p = 0.01). Of the 37 women experiencing excessive milk leakage who preferred one of the devices, 24 preferred the PVC device (p = 0.05). There was no evidence that one device caused more problems or feeding complications than the other. This study is important in alleviating anxiety about device safety while promoting breastfeeding in mothers fearful of leaking at inopportune times.

Adolescent↗
PubMed1991

Crack cocaine: what constitutes state of the art treatment?

The paper presents a standard against which treatments should be measured; it recognizes the importance of a biopsy-chosocial approach to crack addiction, individualized assessment of patients to determine their needs, matching patients to interventions of appropriate intensity, timing the delivery of specific interventions in accordance with the phase of recovery a patient is negotiating, delivering relapse prevention, and appreciating crack smokers' characteristics. Summary analysis of two state of the art outpatient treatment models permits identification of key features of such programs. Analysis reveals that outpatient programs achieve excellence in service delivery to crack patients by referring the most severely addicted to inpatient treatment first and providing comprehensive and intensive outpatient services on a nearly daily basis for six months to a year. Recommendations for policymakers, administrators, treatment professionals, and researchers are provided in light of the paper's analysis.

Ambulatory Care↗
PubMed1990

Crack cocaine smokers as adult children of alcoholics: the dysfunctional family link.

The paper presents data on a sample (N = 61) of crack-cocaine-dependent patients who were treated on an inpatient detoxification unit. The investigation explores adult child of an alcoholic status as a possible etiological factor in the development of addiction to crack cocaine. Data suggests the prevalence of adult child of an alcoholic (ACA) status in this population (61%). Adult child of a dysfunctional family (ACDF) status is also explored as possibly playing an important role as an antecedent or determinant of addiction. The vast majority of patients are adult children of a dysfunctional family (ACDF) of one kind or another (97%); for example, patients experienced domestic violence (25%) and physical abuse (28%). Perhaps as a result of less than ideal object relations in dysfunctional families, many patients were also diagnosed as having personality disorders (31%) or affective disorders (21%). Case vignettes augment research findings, supporting the contention that childhood development in a dysfunctional family constitutes a specific etiological factor in the development of crack cocaine dependence. The paper recommends matching crack-addicted ACAs/ACDFs to treatment modalities that address and remediate the personality and emotional problems that characterize ACAs/ACDFs.

Adolescent↗
PubMed1989

Psychological and environmental determinants of relapse in crack cocaine smokers.

The paper reviews approaches to relapse in the treatment of cocaine abusers. Approaches reveal a common mechanism underlying relapse that involves drug craving, recall of euphoria, environmental cues, denial, myths of being able to sell or use drugs, and painful affect states necessitating use of a multifaceted clinical technique. Empirical validation of a common mechanism underlying relapse establishes a typology of psychological and environmental determinants of relapse for crack cocaine smokers (N = 35) who relapse after hospital detoxification and return a second time. Major findings are that relapse follows a painful emotional state (40%), failure to enter arranged aftercare treatment (37%), or encounters with conditioned environmental stimuli (34%), and involves narcissistic psychopathology and denial (28.5%) and interpersonal stress (24%); 85.7% involve multideterminants. Case examples illustrate the role of multideterminants in relapse. The paper educates clinicians to the integrated theory and multifaceted clinical technique necessary for efficacious treatment of cocaine patients, while the typology predicts probable relapse situations.

Adult↗
PubMed1989

Relapse prevention in psychoeducational groups for compulsive crack cocaine smokers.

The paper presents a model of relapse prevention that utilizes metaphor, education, and psychodynamic and cognitive-behavioral principles in psychoeducational groups for compulsive crack cocaine smokers during inpatient detoxification. Relapse prevention teaches engagement in preventive alternative behaviors after inpatient detoxification. Clinical interventions impress patients with the nature of their psychological vulnerability to internal and external dangers and the importance of aftercare treatment post detoxification to receive needed support negotiating high risk situations. The paper provides a detailed description of the group process and of the actual interventions the clinician utilizes, thereby expanding clinical options on what to do and say when educating patients on relapse. Interventions prepare patients to negotiate the numerous high risk situations they will encounter after inpatient treatment that could easily trigger relapse. Psychoeducation provides patients with a cognitive and intellectual framework in which to understand the process of psychotherapy, the difficulties regulating affect and self esteem, and how aftercare treatment addresses their psychological problems and decreases chances of relapse.

Cocaine↗
PubMed1987

Cocaine dependence treatment on an inpatient detoxification unit.

A psychoanalytic-developmental treatment model includes individual and group psychotherapy which enables compulsive freebase cocaine smokers to articulate explanations for their drug dependence. Relapse prevention education includes recommendations for aftercare treatment. Psychosocial history and DSM-III diagnostic data (N = 31) reveals histories of dysfunctional family dynamics, high rates of depressive disorders, and personality disorders. A case history illustrates application of our treatment model and problems in currently available post-detox treatment. Residential therapeutic communities (TCs) need to offer variable program lengths and specialized crack residences in therapeutic milieus with trained clinical staff. TC programs should offer inpatient psychotherapy, family therapy, and provide direct entrance into program affiliated outpatient services. Recommendations for outpatient services include adjuncts to established anonymous self-help group networks in order to reduce changes of relapse.

Adolescent↗
PubMedDate not supplied

Treating crack cocaine dependence: the critical role of relapse prevention.

In order to adequately address the treatment needs of crack cocaine dependent persons, a multidimensional approach to relapse prevention must be utilized. The value of a biopsychosocial model of crack addiction and the concept of phases of recovery in providing a rationale for the recommended approach to relapse prevention are emphasized. Research findings on the determinants of relapse for crack dependent patients and the psychosocial characteristics of the crack dependent individual justify the utility of certain relapse prevention strategies. Specifically, an approach to relapse is advocated that includes the provision of pharmacological adjuncts, psychoeducation on the multideterminants of relapse, and psychotherapy that attempts to remediate underlying psychological problems that are typically found in crack dependent patients.

Cocaine↗
PubMedDate not supplied

Treating crack cocaine dependence: the critical role of relapse prevention.

In order to adequately address the treatment needs of crack cocaine dependent persons, a multidimensional approach to relapse prevention must be utilized. The value of a biopsychosocial model of crack addiction and the concept of phases of recovery in providing a rationale for the recommended approach to relapse prevention are emphasized. Research findings on the determinants of relapse for crack dependent patients and the psychosocial characteristics of the crack dependent individual justify the utility of certain relapse prevention strategies. Specifically, an approach to relapse is advocated that includes the provision of pharmacological adjuncts, psychoeducation on the multideterminants of relapse, and psychotherapy that attempts to remediate underlying psychological problems that are typically found in crack dependent patients.

Animals↗
PubMedDate not supplied

Cross-cultural counseling with the chemically dependent: preparing for service delivery within a culture of violence.

This article prepares the clinician delivering chemical dependency treatment for more effective work in therapeutic dyads where there are racial, ethnic, or other "differences" between client and therapist. The objective is to prepare clinicians for service delivery within the present culture of violence and for the receipt of additional training in cross-cultural counseling and trauma-resolution psychotherapy. Social learning and unconscious processes are reviewed in order to explain how this culture of violence operates and impacts treatment. The way in which chemically dependent clients of color--especially African-Americans, Native Americans, and Latinos--have been impacted by both personal and cultural trauma is illustrated by a case example. The resolution of clients' personal trauma by properly trained clinicians is presented as relapse prevention and the clients' best defense against becoming a victim of violence and racism. The article ends with a brief description of the recommended clinical technique for this kind of work, and a statement of needed research.

Adult↗