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Biomedical subjects

G R Bond

Publications and source records attributed to G R Bond.

16 recordsLinked to original sources
PubMed1992

How treatment of persons with serious mental illness is portrayed in undergraduate psychology textbooks.

Information on treatment and rehabilitation approaches for persons with serious mental illness was examined in 28 introductory and 14 abnormal psychology textbooks. Both drug and hospital treatment received significantly more coverage than did community rehabilitation approaches in both types of texts. In introductory texts, community rehabilitation received no more coverage than lobotomy. Texts were also examined for their mention of 12 community rehabilitation approaches in current practice. Both types of texts gave a dated presentation of mental health services. However, description of community approaches in abnormal textbooks was more detailed and research-based than in introductory texts. It was hypothesized that textbook coverage mirrors the lack of psychiatric rehabilitation research reported in psychological journals.

Curriculum↗
PubMed1992

Antivenin administration for Centruroides scorpion sting: risks and benefits.

STUDY OBJECTIVES: To assess the clinical severity of envenomation by the Centruroides scorpion in young children; the potential benefit of antivenin administration with regard to time to resolution of symptoms, prevention of hospitalization, and prevention of invasive intervention; and the risk of acute and delayed hypersensitivity reaction. DESIGN: Retrospective chart review with follow-up contact. SETTING: Referral toxicology management center. TYPE OF PARTICIPANTS: Children less than 10 years of age experiencing severe Centruroides scorpion envenomation. INTERVENTIONS: Administration of goat serum-derived anti-Centruroides antivenin. MEASUREMENTS AND MAIN RESULTS: Stings in young children may be life threatening, resulting in extreme neuromuscular activity, tachycardia, and respiratory distress. Administration of anti-Centruroides antivenin resulted in rapid resolution of all symptoms without acute reaction in all 12 patients so treated; 58% of patients treated with antivenin had a delayed onset of rash or symptoms of serum sickness. CONCLUSION: The benefit of rapid resolution of life-threatening symptoms and potential for outpatient management of severe envenomation in young children may justify the risk of acute and delayed reaction associated with antivenin use in this group. The use of antivenin for the less severe envenomation common in older children and adults may subject them to unjustified risk.

Animals↗
PubMed1991

Variations in an assertive outreach model.

The author reviews recent research findings examining variations in an assertive outreach model. Mental health system and client characteristics that have influenced program implementation are discussed.

Community Mental Health Services↗
PubMed1991

Assertive community treatment: correcting some misconceptions.

Discusses historical, policy, and research perspectives on assertive community treatment (ACT) and their relationship to 5 commentaries accompanying our recent article (Bond et al., 1990). Collectively, the commentaries focused on self-help groups, missing the point of the study. Further, the commentaries contained several misconceptions centering on a confusion between deliberate sampling based on policy-driven considerations and self-selection into voluntary organizations. In the time since the Stein and Test (1980) demonstration, programs based on ACT principles have become one of the dominant approaches to community mental health services, especially for consumers who do not readily use office-based treatment. The research foundation is robust and is rapidly evolving. Some community psychologists may be responding to outdated and inaccurate stereotypes of mental health services.

Assertiveness↗
PubMed1990

Assertive community treatment for frequent users of psychiatric hospitals in a large city: a controlled study.

Evaluated a large-city adaptation of the assertive community treatment (ACT) model (Stein & Test, 1980). Outcomes were examined after 1 year for 82 clients, averaging over 17 lifetime psychiatric hospitalizations, randomly assigned either to ACT or to a drop-in (DI) center. After 1 year, 76% of the ACT clients and only 7% of DI clients were involved in the respective programs. The ACT team averaged 2 home and community visits per week to each client. ACT clients averaged significantly fewer state hospital admissions and state hospital days than did DI clients. ACT clients reported greater satisfaction with program services, fewer contacts with the police, and less difficulty with practical problems associated with psychiatric readmission. More ACT clients were known to have stable community housing. Annual per-client treatment costs for ACT were estimated to be $1,500 less than for DI.

Adolescent↗
PubMed1990

An ovine model of maternal iron poisoning in pregnancy.

An ovine model of maternal iron poisoning in pregnancy was used to examine the placental transport of deferoxamine and ferrioxamine and to follow maternal and fetal serum iron concentrations when maternal serum iron levels exceeded total iron-binding capacity. Ewes in the third stage of gestation underwent hysterotomy and delivery of the fetal head through an abdominal incision while under ketamine and halothane anesthesia. The fetal external jugular vein was catheterized for sampling of venous blood while the fetus remained in utero. Administration of deferoxamine mesylate or ferrioxamine mesylate IV to ewes was not accompanied by measurable deferoxamine or ferrioxamine in fetal blood. In a final experiment, four gravid ewes in a control group received 2 mg/kg maternal body wt iron IV over 60 minutes. An experimental group comprising another four ewes received similar doses of iron but then received 50 mg/kg deferoxamine mesylate IV over 15 minutes. Control and deferoxamine ewes reached similar peak maternal serum iron concentrations (2,479 +/- 266 and 2,121 +/- 343 micrograms/dL, respectively). The markedly elevated maternal serum iron concentrations were not accompanied by meaningful elevations in fetal serum iron levels over baseline values. Maternal deferoxamine infusion resulted in a more rapid fall in maternal serum iron concentrations but had no effect on fetal serum iron levels. The ovine fetus appears to be protected from elevated maternal serum iron concentrations in the last trimester of pregnancy. It could not be demonstrated that meaningful quantities of deferoxamine or ferrioxamine cross the placenta in the last trimester.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Use of the MANTRELS score in childhood appendicitis: a prospective study of 187 children with abdominal pain.

We report an evaluation of the MANTRELS clinical score in predicting appendicitis in a prospectively studied pediatric population presenting with abdominal pain. One hundred eighty-nine independent episodes from 187 children 2 to 17 years old were studied. For the groups as a whole and for the individual groups less than 16 years old, the score failed to satisfactorily discriminate those with appendicitis from those without. Had the MANTRELS score been used to determine observation and laparotomy in our patients, 21 additional patients would have been unnecessarily hospitalized, and 16 would have been subjected to unnecessary laparotomies. One patient would have received appropriate intervention earlier. In the 40 children 16 and 17 years old, the MANTRELS score adequately distinguished the two groups. A seven-variable discriminant function, derived from stepwise discriminant analysis, performed slightly better but showed essentially the same findings as the MANTRELS score. We believe the MANTRELS score failed to predict appendicitis in younger children because it does not contain variables that allow for separation of appendicitis from the numerous other conditions mimicking it in the pediatric population. The clinician remains the best judge of the acute abdomen in the pediatric age group.

Abdominal Pain↗
PubMed1990

Occult carbon monoxide poisoning in an infant.

The diagnosis of occult carbon monoxide poisoning in children is a difficult problem and may be frequently overlooked. An infant with recurrent episodes of unrecognized CO exposure and subsequent neurologic deterioration is presented. A clue to the diagnosis in this case was the finding of basal ganglia abnormalities on computed tomography. Clinical findings, etiology, and treatment of CO poisoning are reviewed. We suggest that CO toxicity should be suspected in any child with acute or recurrent neurologic deterioration.

Basal Ganglia Diseases↗
PubMed1990

Acute lead poisoning in nursing home and psychiatric patients from the ingestion of lead-based ceramic glazes.

To our knowledge, acute inorganic lead poisoning from single ingestions of lead compounds has been only rarely reported. During a 14-month period, we were contacted regarding eight instances of acute ingestions of liquid lead-based ceramic glazes by mentally impaired residents of nursing homes or psychiatric facilities participating in ceramic arts programs. While some ingestions did not cause toxic effects, some patients developed acute lead poisoning characterized by abdominal pain, anemia, and basophilic stippling of red blood cells. In the blood of several patients, lead concentrations were far above normal (4 to 9.5 mumol/L). Urinary lead excretions were tremendously elevated during chelation therapy, with one patient excreting 535.9 mumol/L of lead during a 6-day period, the largest lead excretion ever reported in a patient suffering from acute lead poisoning, to our knowledge. All patients recovered following supportive care and appropriate use of chelating agents. Lead-based glazes are commonly found in nursing homes and psychiatric facilities. We suspect that acute or chronic lead poisoning from the ingestion(s) of lead-based ceramic glazes may be an unrecognized but not uncommon problem among such residents. We urge physicians to take ingestions of lead-based glazes seriously and to consider the diagnosis of lead poisoning in nursing home and psychiatric patients who have participated in ceramic crafts programs.

Acute Disease↗
PubMed1989

A comparison of two crisis housing alternatives to psychiatric hospitalization.

This study compared outcomes for demographically matched clients four months after their admission to two short-term crisis programs. The programs provided crisis housing and case management services as alternatives to psychiatric hospitalization for clients with severe and persistent mental illness. One program met housing needs by purchasing shelter in hotels and boarding houses, and the other provided lodging in an eight-bed crisis house. In both programs, two-thirds of the clients avoided hospitalization during four-month follow-up, and both programs were effective in stabilizing clients' housing and financial situations. Clients in the purchase-of-housing program showed an increase in substance abuse problems at follow-up. Average client costs were similar in the two programs. A critical program difference was the substantially higher staff turnover in the crisis house, which was later replaced with scattered-site crisis housing.

Adult↗
PubMed1988

Assertive case management in three CMHCs: a controlled study.

At three community mental health centers (CMHCs) in Indiana, 167 clients at risk for rehospitalization were randomly assigned to experimental groups receiving assertive case management (ACM) or to control groups eligible to receive all other aftercare services at the centers. During a six-month follow-up period, experimental clients received an average of one visit a week from the ACM team, usually in the client's home or in community settings. Overall, ACM clients were rehospitalized an average of 9.2 days, significantly less than the 30.8 days for controls. In two of the three centers, significant rehospitalization differences were also found between ACM and control groups. No differences were found between groups in quality of life, medication compliance, involvement in CMHC programs, or contacts with the legal system in any of the centers. The most cost-effective center had savings of about +5,500 for each ACM client.

Adult↗
PubMed1985

Psychiatric recidivism in a psychosocial rehabilitation setting: a survival analysis.

Survival analysis, a methodology employed in studies of survival after diagnosis of a life-threatening physical illness, is used to examine psychiatric recidivism. The probability of survival in the community without rehospitalization was calculated for 400 consecutive admissions to Thresholds, a psychiatric rehabilitation center serving formerly hospitalized patients. It was found that the probability of a client's being rehospitalized at least once within 15 months of Thresholds intake was .55 and that the probability of rehospitalization varied with sex, race, age, and number of prior hospitalizations. The authors note that early intervention may be indicated for clients at higher risk of rehospitalization. They suggest that survival analysis be used in studies of psychiatric recidivism because it permits direct statistical comparisons between studies.

Actuarial Analysis↗
PubMed1979

The psychotherapeutic impact of women's consciousness-raising groups.

The psychotherapeutic impact of women's consciousness-raising (CR) groups was assessed for 32 women entering groups formed in suburban, middle-class communities. Changes occurring over a six-month period were examined through pre-CR group and follow-up questionnaires and intensive interviews. Women increased in self-esteem and identification with the Women's Movement, but symptom distress was not alleviated, nor were marital relationships affected. While women expressed more positive self attitudes with greater feelings of autonomy and assertiveness, few participants manifested life-style or behavioral changes. The CR groups in this study thus served a limited psychotherapeutic function. In addition, CR and professional psychotherapy were seen as complementary and not as antagonistic help-giving systems.

Adult↗