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Biomedical subjects

J Durell

Publications and source records attributed to J Durell.

At least 19 recordsLinked to original sources

Alignment delays in the N = Z nuclei (72)Kr, (76)Sr, and (80)Zr.

The ground state rotational bands of the N = Z nuclei (72)Kr, (76)Sr, and (80)Zr have been extended into the angular momentum region where rotation alignment of particles is normally expected. By measuring the moments of inertia of these bands we have observed a consistent increase in the rotational frequency required to start pair breaking, when compared to neighboring nuclei. (72)Kr shows the most marked effect. It has been widely suggested that these "delayed alignments" arise from np-pairing correlations. However, alignment frequencies are very sensitive to shape degrees of freedom and normal pairing, so the new experimental observations are still open to interpretation.

Journal Article↗

Treatment services received by supplemental security income drug and alcoholic clients.

This study examined self reported problems and treatment services received by 237 recipients of Supplemental Security Income (SSI) benefits for "drug abusers and alcoholics" who had been assigned and entered into substance abuse treatment. All were administered the Treatment Services Review (TSR), a brief interview in which patients describe treatment services they have received during the past month and substance-related problems they are currently experiencing. In addition to describing serious alcohol and drug problems, SSI recipients reported a need for treatment for medical and psychiatric problems. The TSR data revealed that these clients primarily received drug and alcohol services and more limited medical, psychiatric, and employment services during treatment. There was relatively little indication of the provision of legal or family/social treatment services. The data are consistent with other findings that indicate that treatment for substance dependence provides only limited services other than those for alcohol and drug abuse.

Adult↗

Benefit-cost analysis of residential and outpatient addiction treatment in the State of Washington.

A benefit-cost analysis of full continuum (FC) and partial continuum (PC) care was conducted on a sample of substance abusers from the State of Washington. Economic benefits were derived from client self-reported information at treatment entry and at 9 months postadmission using an augmented version of the Addiction Severity Index (ASI). Average (i.e., per client) economic benefits of treatment from baseline to follow-up for both FC and PC were statistically significant for most variables and in the aggregate. The overall difference in average economic benefit between FC and PC was positive ($8,053) and statistically significant, favoring FC over PC. The average cost of treatment amounted to $2,530 for FC and $1,138 for PC (p < .01). Average net benefits were estimated to be $17,833 (9.70) for FC and $11,173 (23.33) for PC, with values showing statistical significance (p < .05). Results strongly indicate that both treatment options generated positive and significant net benefits to society.

Ambulatory Care↗

Does clinical case management improve outpatient addiction treatment.

This project evaluated whether clinical case managers (CCMs) could increase access and utilization of social services in the community; and thereby improve outcomes of addiction treatment. No case management (NoCM)--patients received standard, group-based, abstinence-oriented, outpatient drug abuse counseling, approximately twice weekly. Clinical case management (CCM)--patients were treated in the same programs but also were assigned a CCM who provided access to pre-contracted, support services such as drug free housing, medical care, legal referral, and parenting classes from community agencies. CCM patients received more alcohol, medical, employment, and legal services than NoCM patients during treatment. At 6 month follow-up CCM patients showed significantly more improvement in alcohol use, medical status, employment, family relations, and legal status than NoCM patients. We conclude that CCM was an effective method of improving outcomes for substance abuse patients in community treatment programs. Essential elements for successful implementation included extensive training to foster collaboration; and pre-contracting of services to assure availability.

Adult↗

Supplemental social services improve outcomes in public addiction treatment.

AIMS: To evaluate the effectiveness and value of social services added to standard addiction rehabilitation. DESIGN: A controlled, quasi-experimental, field study with repeated measures. SETTING: Conducted in two groups of publicly supported outpatient addiction treatment programs. Control programs provided standard, twice-weekly, outpatient group counseling. "Enhanced" programs provided standard counseling but also case managers to coordinate and expedite use of pre-contracted medical screenings, housing assistance, parenting classes and employment services. MEASUREMENTS: The Addiction Severity Index was used to record the nature and severity of patient problems in seven areas at treatment admission and at 6-month follow-up. Services provided during treatment were measured with the Treatment Services Review. Measures were taken on consecutive samples of patients admitted to all programs--before enhancements (wave 1, N = 431)--and at 12 months (wave 2, N = 710); and 26 months following enhancements (wave 3, N = 187). FINDINGS: There were no significant differences in patient characteristics, treatment services or 6-month outcomes of the two sets of programs in wave 1. Wave 2 and especially wave 3 enhanced programs provided significantly more social and medical services than control programs. Patients treated in enhanced programs showed significantly less substance use, fewer physical and mental health problems and better social function at 6-months than Controls. CONCLUSIONS: Adding social services to public sector programs substantially improved the outcomes of addiction treatment. Changes in "real world" systems require time to implement; early evaluations may fail to capture the full impact of those changes.

Adult↗

Characteristics of recipients of Supplemental Security Income (SSI) benefits for drug addicts and alcoholics.

This study examined symptom severity and level of functioning in recipients of Supplemental Security Income (SSI) benefits for drug addicts and alcoholics (DA&A). Although substantial numbers of substance abusers received these benefits until the program was canceled in 1997, little information has been available on the characteristics of these individuals. Approximately 2500 SSI DA&A recipients were assessed at the point in which they were to be referred for treatment services. Results indicated that in addition to long histories of alcohol abuse and recent problems with employment, these DA&A recipients were characterized by high levels of medical and psychiatric problems. Problem severities in these latter two areas were found to be consistently high across several subgroupings of recipients, including those who reported no alcohol or drug use in the prior 30 days. These findings suggest that SSI DA&A recipients are often significantly impaired beyond their alcohol and drug use.

Adult↗

"Intensive" outpatient substance abuse treatment: comparisons with "traditional" outpatient treatment.

UNLABELLED: Do "intensive," freestanding outpatient substance abuse treatment programs actually provide more intensive services than "traditional" outpatient programs? Three hundred and thirty-eight patients in 6 "intensive" outpatient (IO) programs (three or more times weekly) were compared with 580 patients from 10 "traditional" outpatient (TO) programs (one or two times weekly) on severity of admission problems, treatment services received and six month outcomes. RESULTS: 1. IO subjects generally had the most severe medical, employment, legal and psychiatric problems at admission. 2. IO patients received more alcohol and drug focused services; but fewer medical and employment focused services than the TO patients. Both groups received very few psychosocial services. 3. There were not significant differences between the IO and TO program samples at follow-up. However, both groups showed significant reductions in substance use, improvements in personal health and social function.

Adult↗

Norepinephrine metabolism and psychoactive drugs in the endogenous depressions. 1968.

After intraventricular injection of norepinephrine-H3, the concentration of norepinephrine, of normetanephrine and of the deaminated catechols in rat brains was determined, following action of imipramine, desmethylimipramine, chlorpromazine, lithium chloride or cocaine. Following administration of imipramine, desmethylimipramine, and chlorpromazine, norepinephrine concentration decreased significantly at first, had distinctly increased 4.5 hours after imipramine and desmethylimipramine but was normal once again after chlorpromazine. Normetanephrine concentration increased after imipramine and desmethylimipramine but was unchanged after chlorpromazine. Under the effect of these drugs, the deaminated catechols showed no changes compared with control values. Cocaine resembled the antidepressants, but the amount of deaminated compounds was reduced. Lithium chloride, on the other hand, increased the concentration of deaminated catechols under certain conditions, reduced normetanephrine concentration but did not influence norepinephrine concentration. In addition to the animal experiments, the following data of six patients with an "endogenous" depression were recorded over a period of several weeks: the clinical findings by means of the Hamilton Depression Rating Scale, and the excretion of normetanephrine and of vanillylmandelic acid (VMA) in the urine before, during and after treatment with imipramine. The therapy led to a significant reduction of VMA; however, this reduction cannot be correlated with an improvement in the clinical findings. On the other hand, excretion of normetanephrine is apparently not dependent on the administration of imipramine but seems to reflect the clinical state, since improvement of the depression was regularly combined with an increased excretion of normetanephrine.

Animals↗