Biomedical subjects

James A Carter

Publications and source records attributed to James A Carter.

2 recordsLinked to original sources

PubMed2005

An interactive media program for managing psychosocial problems on long-duration spaceflights.

Space crews must be self-reliant to complete long-duration missions successfully. This project involves the development and evaluation of a network of self-guided interactive multimedia programs to train and assist long-duration flyers in the prevention, assessment, and management of psychosocial problems that can arise on extended missions. The system is currently under development and is intended for use both during training and on orbit. A virtual space station 3-dimensional graphic was created to serve as a portal to multimedia-based training, assessment, and intervention resources. Additionally, original content on interpersonal conflict and depression is being developed for the system. Input on the best practices for managing conflict and depression on extended missions was obtained from 13 veteran long-duration flyers, as well as from clinical experts. Formative evaluation of a prototype of the system will be conducted with 10 members of the astronaut corps. Subsequently, the content on conflict and depression will be completed, and the depression self-treatment portion will be evaluated in a randomized controlled trial. Although this study involves developing countermeasures to assist long-duration flyers, it also provides a model that could be applied in many Earthbound settings, both in operational environments and in everyday life.

Aerospace Medicine↗

PubMed2002

A multicenter randomized evaluation of methadone medical maintenance.

Methadone medical maintenance (MMM) is a rational, cost-effective method to match treatment intensity to level of needed services. In the present study, 73 highly stable methadone maintenance patients were randomly assigned to either a routine methadone treatment, MMM--a once monthly reporting schedule--at the methadone maintenance program or MMM at a physician office. A 'stepped care' intensified treatment approach was used for patients who had drug-positive urine specimens or failed the medication recall procedure. Patients left two urine specimens for analysis each month (at least one on a random basis) and responded to one medication recall each month. Results are presented for the first 6 months of the 1-year trial. Only 1% of urine specimens were positive for illicit drugs, there was no evidence of methadone diversion and there were very low rates of medication misuse, with no between group differences. MMM patients initiated more new employment or family/social activities than the routine care patients. MMM patients were more satisfied with their treatment than the routine treatment patients, but all patients rated themselves satisfied or very satisfied with their treatment. Stepped care was well-tolerated and helped match patients to an appropriate intensity of service. The good outcomes observed with the present sample suggest that MMM can be implemented effectively as part of a continuum of care in clinic and office-based sites.

Adult↗