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Biomedical subjects

R Brotman

Publications and source records attributed to R Brotman.

9 recordsLinked to original sources

A comprehensive care program for pregnant addicts: obstetrical, neonatal, and child development outcomes.

This study reports the results of a comprehensive care program for pregnant addicts, one that provides medical, counseling, and child development services. Findings include the following. Women who enroll while pregnant generally stay through childbirth, and most deliveries are free of complication. Most newborns are of normal gestational age and birthweight, and these outcomes are directly related to length and amount of prenatal care. Neonatal withdrawal is directly related to prenatal maternal methadone dose. Child development, as measured by the Bayley Scales, is usually in the normal range, although mean scores for cognitive development decrease through age 2. Female babies generally have higher cognitive and motor scores than males, and their cognitive scores decline less sharply than those of the males. Developmental scores are directly related to neonatal maturity, especially birthweight. Prenatal maternal methadone dose tends to be negatively related to developmental scores for boys but not for girls.

Adult

Naltrexone and conventionality.

This study examines the effect of conventionality on whether patients who were scheduled for naltrexone took it, and on treatment outcomes for patients who did take it. It is based on admission and case record data for 147 male opiate addicts who enrolled in New York Medical College's Multitrack Abstinence Program. Naltrexone-taking is examined against an array of "drug" and "social" variables and is found to be strongly related to four in particular: amount spent daily on heroin, number of arrests, type of residence, and employment. These variables are combined into an index which measures a patient's degree of conventionality. It is found that naltrexone-taking varies directly with degree of conventionality. Furthermore, it is found that, among patients who took naltrexone, those who gained in conventionality while in treatment were more likely than others to leave the program opiate-free after terminating naltrexone therapy.

Adolescent

Employment and social disability among opiate addicts.

This study examines the relationship between employment and social disability. It is based on admission data for 296 opiate addicts who enrolled in New York Medical College's Multitrack Abstinence Program during 1974. Social disability is defined here as an attribute of the patient which may count against him or her in the job market. Employment rates are examined in the light of an index comprised of three specific disabilities: minority group status, lack of a high school degree, and presence of an arrest record. It is found that the proportion of addicts employed upon admission to the program varies inversely with the number of disabilities. Furthermore, it is found that the proportion of addicts who rely on illegal acts for their main source of income varies directly with the number of disabilities.

Black or African American

Female drug use: some observations.

This paper, based on a review of recent social science drug research, summarizes the main findings on female drug use and speculates on its future direction. The findings include the following: women are usually initiated into illicit drug use by men; rates of illicit drug use are lower among females than males (which may reflect the greater personal freedom traditionally granted to males), although the difference narrows among younger persons and among those who subscribe to more liberal values and life styles; women are more likely than men to use psychotherapeutic drugs (which may reflect strains resulting from their unequal status vis-à-vis men); and female opiate addicts, although they tend to hold conventional values, are often involved in such deviant activity as prostitution. To the extent that women gain social equality with men and subscribe to greater personal lifestyle freedom, they may be expected to show a higher rate of illicit drug use, particularly of a recreational kind. On the other hand, the rate of psychotherapeutic drug use may decrease, although if the tensions of the workplace eventually substitute for the tensions of status inequality, the resultant changes in rates and patterns of substance use are problematic.

Age Factors

Total treatment.

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Alcoholism

Quality assurance programs in clinical trials.

Quality assurance programs attempt to assess the uniformity of compliance with a stated study program so that the results from one institution will indeed be comparable to those of all of the other institutions in the group. In the best situation, it should be easy to compare results from one group to those of any other group and any other studies of the same disease, because the basis of selection of the patient population, the treatment of patients, and the endpoints have been uniformly defined throughout. The evaluation of the end results includes a quantitative assessment of the appropriateness of these parameters. Quality assurance programs document the validity of interinstitutional, intergroup, and international studies. They are time-consuming and costly. They can be ulcerogenic. But, in the end, they are the firm basis upon which the statistical analysis can proceed.

Clinical Trials as Topic