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Biomedical subjects

R Mattick

Publications and source records attributed to R Mattick.

10 recordsLinked to original sources
PubMed2001

Are specialist outreach clinics for orthodontic consultation effective? A randomised controlled trial.

OBJECTIVE: To develop outreach clinics for orthodontic consultation and evaluate their costs and effectiveness. DESIGN: Single centre randomised controlled trial with random allocation of referred patients to outreach or main base consultation appointments. SETTING: One hospital orthodontic department and three community health centre clinics in Greater Manchester. Subjects 324 patients who were referred for orthodontic treatment. MAIN OUTCOME MEASURES: The outcome of consultation, the cost and duration of the visit and the consumer's perceptions of the visit. RESULTS: There were no differences in outcome of the consultation. While consumer travel costs and the duration of appointments were significantly higher for the main base clinics, these differences were not great. However, consumers preferred to attend an appointment in an outreach clinic. CONCLUSIONS: There do not appear to be marked advantages or disadvantages in providing consultation appointments for orthodontics in outreach clinics

Analysis of Variance↗
PubMed2001

Withdrawal from methadone maintenance treatment: prognosis and participant perspectives.

OBJECTIVE: To determine the proportion of clients engaged in methadone maintenance treatment who have favourable prognosis for withdrawal, and to examine client perceptions and expectations of withdrawal. METHODS: A broad cross-section of 856 methadone clients was sampled across Melbourne, Sydney and Brisbane. Self-complete surveys were developed for the clients, their clinic staff or pharmacists, and methadone prescribers. The client survey examined aspects of the clients' perspectives of withdrawal, and the surveys for the service providers collected information about each client's current treatment episode. Informed consent was provided by clients to obtain information from their clinic staff member or pharmacist, and their methadone prescriber. RESULTS: Most clients (70%) were at least very interested in methadone withdrawal. Clients were also more optimistic about their own post-withdrawal outcomes (in terms of opioid use) than both their clinic staff and prescribing doctors. Clinical criteria indicated that 31% of clients had a reasonable prognosis for withdrawal. However, when considering all factors, 17% had good withdrawal prognosis, were interested in methadone withdrawal, and believed it was very likely they would remain opioid-free for three months post-withdrawal. CONCLUSIONS: Despite the likely continued increase in client numbers in substitution maintenance treatment, the majority of methadone clients have a poor prognosis for withdrawal and should not be encouraged to cease treatment. IMPLICATIONS: Clients who do not meet key clinical criteria are likely to have poor clinical outcomes regardless of how withdrawal is attempted.

Adult↗
PubMed1997

Methadone maintenance and drug-related crime.

Using data from an evaluation of methadone maintenance treatment, this study investigated factors associated with continued involvement in crime during treatment, and in particular whether there appeared to be differences in effectiveness of treatment between different methadone clinics. The methodology was an observational study, in which 304 patients attending three low-intervention, private methadone clinics in Sydney were interviewed on three occasions over a twelve month period. Outcome measures were self-reported criminal activity and police department records of convictions. By self-report, crime dropped promptly and substantially on entry to treatment, to a level of acquisitive crime about one-eighth that reported during the last addiction period. Analysis of official records indicated that rates of acquisitive convictions were significantly lower in the in-treatment period compared to prior to entry to treatment, corroborating the changes suggested by self-report. Persisting involvement in crime in treatment was predicted by two factors: the cost of persisting use of illicit drugs, particularly cannabis, and ASPD symptom count. Treatment factors also were independently predictive of continued involvement in crime. By both self-report and official records, and adjusting for subject factors, treatment at one clinic was associated with greater involvement in crime. This clinic operated in a chaotic and poorly organized way. It is concluded that crime during methadone treatment is substantially lower than during street addiction, although the extent of reduction depends on the quality of treatment being delivered.

Adult↗
PubMed1993

Methadone maintenance treatment in prisons: The New South Wales Experience.

This paper uses the New South Wales experience with methadone maintenance treatment in prison to address the question: should methadone maintenance treatment be provided in Australian prisons for opioid-dependent prisoners? First, it outlines three rationales for providing drug dependence treatment in prisons: as a way of giving prisoners access to community-based forms of drug treatment in the prison setting; as a measure to reduce recidivism in opioid-dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Secondly, it reviews the kind of research evidence that supports the effectiveness of community-based methadone maintenance treatment in Australia. Thirdly, the effectiveness of the New South Wales Prison Methadone Programme, one of the few prison-based methadone programmes in the world, is evaluated in the light of the available research evidence.

Journal Article↗
PubMed1992

Methadone maintenance and the human immunodeficiency virus: current issues in treatment and research.

This paper examines the changes that have occurred in methadone maintenance programmes in response to the advent of HIV and the adoption of harm minimization policies, and the implications of these changes for research. A need for the use of more rigorous research methods is identified and recommendations are made that take into account both the ethical and practical difficulties of conducting research in this area. Both old, unanswered questions that have resurfaced with the recent massive growth in methadone programmes in some countries, and new questions that need to be answered in order to improve the effectiveness of methadone maintenance in the fight against HIV infection are identified as future areas in need of research.

HIV Infections↗
PubMed1987

Views of practicing psychiatrists on the treatment of anxiety and somatoform disorders.

Psychiatrists in Australia were asked to recommend treatments for several anxiety and somatoform disorders. In previous surveys they had agreed about the preferred treatments for schizophrenia and major affective disorder but not about treatments for "neurotic depression" or agoraphobia. In the present survey, no treatment was regarded as critical by a majority of psychiatrists for any of the five anxiety and somatoform disorders studied. The authors conclude that because neurotic disorders form an important part of the workload of psychiatrists, consensus procedures should be used to develop guidelines for treatment until the research literature can provide more adequate guidance.

Adult↗
PubMed1986

Cognitive mediation in the affective component of spontaneous panic attacks.

Single inhalations of a 50% carbon dioxide/50% oxygen gas mixture were administered to 16 subjects with spontaneous panic attacks and to 16 social phobics who did not experience such attacks. Half of each diagnostic category was randomly allocated to either a no explanation condition in which minimal instructions on expected outcome were provided, or an explanation condition in which all possible sensations were described and attributed to the effects of the gas. Subjects with panic attacks who were given no explanation reported a greater proportion of catastrophic cognitions, greater panic, and a greater similarity of the overall experience to a naturally-occurring panic attack than those with panic attacks who received a full explanation. In contrast, both groups of social phobics reported similar effects to each other, regardless of the explanation given. The results provide support for cognitive mediation in the "panic" component of spontaneous panic attacks.

Adult↗