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  • 1
    Electronic Resource
    Electronic Resource
    Age and mortality among white male problem drinkers (2000)
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 95 (2000), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. This study is designed to determine the relative risk of mortality for white male problem drinkers compared to white males in the general population, and to identify any variation in relative risk of problem drinking in three age groups (18-29, 30-49 and 50-79 years). Design. The research design is prospective, using historical administrative datasets from treatment programs in conjunction with vital records datasets. Participants. Participants include all white men aged 18-79 treated for alcohol-related problems in community mental health substance abuse programs in Vermont during 1991. The treatment group includes 1853 service recipients; the comparison group includes 196 443 adult white male residents of Vermont. Measurement. Measurement of mortality rates for problem drinkers was based on probabilistic determination of overlap between treatment and vital record datasets. Findings. Mortality for problem drinkers is greater than the general population in all three age groups. The estimated relative risk of mortality in the oldest age group was lower than the other groups, but substantially higher than found in recently published research. The estimated relative risk of mortality in the youngest age group, which has rarely been addressed in previous research, was higher than the relative risk in the middle age group. application of a public health research model in which problem drinkers are compared to the general population has potential to inform public policy. In this case, the public health approach identified an elevated risk of mortality associated with problem drinking among older adults that had not been evident in the previous research. Conclusion. The application of a public health research model in which problem drinkers are compared to the general population has potential to inform public policy. In this case, the public health approach identified an elevated risk of mortality associated with problem drinking among older adults that had not been evident in the previous research.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2000.958124911.x
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  • 2
    Electronic Resource
    Electronic Resource
    Utilization of local jails and general hospitals by state psychiatric center patients (2000)
    Springer
    The journal of behavioral health services & research 27 (2000), S. 454-459 
    Details
    ISSN: 1556-3308
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract The idea that the deinstitutionalization of state psychiatric centers has resulted in increased utilization of general hospitals and correctional facilities by people with severe and persistent mental illness is widely held. This hypothesis of transinstitutionalization was tested by examining hospitalization and incarceration rates of people who had been or would be institutionalized in state psychiatric centers in 16 upstate New York counties. The results do not support the hypothesis of transinstitutionalization. Assumptions underlying the hypothesis are examined, potential explanations for the observed patterns are discussed, and areas for further research are suggested.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02287827
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  • 3
    Electronic Resource
    Electronic Resource
    Using incarceration rates to measure mental health program performance (1998)
    Springer
    The journal of behavioral health services & research 25 (1998), S. 300-311 
    Details
    ISSN: 1556-3308
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract This article introduces a more refined conceptualization of the criminal justice involvement of clients of mental health programs than is evident in the existing literature, and demonstrates a research methodology that provides program administrators with standardized measures of program performance in this area. The conceptualization of the criminal justice involvement of people served by community mental health programs distinguishes between three distinct areas of concern: (1) program accessibility to people with a history of criminal justice involvement, (2) criminal justice outcomes, and (3) quality of program performance. The methodology makes use of existing data resources to provide a valid and reliable measure of program performance in these three areas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02287469
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  • 4
    Electronic Resource
    Electronic Resource
    Personal privacy versus public accountability: A technological solution to an ethical dilemma (1998)
    Springer
    The journal of behavioral health services & research 25 (1998), S. 456-463 
    Details
    ISSN: 1556-3308
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract The tension between personal privacy and public accountability produces one of the major ethical dilemmas facing behavioral health program evaluators and service system researchers. This article discusses the source of this tension and introduces a research methodology that allows program evaluators to fully and equally respect both ethical principles. This methodology uses contemporary computer and statistical technology in conjunction with aggregated, de-identified information derived from existing databases to provide valid and reliable measures of the performance of treatment programs while it protects the personal privacy of individuals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02287515
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  • 5
    Electronic Resource
    Electronic Resource
    The effects of interleukin-1 therapy on peripheral blood granulocyte function in humans (1993)
    Springer
    Cancer immunology immunotherapy 37 (1993), S. 26-30 
    Details
    ISSN: 1432-0851
    Keywords: Interleukin-1α ; Granulocytes ; Chemotaxis ; Respiratory burst
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During a phase I trial of interleukin-1α (IL-1α) in patients with ovarian carcinomas, the effects of this treatment on blood granulocyte respiratory burst and locomotive responses were examined. Differences in baseline granulocyte function in patients as well as dose-related effects of IL-1α treatment were observed. Patients enrolled early in the trial (low-dose patients) had significantly lower locomotive responses before treatment than their paired controls; these low responses normalized after 5 days of continuous-infusion IL-1α treatment. Patients enrolled later (high-dose patients) had normal locomotive responses before treatment and IL-1α treatment was associated with suppression of responses to selected stimuli at the end of treatment. Pretreatment respiratory burst responses in both low-and high-dose patient groups were essentially normal, but the rates of granulocyte H2O2 production following phorbol myristate acetate stimulation became significantly less than control values at the end of treatment. In vitro exposure of either patient or control cells to 150 U/ml IL-1α did not alter their locomotive or respiratory burst responses, suggesting the observed in vivo effects were not mediated directly by IL-1α. Treatment with IL-1α is associated with changes in ex vivo granulocyte function that are related to the IL-1α dose. Treatment with low doses of IL-1α may provide a means of normalizing abnormal polymorphonuclear leukocyte function in some patients with ovarian malignancies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01516938
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  • 6
    Electronic Resource
    Electronic Resource
    Practice Patterns and Hospitalization Rates (1998)
    Springer
    Administration and policy in mental health and mental health services research 26 (1998), S. 33-44 
    Details
    ISSN: 1573-3289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract Basic indicators of community support program treatment outcome as well as the degree to which the programs conform to practice guidelines for major depression are evaluated. Hospitalization rates subsequent to treatment are measured, and the correlation between hospitalization rates and practice patterns is determined. Data sets that describe outpatient and inpatient services over a 4-year period, but do not include common person identifiers were analyzed using probabilistic population estimates. Results indicate that there is substantial variation among the community programs in practice patterns and hospitalization rates, and the two are negatively correlated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1021265303283
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  • 7
    Electronic Resource
    Electronic Resource
    Predictors of the use of restraint and seclusion in public psychiatric hospitals (1996)
    Springer
    Administration and policy in mental health and mental health services research 23 (1996), S. 527-532 
    Details
    ISSN: 1573-3289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract The authors report on the replication of a 1984 study of the use of restraint and seclusion at psychiatric hospitals operated by the New York State Office of Mental Health. The results of this study confirm the earlier finding that the hospital itself was the greatest predictor of the use of these interventions, when controlling for patient characteristics associated with the use of restraint and seclusion, such as age, gender, ethnicity legal status, length of stay, and diagnosis. Recent and current attention to these findings has already resulted in reduced rates at high-rate New York State facilities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02108688
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  • 8
    Electronic Resource
    Electronic Resource
    A Risk-Adjusted Measure of Hospitalization Rates for Evaluating Community Mental Health Program Performance (1999)
    Springer
    Administration and policy in mental health and mental health services research 26 (1999), S. 269-279 
    Details
    ISSN: 1573-3289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract The authors describe the use of risk-adjusted hospitalization rates to measure community mental health treatment outcomes. The risk adjustment involves comparing rates of hospitalization subsequent to treatment with rates of hospitalization prior to treatment. The research uses a probabilistic methodology that reliably estimates caseload overlap by comparing the distribution of the dates of birth observed in data sets to the distribution of dates of birth in the general population. Findings indicate that risk-adjusted hospitalization rates are substantially different than unadjusted rates. Half of the community programs in one state consistently achieved positive outcomes in four consecutive years; other programs had mixed results or no change.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1022222010381
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  • 9
    Electronic Resource
    Electronic Resource
    Child, family, and system outcomes of intensive case management in New York State (1996)
    Springer
    Psychiatric quarterly 67 (1996), S. 273-286 
    Details
    ISSN: 1573-6709
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract New York State’s Children and Youth Intensive Case Management (CYICM) was implemented in 1988 as one of several community-based initiatives for children with serious emotional disturbance (SED). Underlying this program is the goal of maintaining children with SED in the least restrictive environment appropriate to their needs. This paper presents CYICM child, family, and system outcomes over six years, describes program refinements, and explores continuing research efforts. Data are supportive of the positive outcomes associated with intensive case management for children with SED. Associated with enrollment in CYICM are a decrease in symptoms, improvement in functioning, and fewer hospitalizations in state-operated psychiatric centers, which translates into cost savings and a possible reduction in hospital beds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02326371
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  • 10
    Electronic Resource
    Electronic Resource
    Clinical and serological differentiation of autoimmune and hepatitis C virus-related chronic hepatitis (1993)
    Springer
    Digestive diseases and sciences 38 (1993), S. 631-636 
    Details
    ISSN: 1573-2568
    Keywords: autoimmune chronic active hepatitis ; chronic hepatitis C ; diagnosis ; polymerase chain reaction ; serological testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recent reports have focused on the difficulty in differentiating autoimmune hepatitis from chronic hepatitic C due to the high prevalenc of anti-HCV in autoimmune hepatitis. The aim of this study was to identify clinical, biochemical, and serological variables that would help distinguish these two diseases. Pretreatment clinical and biochemical variables were compared from 17 patients with steroid-responsive autoimmune chronic active hepatitis and 62 patients with chronic hepatitis C. Serum samples from these patients were tested for autoantibodies and for anti-HCV by first- and second-generation ELISA, recombinant immunoblot assay, and HCV RNA by polymerase chain reaction. Patients with autoimmune hepatitis were more likely to be symptomatic (94% vs 47%,P〈0.005) and jaundiced (76% vs 0%,P〈0.005) at the time of referral. Anti-HCV was found in 53% of patients with autoimmune hepatitis, but only two were positive by immunoblot assay and only one of these had detectable HCV RNA. Antinuclear antibody (ANA) was detected in 21% of patients with chronic hepatitis C, although usually at a lower titer than in autoimmune hepatitis (geometric mean titer=1:160 vs 1:500,P〈0.003). Patients with chronic hepatitis C who were ANA positive were older than those who were ANA negative, although there were no other differences in clinical or biochemical features between these groups. In particular, there was no difference in response rate to antiviral therapy. Thus, autoantibodies are frequently found in chronic hepatitis C, especially in older subjects, but appear to be clinically insignificant. Anti-HCV is frequently present in autoimmune hepatitis but is rarely confirmed by tests of higher specificity. These findings have important implications in selecting patients for antiviral or immunosuppressive therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01316792
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