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Selected AbstractsTreatment retention in adolescent patients treated with methadone or buprenorphine for opioid dependence: a file reviewDRUG AND ALCOHOL REVIEW, Issue 2 2006JAMES BELL Abstract The aim of this study was to compare retention and re-entry to treatment between adolescent subjects treated with methadone, those treated with buprenorphine, and those treated with symptomatic (non-opioid) medication only. We used a retrospective file review of all patients aged less than 18 at first presentation for treatment for opioid dependence. The study was conducted at the Langton Centre, Sydney, Australia, an agency specialising in the treatment of alcohol and other drug dependency. Sixty-one adolescents (age range 14,17 years at the time of commencing treatment); mean reported age of initiation of heroin use was 14 ± 1.3 years (range 11,16). Sixty-one per cent were female. The first episode of treatment was methadone maintenance in 20 subjects, buprenorphine in 25, symptomatic medication in 15; one patient underwent assessment only. These 61 subjects had a total of 112 episodes of treatment. Subjects treated with methadone had significantly longer retention in first treatment episode than subjects treated with buprenorphine (mean days 354 vs. 58, p<0.01 by Cox regression) and missed fewer days in the first month (mean 3 vs. 8 days, p<0.05 by t-test). Subsequent re-entry for further treatment occurred in 25% of subjects treated with methadone, 60% buprenorphine and 60% symptomatic medications. Time to reentry after first episode of buprenorphine treatment was significantly shorter than after methadone treatment (p < 0.05 by Kaplan-Meier test). Methadone maintenance appears to have been more effective than buprenorphine at preventing premature drop-out from treatment of adolescent heroin users. [source] Agricultural productivity and rural incomes in England and the Yangtze Delta, c.1620,c.18201ECONOMIC HISTORY REVIEW, Issue 3 2009ROBERT C. ALLEN The productivity of agriculture in England and the Yangtze Delta are compared c.1620 and c.1820 in order to gauge the performance of the most advanced part of China vis-à-vis its counterpart in Europe. The value of real output is compared using purchasing power parity exchange rates. Output per hectare was nine times greater in the Yangtze Delta than in England. More surprisingly, output per day worked was about 90 per cent of the English performance. This put Yangtze farmers slightly behind English and Dutch farmers c.1820, but ahead of most other farmers in Europe,an impressive achievement. There was little change in Yangtze agricultural productivity between 1620 and 1820. In 1820, the real income of a Yangtze peasant family was also about the same as that of an English agricultural labourer. All was not rosy in the Yangtze, however, for incomes there were on a downward trajectory. Agriculture income per family declined between 1620 and 1820, even though income per day worked changed little since population growth led to smaller farms and fewer days worked per year. The real earnings of women in textile production also declined, since the relative price of cotton cloth dropped,possibly also because a larger population led to greater production. The implication is that the Yangtze family, unlike the English family, had a considerably higher real income c.1620, and that period was the Delta's golden age. [source] Characteristics of wintertime daily and extreme minimum temperature over South KoreaINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 2 2004Sang-Boom Ryoo Abstract In South Korea, consecutive positive temperature anomalies have been observed since the mid-1980s. The objective of this study is to assess the recent trends in, and variability of, daily minimum temperature over South Korea with particular emphasis on its extremes. Temporal characteristics of wintertime daily and extreme minimum temperature-related variables were analysed on a seasonal basis for the period of 1958,59 to 2000,01. The results show continually fewer days with extreme low minimum temperature since the mid-1980s. However, no significant change in the 1 day temperature difference was observed during the same period, indicating little change in the frequency of cold surges. Also, during the period analysed, there is a significant positive trend in the seasonal mean temperature, a negative trend in the frequency of the extreme cold days, and no significant trend in the seasonal occurrence of cold surges. Northern Hemisphere geopotential height fields before and after 1986,87, i.e. the start of successive positive anomalies in the winter surface air temperature over South Korea, showed a substantial decrease throughout the troposphere over the polar region. In the upper levels the overall pattern becomes more wavelike, with eddies embedded between meanders. The differences in the lower troposphere are remarkably similar to the Arctic oscillation, although the centre in the North Atlantic is shifted toward western Europe and differences in the North Pacific are relatively weaker than those in the polar region. The recent positive phase of the Arctic oscillation may contribute to these abrupt changes in wintertime daily minimum temperatures over South Korea. El Niño,southern oscillation phenomena appear to contribute to the interannual variation of cold surge days in South Korea. Years with no cold surges were experienced during La Niña episodes. On the other hand, all years with more than four cases of cold surges were during El Niño episodes. Copyright © 2004 Royal Meteorological Society [source] New Method to Prevent Bladder Dysfunction after Radical Hysterectomy for Uterine Cervical CancerJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2000Dr. Yoshinori Kuwabara Abstract Objective: The purpose was to improve the surgical procedures to prevent bladder dysfunction after radical hysterectomy. Methods: Twelve patients with stage Ib cervical cancer underwent intraoperative electrical stimulation to identify the vesical branches of the pelvic nerves. Autonomic nerve localization in the vesicouterine ligament was examined in 10 patients immunohistochemically. According to the results of the above studies a new method to preserve the vesical branches was developed. Grades of postoperative bladder dysfunction were compared between new (n = 19) and conventional methods (n = 18). Results: Electrical stimulation on the outer surface of the posterior sheath of the vesicouterine ligament caused the increase of intravesical pressure. S-100 protein localized also on this area. Postoperative compliance of the detrusor in cases with the new method demonstrated less decrement from preoperative values than in cases with the conventional method. The new method required significantly fewer days to achieve residual urine volumes less than 50 ml after surgery. Conclusions: The new method significantly reduces bladder dysfunction after radical hysterectomy. [source] Clinical trial: chest pain caused by presumed gastro-oesophageal reflux in coronary artery disease , controlled study of lansoprazole vs. placeboALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010V. Talwar Aliment Pharmacol Ther 2010; 32: 191,199 Summary Background, Gastro-oesophageal reflux (GER) and coronary artery disease commonly co-exist. Coronary artery disease patients may mistake GER-induced pain for cardiac pain or GER might provoke angina. Aim, To investigate if GER might contribute to nocturnal/rest chest pain among coronary artery disease patients. Methods, Double-blind placebo-controlled crossover study investigating effect of lansoprazole on chest pain; 125 patients with angiographically proven coronary artery disease enrolled with at least one weekly episode of nocturnal/rest pain, randomized to lansoprazole 30 mg daily or placebo with crossover after 4 weeks. Symptoms recorded and QOL assessed by Nottingham Health Profile Questionnaire; ST segment depression episodes counted from 24 h electrocardiographic monitoring in final week of both periods. Statistical analysis: ANCOVA with period and carryover analysis. Results, In all, 108 patients completed the study. There was a modest increase in pain-free days on lansoprazole vs. placebo (P < 0.02), with fewer days with pain at rest (P < 0.05) and at night (P < 0.009) on lansoprazole vs. placebo, but no significant differences in ST segment depression episodes (P = 0.64). There was a trend for reduction in the ,physical pain' QOL domain. Conclusions, Among coronary artery disease patients, lansoprazole modestly increases pain-free days and reduces rest/nocturnal pain. As lansoprazole did not affect ST segments, this may be by suppression of GER-provoked pain misinterpreted as angina, rather than acid-provoked ischaemia. [source] Is In-Prison Treatment Enough?LAW & POLICY, Issue 1 2003A Cost-Effectiveness Analysis of Prison-Based Treatment, Aftercare Services for Substance-Abusing Offenders This study performed a cost-effectiveness analysis (CEA) of the Amity in-prison Therapeutic Community (TC) and Vista aftercare programs for criminal offenders in California. For the average treatment participant, the cost of treatment was $4,112, which led to approximately fifty-one fewer days incarcerated (36% less) than the average individual in the control group. This implies that, for the average offender, treatment reduced recidivism at a cost of $80 per incarceration day. For participants who received both in-prison treatment and aftercare services, an additional day of incarceration was avoided at a cost of $51 per day relative to those that received in-prison treatment only. [source] Retention in Psychosocial Treatment of Cocaine Dependence: Predictors and Impact on OutcomeTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2002Lynne Siqueland Ph.D. This report describes retention in treatment in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study (CCTS), a multi-site trial of four psychosocial treatments for 487 cocaine dependent patients. Younger, African-American, and unemployed patients were retained in treatment for fewer days than their counterparts. African-American patients who lived with a partner were retained in treatment for less time than if they lived alone. Higher psychiatric severity kept men in treatment longer but put women at risk for dropping out sooner. Patients who completed the full treatment used drugs less often than patients who dropped out, but outcome did not differ at each month. Patients in the drug counseling condition stayed in treatment for fewer days than patients in psychotherapy, but they were more likely to be abstinent after dropout. Patients with higher psychiatric severity were more at risk for continuing to use drugs after dropout. [source] Screening and Brief Intervention to Reduce Marijuana Use Among Youth and Young Adults in a Pediatric Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Edward Bernstein MD Abstract Objectives:, Marijuana was involved in 209,563 emergency department (ED) visits in 2006, according to the Drug Abuse Warning Network. Although screening and brief intervention (SBI) has been effective in changing drinking among ED patients in a number of studies, tests of marijuana SBI in a pediatric emergency department (PED) have not yet been reported. The aim of this pilot study was to test whether SBI is effective in reducing marijuana consumption among youth and young adults presenting to a PED with a diverse range of clinical entities. Methods:, A three-group randomized controlled preliminary trial was structured to test 1) differences between Intervention (Int) and standard Assessed Control (AC) groups in marijuana consumption, from baseline to 12 months, and 2) the feasibility of adding a Nonassessed Control (NAC) group to evaluate regression to the mean and assessment reactivity. Patients aged 14,21 years in an urban, academic PED were screened during 2006,2007, using standardized risk factor questions. Subjects were eligible if they used marijuana three or more times in the past 30 days, but were excluded for co-occurring high-risk alcohol use. Consented enrollees were randomized to NAC, AC, and Int groups in a two-stage process that permitted blinding to status during assessment and follow-up. NACs received a resource handout, written advice about marijuana use risks, and a 12-month follow-up appointment. ACs were assessed using standardized instruments and received resources, written advice, and 3- and 12-month follow-up appointments. The Int group received assessment, resources, written advice, 3- and 12-month appointments, a 20-minute structured conversation conducted by older peers, and a 10-day booster telephone call. A peer educator utilized a motivational style interview protocol adapted for adolescents to elicit daily life context and future goals, provide feedback, review pros and cons of marijuana use, assess readiness to change, evaluate strengths and assets, negotiate a contract for change, and make referrals to treatment and/or other resources. Measurements included demographic information; 30-day self-report of marijuana use; attempts to quit, cut back, or change conditions of use; and risk factor questions repeated at follow-up. Results:, Among 7,804 PED patients screened, 325 were eligible; 210 consented and enrolled (Int, n = 68; AC, n = 71; NAC, n = 71), with a 12-month follow-up rate of 71%. For the primary objective, we compared Int to AC. At 12 months, Int participants were more likely to be abstinent for the past 30 days than ACs (odds ratio [OR] for reported abstinence = 2.89, 95% confidence interval [CI] = 1.22 to 6.84, p < 0.014). The Int group had greater reduction in days used, baseline to 12 months, controlling for baseline (Int = ,7.1 vs. AC = ,1.8), were less likely to have been high among those who smoked (OR = 0.39, 95% CI = 0.17 to 0.89, p < 0.05), and were more likely to receive referrals. In a linear regression model controlling for baseline use, NACs smoked 4 fewer days per month than ACs, but consumption was not significantly different, suggesting no assessment reactivity effect. Conclusions:, A preliminary trial of SBI promoted marijuana abstinence and reduced consumption among PED patients aged 14,21 years. A no-contact condition for the NAC group over the year after enrollment was insufficient to capture enrollees for follow-up across a range of baseline acuity. [source] Effects of selection for resistance to Sesamia nonagrioides on maize yield, performance and stability under infestation with Sesamia nonagrioides and Ostrinia nubilalis in SpainANNALS OF APPLIED BIOLOGY, Issue 3 2010G. Sandoya A maize synthetic population was improved for resistance to the Mediterranean corn borer (MCB, Sesamia nonagrioides) while maintaining yield. The objectives of this research were to investigate whether yield and yield stability of the maize synthetic population named EPS12 were affected by selection for MCB resistance; also to determine which genotypic and environmental covariates could explain the genotype (G), environment (E) and genotype × environment (GE) effects for yield under corn borer infestation. Plants from three cycles of selection and their testcrosses to three inbred testers (A639, B93 and EP42) were evaluated at two locations in 2 years, under MCB and European corn borer infestations. After selection EPS12 was a more stable genotype. Hybrids derived from crosses between B93 and inbreds obtained from the initial cycles of selection could be recommended for cultivation in northern Spain. The yield of crosses between cycles of selection and testers increased when there were fewer days with temperatures >25°C and higher mean maximum temperatures. Differences in yield among these genotypes were mostly explained by resistance to corn borer attack. In general, among EPS12-derived materials, genetic characteristics that contribute to increased grain yield were also responsible for increased abiotic stress tolerance. [source] Has number of previous episodes any effect on response to group psychoeducation in bipolar patients?ACTA NEUROPSYCHIATRICA, Issue 2 2010A 5-year follow-up post hoc analysis Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martínez-Arán A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. Objective: One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group psychoeducation for bipolar disorders according to the number of previous episodes. Methods: For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry. Results: Patients with more than seven episodes at study entry did not show any significant improvement with psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9,14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity. Conclusion: The number of previous episodes clearly worsens response to psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention. [source] Slow versus rapid enteral feeding advancement in preterm newborn infants 1000,1499 g: a randomized controlled trialACTA PAEDIATRICA, Issue 1 2010Sriram Krishnamurthy Abstract Aim:, To evaluate whether preterm neonates weighing 1000,1499 g at birth receiving rapid enteral feeding advancement at 30 mL/kg/day attain full feedings (180 mL/kg/day) earlier than those receiving slow enteral feeding advancement at 20 mL/kg/day without increase in the incidence of feeding intolerance or necrotizing enterocolitis. Methods:, A total of 100 stable intramural neonates weighing between 1000 and 1499 g and gestational age less than 34 weeks were randomly allocated to enteral feeding (expressed human milk or formula) advancement of 20 mL/kg/day (n = 50) or 30 mL/kg/day (n = 50). Results:, Neonates in the rapid feeding advancement group achieved full volume feedings before the slow advancement group (median 7 days vs. 9 days) (p < 0.001), had significantly fewer days of intravenous fluids (median 2 days vs. 3.4 days) (p < 0.001), shorter length of stay in hospital (median 9.5 days vs. 11 days) (p = 0.003) and regained birth weight earlier (median 16 days vs. 22 days) (p < 0.001). There were no statistical differences in the proportion of infants with apnea, feed interruption or feed intolerance. Conclusion:, Rapid enteral feeding advancements of 30 mL/kg/day are well tolerated by stable preterm neonates weighing 1000,1499 g. [source] | ||||||||||