Treatment Facilities (treatment + facility)

Distribution by Scientific Domains

Kinds of Treatment Facilities

  • residential treatment facility

  • Selected Abstracts

    Critical Failures in a Regional Network of Residential Treatment Facilities

    Thomas W. Pavkov
    The present descriptive case study reports on the state of treatment services and environmental settings in adolescent residential treatment facilities (RTFs) conducted as part of the Residential Treatment Center Evaluation Project. The project frequently uncovered poor quality of care exposing youth to deleterious conditions. Observations related to harsh treatment practices, psychiatric practice and medication management, educational and aftercare planning, and general treatment planning were closely examined. The analysis indicated that accreditation and licensing are insufficient to assure the quality of the service process in RTFs. Future research should address the relationship between treatment quality and treatment outcome. Efforts should also be made to develop strategies for organizational change to support high-quality services in RTFs. [source]

    The drug situation in Thailand: the role of government and the police

    Abstract Thailand has long dealt with the drug problem and has used several strategies to control it, including promulgating and amending drug laws, implementing drug suppression and prevention policies, cooperating with international organizations and, more recently, developing treatment facilities. Although Thailand has recently received positive results regarding reducing the opium cultivation area in the Golden Triangle and in arresting some major drug-trafficking individuals, three important issues still remain: (1) the continuation of using Thailand's advanced transportation system for the movement of illicit drug activities, (2) the rapid increase of amphetamine use among teenagers and (3) the Thai police officers' lack of concern about the drug problem and insufficient knowledge about drug laws. The article concludes that the Thai government must emphasize drug prevention strategies and the interception of illicit transported drugs and motivate its police officers to more fully enforce drug laws. In addition, more research is needed to measure the effectiveness of the drug prevention strategies and treatment programs. [source]

    Retention in methadone maintenance drug treatment for prescription-type opioid primary users compared to heroin users

    ADDICTION, Issue 5 2009
    Caleb J. Banta-Green
    ABSTRACT Aims To assess retention in methadone maintenance treatment for prescription-type opioid primary (PTOP) users compared to heroin users. Design and participants A retrospective cohort study was carried out to examine the association between opiate types used on 12-month retention. The study population consisted of adults admitted to one of 11 not-for-profit methadone maintenance clinics in 2004 and 2005 throughout Washington State (n = 2308). Logistic regression analyses with fixed effects for treatment agencies were conducted. Measurements Opiate use type in past 30 days: any heroin use or primary prescription opioid without heroin use. Demographics, other drugs used, self-reported medical and psychiatric concerns, social, familial and legal issues, public assistance type and housing stability were documented at intake using a comprehensive biopsychosocial instrument, the Treatment and Assessment Reports Generation Tool. Findings The odds of being retained in treatment for PTOP compared to heroin users not adjusting for other factors was 1.33 (95% confidence interval [CI], 1.03, 1.71). In the final logistic regression model the odds of retention for PTOP compared to heroin users was 1.25 (95% CI, 0.93, 1.67), indicating that there was no statistically significant difference in treatment retention by opiate type after adjusting for demographics, treatment agencies, other drug use, public assistance type, medical, psychiatric, social, legal and familial factors. Conclusion The findings of this study suggest that PTOP can be treated at methadone maintenance treatment facilities at least as effectively as heroin users in terms of treatment retention. [source]

    Problematic heroin use incidence trends in Spain

    ADDICTION, Issue 2 2009
    Albert Sánchez-Niubň
    ABSTRACT Aims To estimate the annual incidence of heroin use in Spain. Participants and design Data on individuals' year of first heroin use (from 1971 to 2005), year of first heroin treatment between 1991 and 2005 and most frequent route of heroin administration when presenting to treatment were obtained from the Spanish Drug Observatory Register and used to calculate the delay between onset and treatment. By using a log-linear model approach it was possible to correct for missing observations (heroin users who presented for treatment before 1991 and those who had still not presented by the end of 2005) and to estimate heroin incidence over time. Findings The estimated incidence of problematic heroin use in the population aged 15,44 peaked at 190 per 100 000 in 1980,after rising rapidly from less than 40 per 100 000 in 1971,and fell subsequently to about 8 per 100 000 in 2005. On average, incidence was five times higher in men. Injecting heroin incidence peaked and declined rapidly from 1980; as heroin smoking did not decline as rapidly, from 1985 onwards its estimated incidence has remained above that of heroin injecting. The delay between starting heroin use and entering treatment had a median of 3 years. Conclusions We demonstrate the utility of a method to estimate heroin incidence from analysis of observed trends in presentations at specialist drug treatment facilities. The estimates suggest that incidence of heroin use, especially injecting, has fallen since 1980 and is now lower than in the early 1970s. [source]

    Optimization of a single-effect evaporation system to effectively utilize thermal energy

    Raafat Alnaizy
    Abstract Wastewater treatment facilities at Emirates Gold in Dubai seek to improve the steam economy of the existing single-effect with recirculation and vapor-compression evaporation process. Maximizing steam economy is important as it impacts treatment costs. There are two main approaches for improving steam economy in evaporators. One is to use a multiple-effect evaporator; the other is to use a mechanical vapor recompression. Multiple-effect evaporators were rejected because of higher capital and power cost. One of the suggestions that were made towards improving the steam economy was to recover heat from the steam condensate. A modified process flow diagram was proposed and investigated. The modified process was simulated using SuperPro Designer and Hysys with complete material and energy balance computation. The modified process increased the total water evaporation capacity and gained 40% better steam economy of the process. Another advantage was an increase in the amount of water reused, which is both economical and environmentally friendly. © 2008 American Institute of Chemical Engineers Environ Prog, 2009 [source]

    Paleosols in Central Illinois as Potential Sources of Ammonium in Groundwater

    Justin J. G. Glessner
    Glacially buried paleosols of pre-Holocene age were evaluated as potential sources for anomalously large concentrations of ammonium in groundwater in East Central Illinois. Ammonium has been detected at concentrations that are problematic to water treatment facilities (greater than 2.0 mg/L) in this region. Paleosols characterized for this study were of Quaternary age, specifically Robein Silt samples. Paleosol samples displayed significant capacity to both store and release ammonium through experiments measuring processes of sorption, ion exchange, and weathering. Bacteria and fungi within paleosols may significantly facilitate the leaching of ammonium into groundwater by the processes of assimilation and mineralization. Bacterial genetic material (DNA) was successfully extracted from the Robein Silt, purified, and amplified by polymerase chain reaction to produce 16S rRNA terminal restriction fragment length polymorphism (TRFLP) community analyses. The Robein Silt was found to have established diverse and viable bacterial communities. 16S rRNA TRFLP comparisons to well-known bacterial species yielded possible matches with facultative chemolithotrophs, cellulose consumers, nitrate reducers, and actinomycetes. It was concluded that the Robein Silt is both a source and reservoir for groundwater ammonium. Therefore, the occurrence of relatively large concentrations of ammonium in groundwater monitoring data may not necessarily be an indication of only anthropogenic contamination. The results of this study, however, need to be placed in a hydrological context to better understand whether paleosols can be a significant source of ammonium to drinking water supplies. [source]

    Enhancing the effectiveness of residential treatment for substance abusing pregnant and parenting women: Focus on maternal reflective functioning and mother-child relationship

    Marjukka Pajulo
    Substance abuse during early motherhood has become a significant problem and has led to accelerated efforts to develop specific treatment facilities for these mothers and children. Despite the often intensive treatment efforts in residential settings, there is surprisingly little evidence of their efficacy for enhancing the quality of caregiving. The situation of these mother-child pairs is exceptionally complex and multilevel, and has to be taken into account in the content and structuring of treatment. Intensive work in the "here and now" focusing on the mother-child relationship from pregnancy onwards in an effort to enhance maternal reflective capacity and mindedness is considered a key element for better treatment prognosis, in terms of both abstinence and quality of parenting. Pioneering work with such a focus is described in this article. [source]

    Incidence, types and characteristics of aggressive behaviour in treatment facilities for adults with mild intellectual disability and severe challenging behaviour

    N. H. Tenneij
    Abstract Background Inpatient aggression in treatment facilities for persons with intellectual disability (ID) can have aversive consequences, for co-clients and staff, but also for the aggressors themselves. To manage and eventually prevent inpatient aggressive incidents, more knowledge about their types and characteristics is necessary. Method In four facilities, totalling 150 beds, specialized in the treatment of adults with mild ID or severe challenging behaviour, aggressive incidents were registered during 20 weeks using the Staff Observation Aggression Scale-Revised. Characteristics of auto-aggressive and outwardly directed incidents and differences in their incidence in male and female clients in these facilities were compared. Results During the observation period of 20 weeks, 639 aggressive incidents were documented. Most of these (71%) were outwardly directed, predominantly towards staff, while most of the remaining incidents were of an auto-aggressive nature. Of the 185 clients present during the observation period, 44% were involved in outwardly directed incidents (range per client 1,34), and 12% in auto-aggressive incidents (range per client 1,92). Auto-aggressive and outwardly directed incidents differed regarding source of provocation, means used during the incident, consequences of the incident and measures taken to stop the incident. The proportion of men and women involved in each type of incident was comparable, as well as the majority of the characteristics of outwardly directed incidents caused by men and women. Conclusions Although approximately half of all clients were involved in aggressive incidents, a small minority of clients were responsible for the majority of incidents. Therefore, better management and prevention of aggressive incidents for only a small group of clients could result in a considerable overall reduction of aggressive incidents in treatment facilities. Comparability of aggressive behaviour in these facilities shown by men and women and differences in characteristics of auto-aggressive and outwardly directed incidents are discussed. [source]

    Behind the Walls and Beyond: Restorative Justice, Instrumental Communities, and Effective Residential Treatment

    ABSTRACT Although restorative justice principles and practice have been applied extensively in community-based juvenile justice settings, implementation in residential treatment facilities has been far less common. We describe recent experimentation and possibilities for broader application to disciplinary infractions, the response to harm and crime, promoting community and citizen input, "community building" for conflict resolution skill development and changing the culture of facilities, and reentry. We conceptualize three "communities" as most relevant to addressing needs of incarcerated youths, their victims, and support groups, and then discuss theoretical frameworks and empirical research supportive of restorative practice in this context. Challenges to implementation of restorative practice, compatibility with other treatment and disciplinary agendas, and concerns about preserving the integrity of the model are also considered. [source]

    Developing anticancer chemotherapy services in a developing country: Hodgkin lymphoma experience

    PEDIATRIC BLOOD & CANCER, Issue 4 2008
    Jagdish Chandra MD
    Abstract Background and Objective Reporting on how the cancer treatment facilities were developed at a medical college hospital in India and the profile and outcome of patients with Hodgkin lymphoma (HL) at this new center were the objectives of the study. Methods Patients under 18 years with a diagnosis of HL were evaluated using abdominal ultrasonography, CT scan examination of chest, abdomen and pelvis and bone marrow examination. Most patients were treated with combination chemotherapy. Departments of Radiodiagnosis and Pathology were involved for evaluation. Radiotherapy when required was made available at a nearby hospital. Results Thirty-five patients between 1.2 and 18 years (median age 7 years) were diagnosed as HL during the study period. Advanced disease (Stage IIb or more) was present in 83% cases. Mixed cellularity was the commonest histological subtype (50.5%). Primary therapy used was COPP in 29 (83%) cases. Of the 34 patients who received treatment 30 showed initial good response to therapy. One patient responded to ABVD after having progression on COPP. Of 31 responders, 4 relapsed. Twenty-seven patients (80%) are surviving free of disease for a median follow up of 4.5 years (range 1.5,18 years). Chemotherapy was well tolerated. Febrile neutropenia occurred in four cases. Conclusions Pediatric HL in India was characterized by advanced disease at presentation. Mixed-cellularity was the predominant histological subtype. An effective program was developed with initial attention to patients with HL. Pediatr Blood Cancer 2008;51:485,488. © 2008 Wiley-Liss, Inc. [source]

    Assessment of anthrax vaccination data in the Defense Medical Surveillance System, 1998,2004,

    Daniel C. Payne PhD MSPH
    Abstract Purpose Understanding the completeness and accuracy of U.S. military anthrax vaccination data is important to the design and interpretation of studies to assess the safety of anthrax vaccine. We estimated the agreement between electronically recorded anthrax vaccination data in the Defense Medical Surveillance System (DMSS) versus anthrax vaccination data abstracted from hardcopy medical charts in a representative sample of the U.S. military from 1998 to 2004. Methods Medical chart abstractions were conducted at 28 military treatment facilities for 4201 personnel. Abstracted anthrax vaccination data for 1817 personnel, representing 7400 anthrax vaccine doses, were compared with electronically captured data in the DMSS from 1998 to 2004. Sensitivity, positive predictive value (PPV), specificity and negative predictive value (NPV) were calculated using weighted analyses. Results Weighted person-level analysis revealed DMSS sensitivity,=,93.8% (95%CI,=,91.1, 95.8), specificity,=,87.0% (79.0, 92.3), PPV,=,85.6% (77.2, 91.3) and NPV,=,94.5% (91.7, 96.4). Report of anthrax vaccination within a ±7 days window in both medical chart and DMSS electronic data had a sensitivity of 88.3% (85.4, 90.7) and a PPV of 86.6% (84.9, 88.2) in the vaccine dose-level analysis. Conclusions These results support that anthrax vaccination data captured by the DMSS are adequate for post-marketing surveillance investigations in the U.S. military and are of comparable quality to data captured by other vaccine safety databases. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    Critical Failures in a Regional Network of Residential Treatment Facilities

    Thomas W. Pavkov
    The present descriptive case study reports on the state of treatment services and environmental settings in adolescent residential treatment facilities (RTFs) conducted as part of the Residential Treatment Center Evaluation Project. The project frequently uncovered poor quality of care exposing youth to deleterious conditions. Observations related to harsh treatment practices, psychiatric practice and medication management, educational and aftercare planning, and general treatment planning were closely examined. The analysis indicated that accreditation and licensing are insufficient to assure the quality of the service process in RTFs. Future research should address the relationship between treatment quality and treatment outcome. Efforts should also be made to develop strategies for organizational change to support high-quality services in RTFs. [source]

    Beyond Point and Level Systems: Moving Toward Child-Centered Programming

    FAAN, Wanda K. Mohr PhD
    Many residential treatment facilities and child inpatient units in the United States have been structured by way of motivational programming such as the point and/or level systems. On the surface, they appear to be a straightforward contingency management tool that is based on social learning theory and operant principles. In this article, the authors argue that the assumptions upon which point and level systems are based do not hold up to close empirical scrutiny or theoretical validity, and that point and level system programming is actually counterproductive with some children, and at times can precipitate dangerous clinical situations, such as seclusion and restraint. In this article, the authors critique point and level system programming and assert that continuing such programming is antithetical to individualized, culturally, and developmentally appropriate treatment, and the authors explore the resistance and barriers to changing traditional ways of "doing things." Finally, the authors describe a different approach to providing treatment that is based on a collaborative problem-solving approach and upon which other successful models of treatment have been based. [source]

    Definition and Accountability: A Youth Perspective

    Kathryn Whitehead BA
    This paper reviews the systemic flaws of residential treatment facilities from a youth perspective concerning the lack of transparency, definition and accountability, and the subsequent mistreatment and human rights violations of youth experiencing emotional, behavioral, and cognitive challenges. [source]

    Development of a novel process for the biological conversion of H2S and methanethiol to elemental sulfur

    Jan Sipma
    Abstract The feasibility of anaerobic treatment of wastewater containing methanethiol (MT), an extremely volatile and malodorous sulfur compound, was investigated in lab-scale bioreactors. Inoculum biomass originating from full-scale anaerobic wastewater treatment facilities was used. Several sludges, tested for their ability to degrade MT, revealed the presence of organisms capable of metabolizing MT as their sole source of energy. Furthermore, batch tests were executed to gain a better understanding of the inhibition potential of MT. It was found that increasing MT concentrations affected acetotrophic organisms more dramatically than methylotrophic organisms. Continuous reactor experiments, using two lab-scale upflow anaerobic sludge bed (UASB) reactors (R1 and R2), aimed to determine the maximal MT load and the effect of elevated sulfide concentrations on MT conversion. Both reactors were operated at a hydraulic retention time (HRT) of about 7 hours, a temperature of 30°C, and a pH of between 7.3 and 7.6. At the highest influent MT concentration applied, 14 mM in R1, corresponding to a volumetric loading rate of about 50 mM MT per day, 87% of the organic sulfur was recovered as hydrogen sulfide (12.2 mM) and the remainder as volatile organic sulfur compounds (VOSCs). Upon decreasing the HRT to 3.5 to 4.0 h at a constant MT loading rate, the sulfide concentration in the reactor decreased to 8 mM and MT conversion efficiency increased to values near 100%. MT conversion was apparently inhibited by the high sulfide concentrations in the reactor. The specific MT degradation rate, as determined after 120 days of operation in R1, was 2.83 ± 0.27 mmol MT g VSS,1 day,1. During biological desulfurization of liquid hydrocarbon phases, such as with liquefied petroleum gas (LPG), the combined removal of hydrogen sulfide and MT is desired. In R2, the simultaneous addition of sodium sulfide and MT was therefore studied and the effect of elevated sulfide concentrations was investigated. The addition of sodium sulfide resulted in enhanced disintegration of sludge granules, causing significant washout of biomass. Additional acetate, added to stimulate growth of methanogenic bacteria to promote granulation, was hardly converted at the termination of the experimental period. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 82: 1,11, 2003. [source]

    Factors predicting arrest for homeless persons receiving integrated residential treatment for co-occurring disorders

    Blake Barrett
    Background,Homeless individuals are at increased risk for health and criminal justice problems. Aims,The aim of this study was to examine risk factors affecting arrest rates in a cohort of homeless people with co-occurring psychiatric and substance-abuse disorders. Methods,Baseline data were collected from 96 homeless individuals residing in a residential treatment facility for people with co-occurring disorders. Arrest data were obtained for 2 years following treatment intake. Regression analyses were employed to examine interactions between study variables. Results,One third of the sample was arrested during the 2-year follow-up period, principally for drug offences. People referred to treatment directly from the criminal justice system were four times more likely to re-offend than those referred from other sources. Participants' perceived need for mental-health services reduced risk of arrest while their perception of medical needs increased this risk. Conclusions,The relationship between referral from a criminal justice source and re-arrest after admission to the treatment facility is unsurprising, and consistent with previous literature, but the suggestion of an independently increased risk in the presence of perceived physical health-care needs is worthy of further study. The lower risk of arrest for people who perceive that they have psychological needs is encouraging. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Seasonality effects on pharmaceuticals and s -triazine herbicides in wastewater effluent and surface water from the Canadian side of the upper Detroit River

    Wen Yi Hua
    Abstract The influence of seasonal changes in water conditions and parameters on several major pharmacologically active compounds (PhACs) and s -triazine herbicides was assessed in the wastewater and sewage treatment plant (WSTP) effluent as well as the downstream surface water from sites on the Canadian side of the upper Detroit River, between the Little River WSTP and near the water intake of a major drinking water treatment facility for the City of Windsor (ON, Canada). The assessed PhACs were of neutral (carbamazepine, cotinine, caffeine, cyclophosphamide, fluoxetine, norfluoxetine, pentoxifylline, and trimethoprim) and acidic (ibuprofen, bezafibrate, clofibric acid, diclofenac, fenoprofen, gemfibrozil, indomethacin, naproxen, and ketoprofen) varieties. The major assessed s -triazine herbicides were atrazine, simazine, propazine, prometon, ametryn, prometryn, and terbutryn. At sampling times from September 2002 to June 2003, 15 PhACs were detected in the WSTP effluent at concentrations ranging from 1.7 to 1,244 ng/L. The PhAC concentrations decreased by as much 92 to 100% at the Little River/Detroit River confluence because of the river dilution effect, with further continual decreases at sites downstream from the WSTP. The only quantifiable s -triazine in WSTP effluent, atrazine, ranged from 6.7 to 200 ng/L and was higher in Detroit River surface waters than in WSTP effluent. Only carbamazepine, cotinine, and atrazine were detectable at the low-nanogram and subnanogram levels in surface waters near a drinking water intake site. Unlike the PhACs, atrazine in the Detroit River is not attributable to point sources, and it is heavily influenced by seasonal agricultural usage and runoff. Detroit River surface water concentrations of carbamazepine, cotinine, and atrazine may present a health concern to aquatic wildlife and to humans via the consumption of drinking water. [source]

    Impact of activated sludge-derived colloidal organic carbon on behavior of estrogenic agonist recombinant yeast bioassay

    R. David Holbrook
    Abstract The impact of size-fractionated colloidal organic carbon (COC) originating from a biological wastewater treatment facility on the sensitivity of the yeast estrogen screen (YES) bioassay containing the human estrogen receptor (hER) gene was evaluated. Dose-response curves of serially diluted 17,-estradiol (E2), both in the presence and absence of COC, were generated by the YES bioassay. The concentration of E2 leading to a 50% YES response (effective concentration 50%, or EC50) was used to evaluate quantitatively the estrogenic activity of the different COC-E2 mixtures. The EC50 values for all COC size fractions, including COC-free samples (<1 kD), were statistically greater than the controls using Milli-Q water. Normalized EC50 values significantly increased as a function of COC concentration for the larger size fractions (>0.22 ,m), but were not significantly affected by smaller COC material at environmental levels (1,5 mg/L), while both colloidal polysaccharide concentrations and colloidal fluorophores (measured at an excitation/emission wavelength pair of 350 nm/450 nm) appear to have an important role in the sensitivity of the YES bioassay. Estimates of the colloid-associated E2 fraction did not predict accurately increases in EC50 values. Matrix effects of the specific environment being tested with the YES bioassay need to be evaluated closely due to the sensitivity of the hER and reporter plasmid. [source]

    Role of Citrobacter amalonaticus and Citrobacter farmeri in dissimilatory perchlorate reduction

    Nirmala Bardiya
    The article deals with the novel physiological function of dissimilatory perchlorate reduction by strains JB101 and JB109 isolated from a laboratory-enriched mixed consortium originating from a sewage treatment facility. The biochemical and physiological data of the strains showed good correspondence with members of the family Enterobacteriaceae. The partial 16S rDNA sequence of the strains JB101 and JB109 had similarity of 99.8% to Citrobacter amalonaticus and 98% to Citrobacter farmeri, respectively. The results inferred the possibility of Citrobacter spp. to form an important group of dissimilatory perchlorate reducers among the , subclass of Proteobacteria, since the majority of the perchlorate reducers belong to two monophyletic groups, Dechloromonas and Dechlorosoma in , subclass. The perchlorate-grown Citrobacter strains preferred perchlorate to nitrate as an electron acceptor unlike most of the reported dissimilatory perchlorate reducers. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    Identifying Patients at Risk for Loss to Follow-up After Pain Center Treatment

    PAIN MEDICINE, Issue 1 2001
    Robert B. Cutler PhD
    Objective., This study was designed to identify, at admission to a pain treatment facility, characteristics of patients who will be lost to follow-up after treatment completion. Method., Patients were divided into 3 groups depending on how they responded to the 12-month follow-up. The analysis was a between-subjects design using prospective data collected at a comprehensive pain treatment facility. Low back pain patients (n = 168) received 4 weeks of multidisciplinary pain treatment. The main outcome measure was response/nonresponse to follow-up questionnaires. Results. showed that patients who were later lost to follow-up, or who were reluctant to answer follow-ups, could be predicted at treatment admission by measures of pain and functioning. The prediction equation was validated by a second group of patients, treatment noncompleters (n = 55). Conclusion., Chronic pain patients who are more likely to be lost to follow-up can be identified upon admission to a pain facility. Procedures that should decrease follow-up attrition could be implemented at program admission. [source]

    Hope as an Outcome Variable Among Youths in a Residential Care Setting

    Rodney McNeal PhD
    This study investigated changes in hope among 155 youths (ages 10 to 17 years) placed in a residential treatment facility over a 6,month period. The child and adolescent participants met criteria for a range of emotional and behavioral disorders and received interventions hypothesized to improve hopeful thinking. Hope scores significantly improved over 6 months of treatment. The positive changes in hope were not moderated by ethnicity or sex. For Agency hope scores (i.e., willpower), those with higher levels of psychopathology at admission demonstrated significantly more improvement in agency thinking over the course of 6 months. [source]

    Travelling for radiation cancer treatment: Patient perspectives

    PSYCHO-ONCOLOGY, Issue 7 2003
    Margaret I. Fitch
    Radiation treatment for cancer requires patients to receive frequent administrations and attend the treatment facility on a daily basis for several weeks. Travelling for radiation treatment has the potential to add to the distress an individual may be feeling. This study utilized in-depth interviews to capture 118 patients' perspectives about travelling for cancer treatment. Four themes emerged during the analysis of the data: (1) waiting was the most difficult part of the experience; (2) the idea of travelling for treatment was distressing; (3) travelling for treatment was tiring and posed difficulties for patients; and (4) being away from home had both benefits and drawbacks. Given the inevitability of travelling for radiation treatment, and the issues that arises for patients, supportive strategies need to be designed and implemented. Copyright © 2003 John Wiley & Sons, Ltd. [source]

    Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department

    Gail D'Onofrio MD
    ACADEMIC EMERGENCY MEDICINE 2010; 17:903,911 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, The objective was to evaluate the effects of Project Alcohol and Substance Abuse Services Education and Referral to Treatment (ASSERT), an emergency department (ED)-based screening, brief intervention, and referral to treatment program for unhealthy alcohol and other drug use. Methods:, Health promotion advocates (HPAs) screened ED patients for alcohol and/or drug problems 7 days a week using questions embedded in a general health questionnaire. Patients with unhealthy drinking and/or drug use received a brief negotiation interview (BNI), with the goal of reducing alcohol/drug use and/or accepting a referral to a specialized treatment facility (STF), depending on severity of use. Patients referred to an STF were followed up at 1 month by phone or contact with the STF to determine referral completion and enrollment into the treatment program. Results:, Over a 5-year period (December 1999 through December 2004), 22,534 adult ED patients were screened. A total of 10,246 (45.5%) reported alcohol consumption in the past 30 days, of whom 5,533 (54%) exceeded the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for low-risk drinking. Use of at least one illicit drug was reported by 3,530 patients (15.7%). Over one-fourth of screened patients received BNIs (6,266, or 27.8%). Of these, 3,968 (63%) were referred to an STF. Eighty-three percent of patients were followed at 1 month, and 2,159 (65%) had enrolled in a program. Patients who received a direct admission to an STF were 30 times more likely to enroll than those who were indirectly referred (odds ratio = 30.71; 95% confidence interval = 18.48 to 51.04). After 3 years, funding for Project ASSERT was fully incorporated into the ED budget. Conclusions:, Project ASSERT has been successfully integrated into an urban ED. A direct, facilitated referral for patients with alcohol and other drug problems results in a high rate of enrollment in treatment programs. [source]

    Effects of textual response prompts for adolescents in a substance abuse treatment program

    Sarah Ann Taylor
    Adolescents in a drug and alcohol treatment facility had behavioral deficits in having essential items ready for organized group adventure activities. Checklists (i.e., textual response prompts) were introduced. The data from five participants showed increases in the percentage of required items ready. Generalization was demonstrated across checklists for different activities, across staff and peer leaders, and a different day of the week. Performance was also maintained when the checklist was removed. It was concluded that the use of checklists can be a reliable and efficient strategy to improve performance in adolescents with a substance abuse history. Copyright © 2010 John Wiley & Sons, Ltd. [source]

    The effect of fluency training on math and reading skills in neuropsychiatric diagnosis children: a multiple baseline design

    Stephanie L. Hartnedy
    Fluency (fast and accurate responding) has been found to facilitate the retention, maintenance, endurance, and application of learned skills. Fluency training has been employed effectively in academic, vocational, industrial, and rehabilitative settings. Using a multiple baseline design, this study expanded previous applications by targeting academic deficits of children with neurological and psychiatric diagnoses in a residential treatment facility. Total response rates were measured in 60 second timed probes. Academic tool skills increased and error rates decreased for all participants after implementation of fluency training. Implications for improving attention to task and targeting minimum competency skills are discussed, as is determining the role that practice plays in increasing fluency rate. Copyright © 2005 John Wiley & Sons, Ltd. [source]