Treatment Factors (treatment + factor)

Distribution by Scientific Domains

Selected Abstracts

Twelve-Step affiliation and 3-year substance use outcomes among adolescents: social support and religious service attendance as potential mediators

ADDICTION, Issue 6 2009
Felicia W. Chi
ABSTRACT Aims Twelve-Step affiliation among adolescents is little understood. We examined 12-Step affiliation and its association with substance use outcomes 3 years post-treatment intake among adolescents seeking chemical dependency (CD) treatment in a private, managed-care health plan. We also examined the effects of social support and religious service attendance on the relationship. Design We analyzed data for 357 adolescents, aged 13,18, who entered treatment at four Kaiser Permanente Northern California CD programs between March 2000 and May 2002 and completed both baseline and 3-year follow-up interviews. Measures Measures at follow-up included alcohol and drug use, 12-Step affiliation, social support and frequency of religious service attendance. Findings At 3 years, 68 adolescents (19%) reported attending any 12-Step meetings, and 49 (14%) reported involvement in at least one of seven 12-Step activities, in the previous 6 months. Multivariate logistic regression analyses indicated that after controlling individual and treatment factors, 12-Step attendance at 1 year was marginally significant, while 12-Step attendance at 3 years was associated with both alcohol and drug abstinence at 3 years [odds ratio (OR) 2.58, P < 0.05 and OR 2.53, P < 0.05, respectively]. Similarly, 12-Step activity involvement was associated significantly with 30-day alcohol and drug abstinence. There are possible mediating effects of social support and religious service attendance on the relationship between post-treatment 12-Step affiliation and 3-year outcomes. Conclusions The findings suggest the importance of 12-Step affiliation in maintaining long-term recovery, and help to understand the mechanism through which it works among adolescents. [source]

Changes and predictors of change in the physical health status of heroin users over 24 months

ADDICTION, Issue 3 2009
Anna Williamson
ABSTRACT Aims (i) To describe the course of physical health among the ATOS cohort over 24 months; and (ii) to examine the effects of treatment, drug use patterns and social and psychological factors on health status over 24 months. Design Longitudinal cohort. Setting Sydney, Australia. Participants A total of 615 heroin users recruited for the Australian Treatment Outcome Study (ATOS). Findings The general health of the cohort improved significantly over 24 months. Significant predictors of poor health over 24 months were: being older, being female, past month heroin, other opiate and tobacco use, past month unemployment and current major depression. Spending a greater proportion of time in residential rehabilitation (RR) was associated with better health over 24 months. No other treatment factors demonstrated a significant, independent relationship with health. Conclusions The physical health of dependent heroin users is affected by drug use and psychosocial problems. RR treatment appears to be particularly beneficial to the health of heroin users, suggesting the importance of a comprehensive approach to improving health among this group. [source]

Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancer

Jacqui Frowen BSpPath (Hons)
Abstract Background This prospective study evaluated the impact of patient demographics, tumor characteristics, and radiotherapy treatment on swallowing before and after radiotherapy or chemoradiotherapy. Methods Eighty-one patients with head and neck cancer were examined using videofluoroscopy swallowing studies (VFSS) before treatment and again at 3 and 6 months after treatment. Results Swallowing was best at baseline, significantly worse 3 months posttreatment, and improved by 6 months posttreatment. Worse swallowing was associated with: living in rural areas; ex-heavy alcohol consumption; hypopharyngeal tumor site; large (particularly T4) tumors; nonconformal radiotherapy; bilateral radiation to the pharynx; and longer radiotherapy fields. Through the use of multiple regression analysis, previous swallowing was determined to be the most common predictor of swallowing outcomes, followed by T classification, alcohol history, and radiotherapy technique. Conclusions The pretreatment and treatment factors that influenced swallowing in this cohort should be considered when planning treatment, in discussing potential side effects with patients, and when developing and testing future treatment techniques. 2009 Wiley Periodicals, Inc. Head Neck, 2010 [source]

Prognostic impact of hematogenous tumor cell dissemination in patients with stage II colorectal cancer

Moritz Koch
Abstract Adjuvant chemotherapy is not routinely recommended in patients with colorectal cancer stage UICC II. Some of these patients, however, develop recurrent disease. Therefore, valid prognostic criteria are needed to identify high-risk patients who might benefit from adjuvant therapy. Disseminated tumor cells, detected in blood and bone marrow, may prove to be a valid marker, however, the prognostic relevance of these cells remains debated. In our study, we examined the prognostic significance of disseminated tumor cells in blood and bone marrow of patients with stage II colorectal cancer. Ninety patients with potentially curative (R0) resection of colorectal cancer stage II were prospectively enrolled into the study. Bone marrow and blood samples were examined for disseminated tumor cells by CK 20 RT-PCR. Patient, tumor and treatment factors were analyzed as prognostic factors. Multivariate analysis confirmed tumor cell detection in blood (hazard ratio 2.1, p = 0.03) and T-category (hazard ratio 2.2, p = 0.02) to be independent prognostic factors for relapse-free survival. Tumor cell detection in postoperative blood samples (hazard ratio 7.7, p < 0.001) and number of removed lymph nodes (hazard ratio 6.4, p < 0.001) were independent prognostic factors for disease-specific survival. Detection of circulating tumor cells in blood samples of patients with stage II colorectal cancer identifies patients with poor outcome. This finding should be confirmed by further studies and could then be used as a basis for conducting a randomized trial evaluating the effect of adjuvant chemotherapy in stage II patients. 2006 Wiley-Liss, Inc. [source]

Area-Level Poverty Is Associated with Greater Risk of Ambulatory,Care,Sensitive Hospitalizations in Older Breast Cancer Survivors

Mario Schootman PhD
OBJECTIVES: To estimate the frequency of ambulatory care,sensitive hospitalizations (ACSHs) and to compare the risk of ACSH in breast cancer survivors living in high-poverty with that of those in low-poverty areas. DESIGN: Prospective, multilevel study. SETTING: National, population-based 1991 to 1999 National Cancer Institute Surveillance, Epidemiology, and End Results Program data linked with Medicare claims data throughout the United States. PARTICIPANTS: Breast cancer survivors aged 66 and older. MEASUREMENTS: ACSH was classified according to diagnosis at hospitalization. The percentage of the population living below the U.S. federal poverty line was calculated at the census-tract level. Potential confounders included demographic characteristics, comorbidity, tumor and treatment factors, and availability of medical care. RESULTS: Of 47,643 women, 13.3% had at least one ACSH. Women who lived in high-poverty census tracts (,30% poverty rate) were 1.5 times (95% confidence interval (CI)=1.34,1.72) as likely to have at least one ACSH after diagnosis as women who lived in low-poverty census tracts (<10% poverty rate). After adjusting for most confounders, results remained unchanged. After adjustment for comorbidity, the hazard ratio (HR) was reduced to 1.34 (95% CI=1.18,1.52), but adjusting for all variables did not further reduce the risk of ACSH associated with poverty rate beyond adjustment for comorbidity (HR=1.37, 95% CI=1.19,1.58). CONCLUSION: Elderly breast cancer survivors who lived in high-poverty census tracts may be at increased risk of reduced posttreatment follow-up care, preventive care, or symptom management as a result of not having adequate, timely, and high-quality ambulatory primary care as suggested by ACSH. [source]

Experimental analysis of specific treatment factors: Efficacy and practice implications

Jeffrey M. Lohr
Interest in the empirical demonstration of the clinical efficacy of psychosocial treatments has been rekindled by societal concerns over accountability and cost effectiveness of mental health services. The result has been the identification of specific treatments for specific disorders. The prescription of treatment content should be based on the theory of therapeutic action and/or the disorder to which it is applied. The demonstration of specific treatment efficacy requires experimental evidence showing the influence of specific procedures beyond nonspecific factors of treatment. We provide an analysis of these factors and their effects in evaluating the specific efficacy of prescriptive psychosocial treatments. Experimental procedures and designs that test the validity of specific treatments are described and applied to cognitive-behavioral treatments of generalized anxiety disorder. The empirical and professional implications of specific treatment efficacy in evidence-based practice are discussed. 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 819,834, 2005. [source]

Three-Year Chemical Dependency and Mental Health Treatment Outcomes Among Adolescents: The Role of Continuing Care

ALCOHOLISM, Issue 8 2009
Stacy Sterling
Background:, Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes. Methods:, Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization. Results:, At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively). Conclusions:, A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents. [source]

Is pleomorphic lobular carcinoma really a distinct clinical entity?

Claire L. Buchanan MD
Abstract Background Attempts to define the clinical behavior of pleomorphic lobular carcinoma (PLC) have been limited to small series, and clinical management strategies have yet to be established. We describe our experience with PLC as compared to classic ILC and invasive ductal carcinoma (IDC). Methods From 9/1996 to 5/2003, clinical and histopathologic data for 5,635 patients undergoing primary surgical treatment and sentinel lymph node biopsy for breast cancer were collected. Four hundred eighty one (8.5%) patients were diagnosed with ILC; 3,978 (70.6%) with IDC. Of those with ILC, 356 (74%) patients had material available for pathologic re-review and comprise our study population: 52 were classified as PLC; 298 were classified as classic ILC; and 6 cases were reclassified as IDC. We compared clinical, pathologic, and treatment factors for patients with PLC, ILC, and IDC using the Wilcoxon rank sum and Fisher's exact tests. Results PLC were larger than ILC and IDC (20 vs. 15 vs. 13, P,<,0.001), had more positive nodes (median 1 vs. 0 vs. 0, P,<,0.05) and more frequently required mastectomy (63.5% vs. 38.7% vs. 28.8%, P,<,0.001). In addition, more patients with PLC had developed metastatic disease compared to patients with ILC (11.5% vs. 3.7%, P,<,0.05). Conclusions These findings suggest that PLC is a distinct clinical entity that presents at a more advanced stage and may require more aggressive surgical and adjuvant treatment. J. Surg. Oncol. 2008;98:314,317. 2008 Wiley-Liss, Inc. [source]

Posttrauamatic stress disorder (PTSD) in young adult survivors of childhood cancer

Mary T. Rourke PhD
Abstract Background Posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD) were assessed in young adult survivors of childhood cancer, including the role of four sets of variables in understanding PTSD in this population: demographic characteristics, disease and treatment factors, psychosocial and functional outcomes, and cancer-related beliefs. Procedure One hundred eighty-two survivors of pediatric malignancies, ages 18,37 years old completed a psychiatric interview and self-report measures. Survivors were ,5 years from diagnosis and ,2 years from the completion of cancer treatment for a variety of cancers. Results Nearly 16% of the sample had PTSD. Most survivors reported re-experiencing symptoms. There were no significant differences between survivors with and without PTSD on demographic or disease and treatment variables. Survivors with PTSD reported more psychological problems and negative beliefs about their illness and health status than those without PTSD. A logistic regression model predicted 50% of the variance in PTSD. Conclusions PTSD affects a subset of young adult cancer survivors. These survivors experience more psychological problems in general. Beliefs about the cancer experience are more potent predictors of PTSD than demographic or disease and treatment factors. Screening for PTSS and PTSD in cancer survivors is recommended. Pediatr Blood Cancer 2007;49:177,182. 2006 Wiley-Liss, Inc. [source]

On the Status of Restoration Science: Obstacles and Opportunities

Evan Weiher
Abstract Terrestrial restoration ecology is not as well developed as aquatic and wetland restoration. There are several key obstacles to progress in restoration ecology, but these obstacles may also be viewed as opportunities to exploit. One obstacle is demonstration science, or an overreliance on simplistic experiments with few treatment factors and few levels of those factors. Complex, multivariate experiments yield greater insights, especially when teamed with sophisticated methods of data analysis. A second key obstacle is myopic scholarship that has led to little synthesis and weak conceptual theory. A greater awareness of and explicit references to ecological principles will help develop the conceptual basis of restoration science. Where should restoration ecology be headed? We should consider forming partnerships with developers, landscape artists, and industry to do complex, large-scale experiments and make restoration a more common part of everyday life. [source]

Gene expression in Large White or Duroc-sired female and castrated male pigs and relationships with pork quality

A. Kwasiborski
Summary This study assessed expression of 12 genes in 24 pig longissimus samples earlier subjected to a proteomic study by our group. Genes were selected on the basis of the earlier proteomic results. Pigs differed in rearing environment (indoors or outdoors), sire breed (Duroc or Large White) and gender (female or castrated male). At slaughter they experienced different stress conditions. The proportion of gene expression changes influenced by treatment factors was consistent with the proportion of protein changes in an earlier proteomic analysis of the same pigs. Expression levels of genes were often correlated. Gene expression was generally not correlated with the levels of the corresponding protein. Finally, most meat quality traits were correlated with the expression of at least one of the studied genes. The most meaningful of these was the association of a slower pH decline with lower levels of HSP72 expression and higher levels of HSP72 protein. ANXA2 and cMDH expression were also associated with various meat quality traits. These relationships may be related to pre-slaughter stress levels and fibre type composition. [source]

Levene Tests of Homogeneity of Variance for General Block and Treatment Designs

BIOMETRICS, Issue 1 2002
Michael E. O'Neill
Summary. This article develops a weighted least squares version of Levene's test of homogeneity of variance for a general design, available both for univariate and multivariate situations. When the design is balanced, the univariate and two common multivariate test statistics turn out to be proportional to the corresponding ordinary least squares test statistics obtained from an analysis of variance of the absolute values of the standardized mean-based residuals from the original analysis of the data. The constant of proportionality is simply a design-dependent multiplier (which does not necessarily tend to unity). Explicit results are presented for randomized block and Latin square designs and are illustrated for factorial treatment designs and split-plot experiments. The distribution of the univariate test statistic is close to a standard F -distribution, although it can be slightly underdispersed. For a complex design, the test assesses homogeneity of variance across blocks, treatments, or treatment factors and offers an objective interpretation of residual plots. [source]