bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacological options for management of opioid dependence
Authors: Christie Macdonald J. , Harvey Anna I. 
Published: July 2006

AbstractMethadone is currently the only opioid available for the pharmacotherapy of opioid dependence. Cross‐tolerance between methadone and other opioids constitutes the pharmacological basis for substitution and attenuating the effects of illicit opioid use. However, these principles limit the utility of methadone. Potential alternative opioids include long‐acting partial agonists such as buprenorphine and pure antagonists such as naltrexone. Buprenorphine is an alternative to methadone with intermediate intrinsic efficacy. It has a large margin of safety, yet displays some agonist actions similar to methadone. It has greater potential than methadone to safely and effectively block the actions of illicit opioids. Naltrexone is a safe, convenient opioid‐antagonist for use following detoxification from opioid agonists. Its main use is to block the actions of other opioids, thereby attenuating or eliminating illicit use during treatment. However, it is poorly accepted by many clients, limiting its application to a sub‐group who are highly motivated to detoxify. The distinct pharmacological properties of these opioids can overcome some of the drawbacks of methadone, but other limitations may emerge. Non‐opioid adjuncts such as α2‐adrenoceptor agonists can also have a role during detoxification. These drugs might be of use for specific groups of opioid users, providing therapists with the flexibility to tailor pharmacotherapy to the individual needs of clients.
In‐patient setting and long duration for the treatment of alcohol dependence? Out‐patient care is as good
Authors: MATTICK RICHARD P. , JARVIS TRACEY 
Published: July 2006

AbstractA combined narrative/meta‐analytic review of the results of a number of well‐conducted randomized controlled clinical trials indicates that there is no evidence that usual treatment delivered in an in‐patient or residential setting is superior to treatment delivered on an out‐patient or non‐residential basis for the treatment of alcohol dependence. Nor is there any evidence to support the view that in‐patient/residential treatment is superior to day patient intervention, or that longer in‐patient treatment is superior to shorter in‐patient treatment. The studies suggest that in‐patient/residential care should not be considered as a standard setting for intervention for alcohol dependence. However, the results of these trials do not contradict the view that in‐patient/residential care remains suitable for specific sub‐populations of alcohol dependent individuals, such as those requiring closely supervised detoxification, respite care, or who (because of the extreme severity of dependence on alcohol) may require an intense form of supervised intervention. Research should be conducted to establish whether treatment on an in‐patient basis does yield an advantage for this last group. [Mattick RP, Jarvis T. In‐patient setting and long duration for the treatment of alcohol dependence? Out‐patient care is as good. Drug Alcohol Rev 1994;13:127–135.]
A summary of recommendations for the management of alcohol problems: the quality assurance in the treatment of drug dependence project
Authors: MATTICK RICHARD P. , JARVIS TRACEY 
Published: July 2006

AbstractThis report presents outlines for approaches to intervening with excessive drinkers and problem/dependent drinkers. These recommendations are based on a meta‐analysis of the treatment‐outcome literature, a survey of treatment practices used in Australia and the views of a panel of experts. Recommendations for assessment, detoxification and intervention for excessive, problem and dependent drinkers are made. A number of interventions that are deemed unsuitable for use in this area, or that hold promise but require more evidence before they can be advocated for use are set out. [Mattick RP, Jarvis T. A summary of recommendations for the management of alcohol problems: The quality assurance in the treatment of drug dependence project. Drug Alcohol Rev 1994;13:167–177.]
Drug and alcohol education in New South Wales: what do nurses want to learn?
Authors: NOVAK HELENA , PETCH IRENE 
Published: July 2006

AbstractWe surveyed 432 accredited nurses in New South Wales to identify topics they perceived as a priority for inclusion in drug and alcohol education programmes. The results were analysed according to educational preparation, field of nursing speciality and area/region of employment of subjects. The selection of topics was influenced by field of nursing and location (urban versus country) of employment. These results suggest that more than just a single, core course is necessary to meet the needs of nurses. Additional courses, whose content is augmented by topics which are specifically relevant to various nursing fields, need to be provided to keep inservice and continuing drug and alcohol education clinically relevant. [Novak, H., Petch, I. Drug and alcohol education in New South Wales: what do nurses want to learn? Drug Alcohol Rev 1994;13:185–193.]
In‐patient treatment for the alcohol‐dependent person: a public health perspective
Authors: ALI ROBERT L. , CORMACK SIMONE M. 
Published: July 2006

AbstractIn accordance with public health principles, this paper is concerned with examining the individual, economic and political outcomes of in‐patient treatment for alcohol dependence. It is argued that in‐patient treatment for alcohol dependence per se is not justifiable at any of these levels, although in‐patient treatment is justifiable for the treatment of the serious biomedical sequelae of dependence. For the alcohol‐dependent person, the drinking, social, financial, psychological, work‐related and health outcomes of out‐patient treatment are as good as those for in‐patient treatment; economically, out‐patient programmes are more cost‐effective than in‐patient programmes; politically, moving the focus of treatment away from in‐patient services is more likely to contribute to a cultural milieu which recognizes problems associated with alcohol dependence early and in their many different forms, rather than only by their long‐term health consequences. [Ali RL., Cormack SM. In‐patient treatment for the alcohol‐dependent person: a public health perspective. Drug Alcohol Rev 1994;13:201–208.]
Is in‐patient treatment justified for alcohol dependence?
Authors: JURD STEPHEN 
Published: July 2006

AbstractThree lines of argument support the use of in‐patient treatment for alcohol dependence. The first of these is that of natural justice. People ailing from their dependence on alcohol have a right to as full a range of treatment options as other people have for oter disorders. Alcohol dependence is a disorder with a substantial morbidity and mortality. We should not forget that. Secondly, a variety of in‐patient treatments have been shown to have a place in the treatment armamentarium. Some in‐patient treatment is better than others, and treatment matching produces better results. Thirdly, the cost of in‐patient treatment for alcohol dependence has repeatedly been shown to produce a worthwhile economic benefit. [Jurd, S. Is in‐patient treatment justified for alcohol dependence? Drug Alcohol Rev 1994;13:195–199.]
Promotion of responsible drinking in hotels
Authors: MCLEAN STUART , WOOD LES , MONTGOMERY IAIN , DAVIDSON JODIE , JONES MICHAEL 
Published: July 2006

AbstractThis study reports on an intervention programme to promote responsible drinking in hotels. The licensees of eight hotels agreed to participate in a trial of measures designed to assist patrons to avoid drink‐driving, and seven other hotels were used as controls. The interventions acceptable to licensees comprised commercial‐quality promotional material with the theme “0.05 Know Your Limits”, and a breath analysis machine and poster on its use. Patrons leaving the hotels on Thursday, Friday and Saturday nights were interviewed and breath‐tested. Although the intervention material had been seen by one‐third of patrons in the intervention hotels, there was no significant difference between them and control hotel patrons in either median BAC or the proportion who were going to drive with BAC over the legal limit. There was poor compliance by hotels with the intervention procedures, indicating that a major impediment to the implementation and evaluation of programmes to promote responsible drinking is a lack of motivation by many licensees, despite support by some licensees and the Australian Hotels Association. [McLean, S, Wood L, Montgomery I, Davidson J, Jones M. Promotion of responsible drinking in hotels. Drug Alcohol Rev 1994;13:247–255.]
Alcohol dependence in the 1990 US National Alcohol Survey: operationalizing and comparing two nosological systems
Authors: CAETANO RAUL , ROOM ROBIN 
Published: July 2006

AbstractThe criteria for alcohol dependence in both the ICD‐10 and DSM‐III‐R nosologies were measured in a national general population survey, using 24 stem items and follow‐ups. For current (12‐month) dependence (at the criterion of 3 + components), the rate was 3.2% according to DSM‐III‐R criteria, and 5.4% according to ICD‐10. The Kappa coefficient of agreement between the two systems for classification of individuals as currently dependent was 0.62, and for lifetime diagnosis the Kappa coefficient was 0.68. Prevalence for the individual components of each diagnosis and for the underlying items are given, and the contribution of each component to the overall dependence score is examined. Implications of the results for future epidemiological work with the two classifications are discussed. [Caetano R, Room R. Alcohol dependence in the 1990 US National Alcohol Survey: operationalizing and comparing two nosological systems. Drug Alcohol Rev 1994;13:257–267.]
Route of administration and adverse effects of amphetamine use among young adults in Sydney, Australia
Authors: HALL WAYNE , HANDO JULIE 
Published: July 2006

AbstractThe relationship between route of administration and the adverse effects of amphetamine use (dependence symptoms, treatment‐seeking, adverse psychological symptoms and violence) were examined among 231 Australian amphetamine users, half of whom usually injected amphetamine. Although 87% of users were recruited from non‐treatment sources, a third had experienced symptoms of dependence on amphetamine, and a third had experienced an amphetamine‐related health problem for which one in four had sought medical attention. There was also a high prevalence of psychological symptoms, such as depression, anxiety, paranoia, hallucinations and violence which were related to frequency of amphetamine use, and use by injection. Amphetamine users need to be better informed about the potential adverse effects of amphetamine use, and about ways in which they can reduce their risks of experiencing these harms by avoiding injecting use, and the regular use of high doses of amphetamines. [Hall W, Hando J. Route of administration and adverse effects of amphetamine use among young adults in Sydney, Australia, Drug Alcohol Rev 1994;13:277–284.]
Geographical differences in risk‐taking among Sydney methadone maintenance patients: a comparison of inner city and outer south western methadone maintenance patients
Authors: DARKE SHANE , HALL WAYNE , SWIFT WENDY 
Published: July 2006

AbstractThe study compared the demographic profiles, treatment factors, current drug use, injecting behaviour and psychological functioning of inner city (ICS) and south‐west Sydney (SWS) methadone patients. A total of 104 patients from two clinics in the inner city, and 118 patients from two clinics in the outer south‐western suburbs of Sydney were interviewed using a structured interview. SWS patients were more likely to be married or de facto, to have a regular sexual partner who was an injecting drug user, and to have children in their care. While they were no more likely to have recently injected, SWS patients were twice as likely to have recently shared a needle. While SWS patients were more likely to have had sex in the month preceding interview, ICS patients were more likely to have had more than one partner in that period. Patients from the south‐western clinics were twice as likely to receive a diagnosis of antisocial personality disorder, and had poorer social functioning. The clinical implications of these differences are discussed. [Darke S, Hall W, Swift W. Geographical differences in risk‐taking among Sydney methadone maintenance patients: a comparison of inner city and outer south western methadone maintenance patients. Drug Alcohol Rev 1994;13:301–305.]
The effects of alcohol abuse on children and the partner's capacity to initiate change
Authors: BARBER JAMES G. , CRISP BETH R. 
Published: July 2006

AbstractThis paper identifies the social, psychological and cognitive effects of parental alcohol abuse on children across the lifecycle. While the evidence regarding cognitive effects is mixed, there is ample evidence of negative effects on a range of developmental outcomes. Recent advances in unilateral partner interventions open up one avenue for ameliorating this damage even when the drinker is resistant to change. [Barber JG, Crisp BR. The effects of alcohol abuse on children and the partner's capacity to initiate change. Drug Alcohol Rev 1994;13:409–416]
Excessive drinking and significant others
Authors: HOLMILA MARJA 
Published: July 2006

AbstractThis paper sets out to examine the experience of being a significant other by first discussing the existing notions and research traditions of the phenomenon. In the light of survey data it is shown that drinking problems are not only met within the circle of the nuclear family, or between the spouses. This approach presents an alternative perspective to that, which focuses on the relationship between the drinking male and the “co‐dependent” female. There are also feelings of responsibility and concern between alcoholics and their close male relatives, colleagues and friends. Comparison between the male and female experience of being a significant other is taken as a goal for further research. [Holmila M. Excessive drinking and significant others. Drug Alcohol Rev 1994;13:431–436]
Co‐dependency: a critical review
Authors: HANDS MELANIE , DEAR GREG 
Published: July 2006

AbstractThe term “co‐dependency” has become somewhat established within the vernacular of the addiction field and is being used increasingly within the popular psychology and self‐help literature. A review of this literature reveals that there is general agreement as to the core characteristics of co‐dependency but virtually no agreement as to a workable definition. Remarkably little research has been published to examine any of the assumptions within the model, so that most of the ideas presented in the literature rest on clinical observation and/or personal experience. The concept has been widely criticized from a number of theoretical perspectives. Of particular note are the feminist objections to the model. In addition, a number of the central concepts within the co‐dependency model are at odds with some of the research into family coping. Further research is urgently needed in this area. Despite many conceptual problems the development of this model has had an undoubted positive influence on family treatment and support benefiting many people within the self‐help arena. [Hands MA, Dear G. Co‐dependency: a critical review. Drug Alcohol Rev 1994;13:437–445]
Estimating the duration of common elective operations: implications for operating list management
Authors: Pandit J. J. , Carey A. 
Published: July 2006

SummaryOver‐running operating lists are known to be a common cause of cancellation of operations on the day of surgery. We investigated whether lists were overbooked because surgeons were optimistic in their estimates of the time that operations would take to complete. We used a questionnaire to assess the estimates of total operation time of 22 surgeons, 35 anaesthetists and 16 senior nursing staff for 31 common, general surgical and urological procedures. The response rate was 66%. We found no difference between the estimates of these three groups of staff, or between these estimates and times obtained from theatre computer records (p = 0.722). We then applied the average of the surgeons' estimates prospectively to 50 consecutive published surgical lists. Surgical estimates were very accurate in predicting the actual duration of the list (r2 = 0.61; p < 0.001), but were poor at booking the list to within its scheduled duration: 50% of lists were predictably overbooked, 50% over‐ran their scheduled time, and 34% of lists suffered a cancellation. We suggest that using the estimates of operating times to plan lists would reduce the incidence of predictable over‐runs and cancellations.
The effect of caudal block on functional residual capacity and ventilation homogeneity in healthy children*
Authors: Von Ungern‐Sternberg B. S. , Regli A. , Frei F. J. , Hammer J. , Schibler A. , Erb T. O. 
Published: July 2006

SummaryCaudal block results in a motor blockade that can reduce abdominal wall tension. This could interact with the balance between chest wall and lung recoil pressure and tension of the diaphragm, which determines the static resting volume of the lung. On this rationale, we hypothesised that caudal block causes an increase in functional residual capacity and ventilation distribution in anaesthetised children. Fifty‐two healthy children (15–30 kg, 3–8 years of age) undergoing elective surgery with general anaesthesia and caudal block were studied and randomly allocated to two groups: caudal block or control. Following induction of anaesthesia, the first measurement was obtained in the supine position (baseline). All children were then turned to the left lateral position and patients in the caudal block group received a caudal block with bupivacaine. No intervention took place in the control group. After 15 min in the supine position, the second assessment was performed. Functional residual capacity and parameters of ventilation distribution were calculated by a blinded reviewer. Functional residual capacity was similar at baseline in both groups. In the caudal block group, the capacity increased significantly (p < 0.0001) following caudal block, while in the control group, it remained unchanged. In both groups, parameters of ventilation distribution were consistent with the changes in functional residual capacity. Caudal block resulted in a significant increase in functional residual capacity and improvement in ventilation homogeneity in comparison with the control group. This indicates that caudal block might have a beneficial effect on gas exchange in anaesthetised, spontaneously breathing preschool‐aged children with healthy lungs.
Flexibility and light emission of disposable paediatric Miller 1 laryngoscope blades*
Authors: Goodwin N. , Wilkes A. R. , Hall J. E. 
Published: July 2006

SummaryWith the emergence of Creutzfeldt‐Jakob disease and the discovery of prions in tonsillar material, there has been an increase in the number of available disposable laryngoscope blades. This has led to non‐conformity over many aspects of blade design. Miller 1 disposable blades have been produced in both metal and plastic and appear to have different properties of rigidity. We examined the rigidity of 11 disposable Miller 1 blades in three different axes of force. There was a significant difference in flexibility between metal and plastic blades in both primary and torsional axis (p = 0.006). We also studied the blades' light intensity and angle of light emission, finding up to an eightfold difference in the level of illumination provided at a distance of 10 mm from the tips of the blades. The area of maximal illumination varied, with some blades providing narrow beams of light, and others provided a more dispersed field of illumination. In addition, the angle of maximal illumination varied between the blade types from a central position to one directed to the right‐hand side.
The clinical outcome and toxicity of high‐dose chemotherapy and autologous stem cell transplantation in patients with myeloma or amyloid and severe renal impairment: a British society of blood and marrow transplantation study
Authors: Bird Jennifer M. , Fuge Rhian , Sirohi Bhawna , Apperley Jane F. , Hunter Ann , Snowden John , Mahendra Premini , Milligan Donald , Byrne Jenny , Littlewood Timothy , Fegan Christopher , McQuaker Grant , Pagliuca Antonio , Johnson Peter , Rahemtulla Amin , Morris Curly , Marks David I. 
Published: July 2006

SummaryThe outcome of high‐dose chemotherapy (HDT) was evaluated retrospectively in 27 patients with myeloma and four patients with AL amyloidosis with severe renal impairment. Twenty‐three patients were receiving dialysis and the rest had a creatinine clearance of <20 ml/min. The median melphalan dose was 140 mg/m2 (range: 60–200 mg/m2), but 10 patients (37%) received 200 mg/m2. Myeloid and platelet engraftment were similar to that seen in patients without renal failure. Five of 27 patients died of transplant‐related toxicity before the day 100. Twenty of 27 patients had a response (70%). The median time to disease progression was 32 months (range: 6–54 months) and the median time to best response was 6·5 months. Four of 17 evaluable patients (24%) became dialysis‐independent at a median of 5 months post‐HDT/stem cell transplantation. At a median follow‐up of 70 months, 7/23 patients with myeloma were alive but three of these seven patients had progressive disease. Two of the four patients with amyloidosis have survived. HDT is feasible in these patients and results in 5‐year survival in about one‐third of patients.
The role of Janus kinases in haemopoiesis and haematological malignancy
Authors: Khwaja Asim 
Published: July 2006

SummaryThe production of blood cells is regulated by a number of protein growth factors and cytokines that influence cell survival, proliferation and differentiation. Many of these molecules bind to cell surface receptors, which belong to a family of closely related cytokine receptors that lack intrinsic catalytic activity but are intimately associated with tyrosine kinases of the Janus kinase (JAK) family. Ligand binding induces the activation of JAKs, which sit at the apex of a signalling cascade in which a key role is played by members of the signal transducers and activators of transcription (STAT) group. Congenital deficiencies in JAK–STAT signalling are associated with immunodeficiency states and acquired activating mutations and translocations are involved in the pathophysiology of haematological malignancy. The latter findings have raised hopes that drugs that target aberrant JAK–STAT signalling may be useful for the treatment of human disease.
The use of intensive family preservation services with adoptive families
Authors: Berry Marianne , Propp Jennifer , Martens Priscilla 
Published: July 2006

ABSTRACTWith the increase in special needs adoption, there is growing concern about the adjustment of these children and families beyond legalization. The purpose of this study was to explore in greater depth the use of intensive family preservation services with adoptive families and the factors related to the family’s ability to stay intact beyond services. Multiple regression analyses were used to determine factors that were predictive of the family’s ability to remain intact at 6 and 12 months post services. Potential predictors of family intactness included child characteristics, family characteristics, previous placement history and service characteristics. Results at 6 months found no significance in the full model; however, the individual factors of ethnic origin of the child, full‐time employment of the primary parent and initial placement reason were significant predictors of family intactness. At 12 months post services, the full model was highly significant, with service characteristics being the greatest predictor of the family’s ability to remain intact.