Medicine and Health Sciences Commons^™

Predicting Dropout In The First 3 Months Of 12-Step Residential Drug And Alcohol Treatment In An Australian Sample, Frank P. Deane, David J. Wootton, Ching-I Hsu, Peter J. Kelly

Frank Deane

Objective: Premature termination from treatment is a major factor associated with poorer drug and alcohol treatment outcomes. The present study investigated client-related baseline predictors of dropout at 3 months from a faith-based 12-step residential drug treatment program. Method: Data were collected over a period of 14 months from eight residential drug and alcohol treatment programs run by The Australian Salvation Army. The final sample consisted of 618 participants, including 524 men (84.8%) and 94 women (15.2%). Predictor variables of interest were age, gender, primary drug of concern, criminal involvement, psychological distress, drug cravings, self-efficacy to abstain, spirituality, forgiveness of self …

Evaluation Of Very High- And Very Low-Dose Intravitreal Aflibercept In Patients With Neovascular Age-Related Macular Degeneration., Quan Dong Nguyen, Peter A. Campochiaro, Syed Mahmood Shah, David J. Browning, Henry L. Hudson, Peter L. Sonkin, Seenu M. Hariprasad, Peter K. Kaiser, Jason Slakter, Julia A. Haller, Diana V. Do, William Mieler, Karen Chu, Avner Ingerman, Robert Vitti, Alyson J. Berliner, Jesse Cedarbaum, Clear-It 1 Investigators

Journal Articles: Ophthalmology

PURPOSE: To determine bioactivity and duration of effect of intravitreal aflibercept injection (also known as vascular endothelial growth factor Trap-Eye) for neovascular age-related macular degeneration (AMD).

METHODS: In this double-masked, phase 1 study, 28 patients with lesions ≤12 disc areas, ≥50% active choroidal neovascularization (CNV), and best corrected visual acuity (BCVA) ≤20/40 were randomized 1:1 to a single intravitreal injection of aflibercept 0.15 or 4 mg. The primary end point was the change from baseline in central retinal/lesion thickness (CR/LT) at week-8. Secondary outcomes were the change from baseline BCVA, the change in CNV lesion size and area of leakage, …

Predictors Of Drug Court Client Graduation, Marie E. Gill

Theses and Dissertations (ETD)

Background: Substance use disorder in the United States adversely effects society by burdening the justice system with offender incarceration for drug-related crimes, it also strains in the healthcare system with costs in excess of $216 billion dollars for treatment of drug-related mental and physical illnesses. Many offenders of nonviolent crimes with substance use disorder have been diverted to Drug Court (DC) for year-long supervised community-based drug addiction treatment as an alternative to incarceration for non-violent drug-related crimes. Drug Court program outcomes, however, have been studied as a criminal justice intervention, rather than a primary care mental health intervention. The majority …

Treatment Of Steroid-Induced Elevated Intraocular Pressure With Anecortave Acetate: A Randomized Clinical Trial., Ingeborg Stalmans, David G. Callanan, Monte S. Dirks, Marlene R. Moster, Alan L. Robin, Joachim Van Calster, Sally A. Scheib, Jaime E. Dickerson, Theresa A. Landry, Michael V. W. Bergamini

Wills Eye Hospital Papers

PURPOSE: The present study is the first randomized clinical trial designed to evaluate the intraocular pressure (IOP)-lowering effect of anecortave acetate (AA) administered at 3 doses (3, 15, or 30 mg) as an anterior juxtascleral depot (AJD) in patients experiencing elevated IOP due to corticosteroid therapy.

METHODS: This was a double-masked, randomized, placebo-controlled, multicenter, parallel group trial. Eligible patients had an IOP of at least 24 mmHg and an IOP increase of at least 10 mmHg relative to their IOP before treatment with steroids. A target IOP was established for each patient at baseline. Patients were randomized to 1 of …

Using The Theory Of Planned Behavior And Barriers To Treatment To Predict Intention To Enter Further Treatment Following Residential Drug And Alcohol Detoxification: A Pilot Study, Peter J. Kelly, Frank P. Deane, Zoe Mccarthy, Trevor P. Crowe

Trevor Crowe

There has been limited research examining the impact of clients’ behavioural beliefs on whether they intend to access further treatment following residential drug and alcohol detoxification. Treatment post-detoxification is generally recommended to reduce relapse and for more sustained positive outcomes. The present pilot study examined the extent to which (1) primary components of the Theory of Planned Behaviour (TPB), (2) perceived barriers to accessing treatment and (3) the participants’ previous involvement in substance abuse treatment predicted intentions to enter further treatment following residential detoxification. One hundred and sixty eight participants accessing Salvation Army detoxification units in Australia completed a survey …

Withanolide Compounds As Inhibitors Of Fibrosis And Identification Of Molecular Targets For Anti-Fibrotic Drug Development, Royce Mohan, Paola Bargagna-Mohan

Ophthalmology and Visual Science Faculty Patents

Provided are methods for screening for drugs effective for treating fibrotic conditions. One screening method comprises exposing a cell to a test compound, monitoring the effect of the test compound on the amount or form of a cell molecule, comparing the amount or form of the cell molecule with the result obtained by treatment of the cell with an anti-fibrotic -effective amount of a withanolide compound, and selecting a drug effective for treating a fibrotic disease based on the ability of the test compound to provide the effect obtained by the withanolide compound on the cell molecule. Also provided is …

A Phase Ii Study Of Pulse Dose Imatinib Mesylate And Weekly Paclitaxel In Patients Aged 70 And Over With Advanced Non-Small Cell Lung Cancer, Julie E. Bauman, Keith D. Eaton, Sarah G. Wallace, Laurie L. Carr, Sang-Joon Lee, Dennie V. Jones, Hugo Arias-Pulido, Lisa A. Cerilli, Renato G. Martins

Internal Medicine Faculty Publications

BACKGROUND: In non-small cell lung cancer (NSCLC), interstitial hypertension is a barrier to chemotherapy delivery, and is mediated by platelet derived growth factor receptor (PDGFR). Antagonizing PDGFR with imatinib may improve intra-tumoral delivery of paclitaxel, increasing response rate (RR).

METHODS: This single-stage, open-label phase II study evaluated pulse dose imatinib and weekly paclitaxel in elderly patients with advanced NSCLC. Eligible patients were aged ≥ 70 with untreated, stage IIIB-IV NSCLC and ECOG performance status 0-2. Primary endpoint was RR. Secondary endpoints included median progression free and overall survival (PFS, OS) and correlatives of PDGFR pathway activation. Baseline Charlson Comorbidity Index …

Rat Brain Pro-Oxidant Effects Of Peripherally Administered 5 Nm Ceria 30 Days After Exposure, Sarita S. Hardas, Rukhsana Sultana, Govind Warrier, Mo Dan, Rebecca L. Florence, Peng Wu, Eric A. Grulke, Michael T. Tseng, Jason M. Unrine, Uschi M. Graham, Robert A. Yokel, D. Allan Butterfield

Chemistry Faculty Publications

The objective of this study was to determine the residual pro-or anti-oxidant effects in rat brain 30 days after systemic administration of a 5 nm citrate-stabilized ceria dispersion. A ∼4% aqueous ceria dispersion was iv-infused (0 or 85 mg/kg) into rats which were terminated 30 days later. Ceria concentration, localization, and chemical speciation in the brain was assessed by inductively coupled plasma mass spectrometry (ICP-MS), light and electron microscopy (EM), and electron energy loss spectroscopy (EELS), respectively. Pro- or anti-oxidant effects were evaluated by measuring levels of protein carbonyls (PC), 3-nitrotyrosine (3NT), and protein-bound-4-hydroxy-2-trans-nonenal (HNE) in the hippocampus, cortex, and …

Short- And Long-Term Effects Of Antipsychotic Drug Treatment On Weight Gain And H1 Receptor Expression, Kelly Newell, Xu-Feng Huang, Chao Deng, Tom Burne, Mei Han

Xu-Feng Huang

The present study investigated body weight gain, food intake, open-field activity and brain histamine H1 receptor mRNA and protein expression in rats treated with three types of antipsychotics. Rats were divided into eight groups and treated with aripiprazole (2.25mg/kg/day), olanzapine (1.5mg/kg/day), haloperidol (0.3mg/kg/day) or vehicle (as control) for 1 or 12 weeks. Administration of olanzapine for 1 week led to a threefold increase in body weight gain and a 35% increase in fat deposits compared to controls (p<0.05). In the 12-week olanzapine treatment group, accumulative food intake was significantly higher in the first 7 weeks of treatment compared to …

Aripiprazole Differentially Affects Mesolimbic And Nigrostriatal Dopaminergic Transmission: Implications For Long-Term Drug Efficacy And Low Extrapyramidal Side-Effects, Xu-Feng Huang, Chao Deng, Mei Han

Xu-Feng Huang

Aripiprazole has been used effectively to treat schizophrenia in the clinic ; however, its mechanisms ofaction are not clear. This study examined how short- and long-term aripiprazole treatment affects dopaminergic transmission in mesolimbic and nigrostriatal pathways. For comparison, the effects of haloperidol and olanzapine treatment were also examined. Aripiprazole significantly increased D2 receptor mRNA expression and decreased tyrosine hydroxylase (TH) mRNA expression in the ventral tegmental area (VTA) after 1- and 12-wk treatment, but had no effect in substantia nigra (SN) and nucleus accumbens (NAc). Aripiprazole also decreased dopamine transporter (DAT) binding density in NAc (for 1- and 12- wk …

Lifestyle-Gene-Drug Interactions In Relation To The Metabolic Syndrome, Leonard Storlien, Xu-Feng Huang, Linda Tapsell, Cecilia Karlsson, Maria Niklasson, John Pears, Bjorn Cl Carlsson

Xu-Feng Huang

No abstract provided.

Adverse Drug Reactions To Poison Antidotes: Part 1, Alison Jones

Alison L Jones

Summary: The probability of benefit generally outweighs the risk of adverse reactions for antidotes such as N-acetylcysteine used for treatment of paracetamol (acetaminophen) poisoning, and naloxone used in opioid poisoning. For some antidotes, such as dicobalt edetate in cyanide poisoning, administration carries high risk, and the clinical decision to use the antidote is only taken in severe poisoning. Use of an antidote rarely replaces the need for supportive measures. Except for N-acetylcysteine in paracetamol poisoning, the clinical state and not plasma concentration dictates whether an antidote is used. In pregnancy, it is usually reasoned that treatment of the mother takes …

Measuring Plasma Salicylate Concentrations In All Patients With Drug Overdose Or Altered Consciousness: Is It Necessary?, David Wood, Paul Dargan, Alison Jones

Alison L Jones

Background: Salicylate self poisoning is potentially fatal. Plasma salicylate concentrations can be used to guide management when taken in the context of clinical features of toxicity and acid base status. Previous studies in the USA and Hong Kong have shown that routine measurement of plasma salicylate concentrations in all overdose patients is inappropriate, but there have been no previous studies in the UK. Methods: A retrospective case note study from 1 February 2001 to 31 January 2002 was undertaken at the emergency department of St. Thomas’ Hospital, London. Records were reviewed and information on demographic data, history, details of salicylate …

Adverse Drug Reactions To Poison Antidotes: Part 2, Alison Jones

Alison L Jones

Administration of antidotes such as dicobalt edetate in cyanide poisoning or dimercaprol in arsenic poisoning carries a high risk of adverse reactions, and the clinical decision to use the antidote is only taken in severe poisoning. Supportive measures such as ventilation may be required in addition to the antidote. In pregnancy, it is usually reasoned that treatment of the mother takes precedence and provides the best chance for fetal survival, notwithstanding worries about teratogenicity.

Drug Interactions With Paracetamol, M Toes, Alison Jones, L Prescott

Alison L Jones

Paracetamol (acetaminophen) is one of the most commonly used analgesic antipyretic drugs worldwide, and it is widely available by prescription and over the counter (OTC). Fortunately, few clinically significant drug interactions have been documented. There is probable potentiation of hepatotoxicity following an overdose from the paracetamol metabolite NAPQI by enzyme-inducing drugs. There is considerable controversy regarding the possible interaction with warfarin in its potential to increase its anticoagulant effects because of discrepancies between observational studies and those in healthy volunteers. Otherwise, no serious adverse drug interactions with therapeutic doses of paracetamol have been confirmed in humans. Because the absorption of …

Risk Of Road Traffic Accidents In Patients Discharged Following Treatment For Psychotropic Drug Overdose: A Self-Controlled Case Series Study In Australia, Tharaka L. Dassanayake, Alison L. Jones, Patricia Michie, Gregory Carter, Patrick Mcelduff, Barrie J. Stokes, Ian Whyte

Alison L Jones

Background: Use of psychotropic drugs is known to impair driving and increase the risk of road traffic accidents. They are also the most common drugs taken in overdose in hospital-treated episodes of self-poisoning. Most patients who take psychotropic drug overdoses are discharged within 48 hours, while they still have possible subclinical drug effects. Objective: Using a self-controlled case series design, we aimed to determine whether patients with psychotropic drug overdose are at a higher risk of a traffic accident in the period following discharge compared with a control period not associated with hospital-treated drug overdose. Methodology: Using the New South …

Doctors' Knowledge Of The Appropriate Use And Route Of Administration Of Antidotes In The Management Of Recreational Drug Toxicity, S Lidder, Hanna Ovaska, J.R.H Archer, S Greene, Alison Jones, Paul Dargan, David Wood

Alison L Jones

Background: Specific antidotes (eg, naloxone, flumazenil, cyproheptadine and benzodiazepines) are available for the management of certain recreational drug-induced toxicities. Some controversies surround the use of some of these antidotes, especially flumazenil in benzodiazepine toxicity. There are no previously published data on doctors’ knowledge of the use of these specific antidotes. Methods: A questionnaire survey was designed to determine internal/emergency medicine doctors’ knowledge of the appropriate use of antidotes in the management of clinical scenarios of acutely poisoned patients. For nine simulated clinical scenarios of acute toxicity from recreational drugs (benzodiazepines, cocaine, N-methyl-L-(3, 4-methylene-dioxyphenyl)-2-aminopropane (MDMA)-induced serotonin toxicity and opioids), they were …

Neuroleptic Malignant Syndrome Or A Statin Drug Reaction? A Case Report, Joyce Cooper, Alison Jones

Alison L Jones

A 60-year-old woman with a long psychiatric history presented with delirium and mutism. She was febrile, with marked limb rigidity and elevated creatinine kinase (CK) level. Current medications included pericyazine. Current or recent use of dopamine-blocking agents, such as pericyazine, together with a disturbance in conscious state, autonomic dysfunction, and an elevated CK level may be suggestive of neuroleptic malignant syndrome (NMS). The diagnosis was confirmed as NMS, and she was successfully treated with bromocriptine. Eight years later, she represents with symptoms suggesting recurrence of NMS including elevated CK level and myalgia, however, without limb rigidity. Current medications include quetiapine, …

Drug Abusers And Poisoned Patients: A Potential Source Of Organs For Transplantation?, Alison Jones, K Simpson

Alison L Jones

One of the major constraints to transplantation of solid organs is lack of availability of grafts and any attempt to use all available donors is to be welcomed. We address the possibility of expanding the transplant donor pool by inclusion of more patients who have suffered intoxication with drugs premortem. Particularly important in this context is the exclusion of organ-specific damage, and also infective risk to the potential recipient due to viral causes in the donor.

Drug Misuse Should Always Be Considered In Young People With Impaired Consciousness, K R. Whelan, Alison L. Jones, Paul I. Dargan

Alison L Jones

We agree with Ikeda et al that the absence of systolic hypertension may provide some discriminatory power towards exclusion of brain lesions, be they ischaemic, haemorrhagic, or space occupying in nature.1 However, we disagree with them that neurological examination of patients with impaired consciousness is often a waste of time and resources and can delay diagnosis.

Cognitive Impairment In Patients Clinically Recovered From Central Nervous System Depressant Drug Overdose, Tharaka Dassanayake, Patricia Michie, Alison Jones, Gregory Carter, Trevor Mallard, Ian Whyte

Alison L Jones

Central nervous system depressant drugs (CNS-Ds) are known to impair cognitive functions. Overdose of these drugs is common, and most of the hospital-treated patients are discharged within 24 to 48 hours. No previous studies have examined whether they have residual impairment at the time of discharge. Our aim was to evaluate whether patients with CNS-D overdose are impaired in cognitive domains important in daily activities at that time. We compared visuomotor skills (Trail-Making Test A and Choice Reaction Time), executive functions (viz attentional set-shifting: Trail-Making Test B; and planning: Stockings of Cambridge Task from the Cambridge Neuropsychological Test Automated Battery), …

Invisible, Underserved, And Diverse: The Health Of Women In Prison, Janette Taylor, R. Williams, M. Eliason

Janette Y. Taylor

In the United States of America, women are the fastest growing segment of the criminal justice system. They are entering the system with far greater physical and mental health problems than men, but with fewer health services. Additionally, within this expanding population of incarcerated women, are disproportionately represented poor women of color with serious health needs. This article: a) uses an ecosocial model to examine and critique the health and healthcare of women in prison, b) examines social structures that influence incarceration and health status, and c) proposes reconsideration of current prison health services and education.

Using The Theory Of Planned Behavior And Barriers To Treatment To Predict Intention To Enter Further Treatment Following Residential Drug And Alcohol Detoxification: A Pilot Study, Peter J. Kelly, Frank P. Deane, Zoe Mccarthy, Trevor P. Crowe

Frank Deane

There has been limited research examining the impact of clients’ behavioural beliefs on whether they intend to access further treatment following residential drug and alcohol detoxification. Treatment post-detoxification is generally recommended to reduce relapse and for more sustained positive outcomes. The present pilot study examined the extent to which (1) primary components of the Theory of Planned Behaviour (TPB), (2) perceived barriers to accessing treatment and (3) the participants’ previous involvement in substance abuse treatment predicted intentions to enter further treatment following residential detoxification. One hundred and sixty eight participants accessing Salvation Army detoxification units in Australia completed a survey …

Predictors Of Burnout Amongst Australian Drug And Alcohol Workers, M Dimartino, Peter Kelly, Frank Deane

Peter Kelly

No abstract provided.

Exploring Spiritual Growth And Forgiveness In Drug And Alcohol Recovery, Geoffrey Lyons, Frank Deane, Peter Kelly

Peter Kelly

No abstract provided.

Staff Attitudes Towards Evidence Based Practice In A Residential Drug And Alcohol Rehabilitation Service, M Lovett, Peter Kelly, Frank Deane, Trevor Crowe

Peter Kelly

No abstract provided.

Using The Theory Of Planned Behavior And Barriers To Treatment To Predict Intention To Enter Further Treatment Following Residential Drug And Alcohol Detoxification: A Pilot Study, Peter J. Kelly, Frank P. Deane, Zoe Mccarthy, Trevor P. Crowe

Peter Kelly

There has been limited research examining the impact of clients’ behavioural beliefs on whether they intend to access further treatment following residential drug and alcohol detoxification. Treatment post-detoxification is generally recommended to reduce relapse and for more sustained positive outcomes. The present pilot study examined the extent to which (1) primary components of the Theory of Planned Behaviour (TPB), (2) perceived barriers to accessing treatment and (3) the participants’ previous involvement in substance abuse treatment predicted intentions to enter further treatment following residential detoxification. One hundred and sixty eight participants accessing Salvation Army detoxification units in Australia completed a survey …

Utilizing A Health Behavior Model To Design Drug Education/Prevention Programs, Donald Iverson

Don C. Iverson

The underlying philosophical and practical problems encountered when designing drug education/prevention programs are reviewed. The necessity for utilizing a health behavior model as the basis for any prevention program is discussed and the Health Belief Model is proposed as the model of choice. The Health Belief Model is described and its most relevant components are outlined. The drug education material and teaching methodology which complement the model are reviewed as well as specific suggestions regarding selection of the most appropriate material for inclusion in the program.

The Effects Of An Education Intervention Program For Juvenile Drug Abusers And Their Parents, Donald Iverson, Stephen Jurs, Lawrence Johnson, Rita Rohen

Don C. Iverson

The Juvenile Intervention Program represents an attempt to intervene in the development of juvenile drug dependence. The program involves the early identification of juvenile drug abusers followed by the recruitment of the juveniles and their parents into the program. The program utilizes the principles of family involvement and peer pressure throughout the program, while the basis of the program involves the education of the participants in such areas as family architecture, family communication patterns and drug knowledge.

Effects Of Low-Dose Drinking Water Arsenic On Mouse Fetal And Postnatal Growth And Development, Courtney D. Kozul-Horvath, Fokko Zandbergen, Brian P. Jackson, Richard I. Enelow, Joshua W. Hamilton

Dartmouth Scholarship

Background: Arsenic (As) exposure is a significant worldwide environmental health concern. Chronic exposure via contaminated drinking water has been associated with an increased incidence of a number of diseases, including reproductive and developmental effects. The goal of this study was to identify adverse outcomes in a mouse model of early life exposure to low-dose drinking water As (10 ppb, current U.S. EPA Maximum Contaminant Level). Methodology and Findings: C57B6/J pups were exposed to 10 ppb As, via the dam in her drinking water, either in utero and/or during the postnatal period. Birth outcomes, the growth of the F1 offspring, and …