Detoxification in rehabilitation in England: effective continuity of care or unhappy bedfellows?

There is evidence that residential detoxification alone does not provide satisfactory treatment outcomes and that outcomes are significantly enhanced when clients completing residential detoxification attend rehabilitation services (Gossop, Marsden, Stewart, & Rolfe, 1999; Ghodse, Reynolds, Baldacchino, et al., 2002). One way of increasing the likelihood of this continuity of treatment is by providing detoxification and rehabilitation within the same treatment facility to prevent drop-out, while the client awaits a rehabilitation bed or in the transition process. However, there is little research evidence available on the facilities that offer both medical detoxification and residential rehabilitation. The current study compares self-reported treatment provision in 87 residential rehabilitation services in England, 34 of whom (39.1%) reported that they offered detoxification services within their treatment programmes. Although there were no differences in self-reported treatment philosophies, residential rehabilitation services that offered detoxification were typically of shorter duration overall, had significantly more beds and reported offering more group work than residential rehabilitation services that did not offer detoxification. Outcomes were also different, with twice as many clients discharged on disciplinary grounds from residential rehabilitation services without detoxification facilities. The paper questions the UK classification of residential drug treatment services as either detoxification or rehabilitation and suggests the need for greater research focus on the aims, processes and outcomes of this group of treatment providers

Methods for Evaluating Respondent Attrition in Web-Based Surveys

Background: Electronic surveys are convenient, cost effective, and increasingly popular tools for collecting information. While the online platform allows researchers to recruit and enroll more participants, there is an increased risk of participant dropout in Web-based research. Often, these dropout trends are simply reported, adjusted for, or ignored altogether. Objective: To propose a conceptual framework that analyzes respondent attrition and demonstrates the utility of these methods with existing survey data. Methods: First, we suggest visualization of attrition trends using bar charts and survival curves. Next, we propose a generalized linear mixed model (GLMM) to detect or confirm significant attrition points. Finally, we suggest applications of existing statistical methods to investigate the effect of internal survey characteristics and patient characteristics on dropout. In order to apply this framework, we conducted a case study; a seventeen-item Informed Decision-Making (IDM) module addressing how and why patients make decisions about cancer screening. Results: Using the framework, we were able to find significant attrition points at Questions 4, 6, 7, and 9, and were also able to identify participant responses and characteristics associated with dropout at these points and overall. Conclusions: When these methods were applied to survey data, significant attrition trends were revealed, both visually and empirically, that can inspire researchers to investigate the factors associated with survey dropout, address whether survey completion is associated with health outcomes, and compare attrition patterns between groups. The framework can be used to extract information beyond simple responses, can be useful during survey development, and can help determine the external validity of survey results

Relativistic Ring-Diagram Nuclear Matter Calculations

A relativistic extension of the particle-particle hole-hole ring-diagram many-body formalism is developed by using the Dirac equation for single-particle motion in the medium. Applying this new formalism, calculations are performed for nuclear matter. The results show that the saturation density is improved and the equation of state becomes softer as compared to corresponding Dirac-Brueckner-Hartree-Fock calculations. Using the Bonn A potential, nuclear matter is predicted to saturate at an energy per nucleon of --15.30 MeV and a density equivalent to a Fermi momentum of 1.38 fm$^{-1}$, in excellent agreement with empirical information. The compression modulus is 152 MeV at the saturation point.Comment: 23 pages text (LaTex) and 2 figures (paper, will be faxed upon request), UI-NTH-92-0

Horn-Coupled, Commercially-Fabricated Aluminum Lumped-Element Kinetic Inductance Detectors for Millimeter Wavelengths

We discuss the design, fabrication, and testing of prototype horn-coupled, lumped-element kinetic inductance detectors (LEKIDs) designed for cosmic microwave background (CMB) studies. The LEKIDs are made from a thin aluminum film deposited on a silicon wafer and patterned using standard photolithographic techniques at STAR Cryoelectronics, a commercial device foundry. We fabricated twenty-element arrays, optimized for a spectral band centered on 150 GHz, to test the sensitivity and yield of the devices as well as the multiplexing scheme. We characterized the detectors in two configurations. First, the detectors were tested in a dark environment with the horn apertures covered, and second, the horn apertures were pointed towards a beam-filling cryogenic blackbody load. These tests show that the multiplexing scheme is robust and scalable, the yield across multiple LEKID arrays is 91%, and the noise-equivalent temperatures (NET) for a 4 K optical load are in the range 26\thinspace\pm6 \thinspace \mu \mbox{K} \sqrt{\mbox{s}}

Decomposition of Ruthenium Olefin Metathesis Catalysts

The decomposition of a series of ruthenium metathesis catalysts has been examined using methylidene species as model complexes. All of the phosphine-containing methylidene complexes decomposed to generate methylphosphonium salts, and their decomposition routes followed first-order kinetics. The formation of these salts in high conversion, coupled with the observed kinetic behavior for this reaction, suggests that the major decomposition pathway involves nucleophilic attack of a dissociated phosphine on the methylidene carbon. This mechanism also is consistent with decomposition observed in the presence of ethylene as a model olefin substrate. The decomposition of phosphine-free catalyst (H_2IMes)(Cl)_2Ru CH(2-C_6H_4-O-i-Pr) (H_2IMes = 1,3-dimesityl-4,5-dihydroimidazol-2-ylidene) with ethylene was found to generate unidentified ruthenium hydride species. The novel ruthenium complex (H_2IMes)(pyridine)_3(Cl)_2Ru, which was generated during the synthetic attempts to prepare the highly unstable pyridine-based methylidene complex (H_2IMes)(pyridine)_2(Cl)_2Ru CH_2, is also reported

In vivo assessment of drug efficacy against Plasmodium falciparum malaria: duration of follow-up.

To determine the optimum duration of follow-up for the assessment of drug efficacy against Plasmodium falciparum malaria, 96 trial arms from randomized controlled trials (RCTs) with follow-up of 28 days or longer that were conducted between 1990 and 2003 were analyzed. These trials enrolled 13,772 patients, and participating patients comprised 23% of all patients enrolled in RCTs over the past 40 years; 61 (64%) trial arms were conducted in areas where the rate of malaria transmission was low, and 58 (50%) trial arms were supported by parasite genotyping to distinguish true recrudescences from reinfections. The median overall failure rate reported was 10% (range, 0 to 47%). The widely used day 14 assessment had a sensitivity of between 0 and 37% in identifying treatment failures and had no predictive value. Assessment at day 28 had a sensitivity of 66% overall (28 to 100% in individual trials) but could be used to predict the true failure rate if either parasite genotyping was performed (r(2) = 0.94) or if the entomological inoculation rate was known. In the assessment of drug efficacy against falciparum malaria, 28 days should be the minimum period of follow-up

y scaling in electron-nucleus scattering

Data on inclusive electron scattering from A = 4, 12, 27, 56, 197 nuclei at large momentum transfer are presented and analyzed in terms of y scaling. We find that the data do scale for y 1), and we study the convergence of the scaling function with the momentum transfer Q^2 and A

High field magnetic resonant properties of beta'-(ET)2SF5CF2SO3

A systematic electron spin resonance (ESR) investigation of the low temperature regime for the (ET)2SF5CF2SO3 system was performed in the frequency range of ~200-700 GHz, using backward wave oscillator sources, and at fields up to 25 T. Newly acquired access to the high frequency and fields shows experimental ESR results in agreement with the nuclear magnetic resonance (NMR) investigation, revealing evidence that the transition seen at 20 K is not of conventional spin-Peierls order. A significant change of the spin resonance spectrum in beta'-(ET)2SF5CF2SO3 at low temperatures, indicates a transition into a three-dimensional-antiferromagnetic (3D AFM) phase.Comment: 4 pages, 7 figures, minor grammatical change

Nuclear Self-energy and Realistic Interactions

The structure of nucleon self-energy in nuclear matter is evaluated for various realistic models of the nucleon-nucleon (NN) interaction. Starting from the Brueckner-Hartree-Fock approximation without the usual angle-average approximation, the effects of hole-hole contributions and a self-consistent treatment within the framework of the Green function approach are investigated. Special attention is paid to the predictions for the spectral function originating from various models of the NN interaction which all yield an accurate fit for the NN phase shifts.Comment: 26 pages, 12 figure