Physicians\u27 Treatment of Elderly Alcoholics

A review of the literature on physicians\u27 perceptions of alcoholics and the elderly shows that scant professional or research attention has been given to the elderly alcoholic. Medical schools offer little training on alcoholism, fostering the impression that physicians do not have responsibility for treating alcoholic patients. An exploratory study of 26 physicians reaffirmed physicians\u27 limited knowledge of, or interest in, addressing older patients\u27 drinking problems, as assessed by physicians\u27 responses to vignettes. These findings challenge the existing health care system, especially in light of the current demographic predictions that the proportion of the elderly population wilt increase substantially and the prevalence of alcohol-related problems in this age group. Strategies to address the drinking problems of the elderly are discussed

Alternatives to Incarceration for Substance Abusing Female Defendants/Offenders in Massachusetts, 1996-1998

In July 1997, the Massachusetts State Legislature, recognizing the challenge presented by the problem of substance abuse for women in the criminal justice system, authorized funds to the Department of Public Health’s Bureau of Substance Abuse Services for a study of substance using female offenders to be conducted by the John W. McCormack Institute at the University of Massachusetts Boston. Since March 1998, a group of researchers at the McCormack Institute and the Criminal Justice Center at UMass Boston has gathered and analyzed a wealth of quantitative and qualitative information on women offenders in Massachusetts. This information includes data from the case files for a random sample of women arraigned in 1996 in two district courts in Greater Boston; interviews with court personnel from these two courts; interviews with a statewide sample of treatment providers; interviews with substance abusing female offenders in Greater Boston; and the Department of Public Health’s Bureau of Substance Abuse Services admission and discharge statistics. It is important to keep in mind that the data from the probation case files were not limited to women who were “on probation” but included a sample drawn from all women arraigned in 1996. In addition, all data were gathered in Spring/Summer 1998 and capture the court response from 1996 thru 1998. The following summarizes the results of our study and offers a series of recommendations for court personnel, treatment providers, and other policy makers concerned with the issues of women who are both substance abusers and who have entered (or who are at risk of entering) the Massachusetts criminal justice system

Parenting from Prison: Family Relationships of Incarcerated Women in Massachusetts

Historically in the United States, there has been little concern about the needs of incarcerated women and their family members, especially children. This began to change with the tremendous increase in the number of incarcerated women. The rate of women’s incarceration increased dramatically during the 1980s and today the number of female inmates continues to rise faster than the number of male inmates. In 1986, 19,812 women were incarcerated in the United States and this number rose in 1991 to 38,796. Today, over 112,000 women are incarcerated in state or federal facilities (Sabol et al., 2007; Snell 1994). While in 1995 women comprised 6.1% of the prison population, women currently make up 7.2% (Sabol et al., 2007). This report will review the literature on incarcerated women with a particular emphasis on family relationships, provide an overview of incarcerated women in Massachusetts and their family ties, and specifically focus on mothers’ concerns for their children. It will offer a review of “innovative practices” in the field and offer recommendations for improving the care of women in correctional facilities in Massachusetts with regard to women’s family connections. The overall goal of the project is to identify existing needs, resources and challenges related to the development and maintenance of contact between incarcerated women in Massachusetts and members of their families, especially children

Inotuzumab ozogamicin in pediatric patients with relapsed/refractory acute lymphoblastic leukemia

Although inotuzumab ozogamicin (InO) is recognized as an effective agent in relapsed acute lymphoblastic leukemia (ALL) in adults, data on safety and efficacy in pediatric patients are scarce. We report the use of InO in 51 children with relapsed/ refractory ALL treated in the compassionate use program. In this heavily pretreated cohort, complete remission was achieved in 67% of patients with overt marrow disease. The majority (71%) of responders were negative for minimal residual disease. Responses were observed irrespective of cytogenetic subtype or number or type of prior treatment regimens. InO was welltolerated; grade 3 hepatic transaminitis or hyperbilirubinemia were noted in 6 (12%) and grade 3/4 infections in 11 (22%) patients. No patient developed sinusoidal obstruction syndrome (SOS) during InO therapy; however, 11 of 21 (52%) patients who underwent hematopoietic stem cell transplantation (HSCT) following InO developed SOS. Downregulation of surface CD22 was detected as a possible escape mechanism in three patients who developed a subsequent relapse after InO. We conclude that InO is a well-tolerated, effective therapy for children with relapsed ALL and prospective studies are warranted. Identification of risk factors for developing post-HSCT SOS and strategies to mitigate this risk are ongoing

Substance Abuse Treatment: Options, Challenges, and Effectiveness

This is the first compendium of the entire range of options available for treating substance abuse, with a focus on effectiveness. The book synthesizes treatment approaches from medicine, psychology, sociology, and social work, and investigates regimens that range from brief interventions to the most intensive and expensive types of inpatient treatment programs. It examines controversies over best practices in substance treatment and closely analyzes current research findings and their applicability for improving substance abuse treatment in the future. Written for both academics and clinicians, the book translates complex research findings into an easily understandable format. Substance Abuse Treatment examines the circumstances under which a treatment is considered effective and how effectiveness is measured. It discusses treatment goals and looks at the importance of client motivation in positive treatment outcomes. A great variety of inpatient and outpatient treatment options are examined, as are self-help programs such as Alcoholics Anonymous. This segues to a discussion of the changing role of self-help programs in treatment. The text also analyzes changes in the substance abuse treatment industry that make treatment more costly and less available to those without financial resources. It gives special attention to the treatment of diverse populations, those with co-occurring disorders, and criminal justice populations. National, state, and local prevention efforts are covered as well as substance abuse prevention and future issues in treatment. The book is intended for undergraduate and graduate substance abuse courses in all relevant areas of study. In addition, it will be an important reference for substance abuse clinicians and other health professionals who treat patients with substance abuse issues

Parenting from Prison: Family Relationships of Incarcerated Women in Massachusetts

Historically in the United States, there has been little concern about the needs of incarcerated women and their family members, especially children. This began to change with the tremendous increase in the number of incarcerated women. The rate of women’s incarceration increased dramatically during the 1980s and today the number of female inmates continues to rise faster than the number of male inmates. In 1986, 19,812 women were incarcerated in the United States and this number rose in 1991 to 38,796. Today, over 112,000 women are incarcerated in state or federal facilities (Sabol et al., 2007; Snell 1994). While in 1995 women comprised 6.1% of the prison population, women currently make up 7.2% (Sabol et al., 2007). This report will review the literature on incarcerated women with a particular emphasis on family relationships, provide an overview of incarcerated women in Massachusetts and their family ties, and specifically focus on mothers’ concerns for their children. It will offer a review of “innovative practices” in the field and offer recommendations for improving the care of women in correctional facilities in Massachusetts with regard to women’s family connections. The overall goal of the project is to identify existing needs, resources and challenges related to the development and maintenance of contact between incarcerated women in Massachusetts and members of their families, especially children

The Health Equity Scholars Program: Innovation in the Leaky Pipeline

Despite attempts to increase enrollment of under-represented minorities (URMs: primarily Black/African American, Hispanic/Latino, and Native American students) in health professional programs, limited progress has been made. Compelling reasons to rectify this situation include equity for URMs, better prepared health professionals when programs are diverse, better quality and access to health care for UMR populations, and the need for diverse talent to tackle difficult questions in health science and health care delivery. However, many students who initiate traditional “pipeline” programs designed to link URMs to professional schools in health professions and the sciences, do not complete them. In addition, program requirements often restrict entry to highly qualified students while not expanding opportunities for promising, but potentially less well-prepared candidates. The current study describes innovations in an undergraduate pipeline program, the Health Equity Scholars Program (HESP) designed to address barriers URMs experience in more traditional programs, and provides evaluative outcomes and qualitative feedback from participants. A primary outcome was timely college graduation. Eighty percent (80%) of participants, both transfer students and first time students, so far achieved this outcome, with 91% on track, compared to the campus average of 42% for all first time students and 58–67% for transfers. Grade point averages also improved (p = 0.056) after program participation. Graduates (94%) were working in health care/human services positions and three were in health-related graduate programs. Creating a more flexible program that admits a broader range of URMs has potential to expand the numbers of URM students interested and prepared to make a contribution to health equity research and clinical care