RESUMEN
The purpose of this exploratory study was to determine if a low-cost alternative to assertive community treatment (ACT) programs could achieve results comparable to those previously reported by high-fidelity ACT programs with regard to state hospital utilization by patients with long-term, treatment-refractory serious mental illness and high rates of hospital recidivism. A sample of 30 patients was exposed to a low- cost alternative to ACT for a 12-month period. A quasi-experimental research design was used to compare state hospital utilization by the treatment group and a matched comparison group. The treatment group exhibited significantly less state hospital utilization than the comparison group and had an 88% reduction in state hospital utilization in comparison to its 10-year baseline. Low cost alternatives to ACT programs may be as effective as high-fidelity programs in reducing state hospital utilization and may be more easily adaptable to the current structure, operation, and financial constraints of community mental health centers.
Asunto(s)
Prescripciones de Medicamentos/clasificación , Drogas Ilícitas/clasificación , Trastornos Relacionados con Sustancias/etiología , Recolección de Datos , Costos de los Medicamentos , Prescripciones de Medicamentos/economía , Humanos , Drogas Ilícitas/economía , Pennsylvania , Inhabilitación Médica , Rol del Médico , Factores de RiesgoRESUMEN
The predictive validity of the resource deterioration model was tested with a sample of 100 Black, elderly, low-income, unmarried, caregiving mothers of adult schizophrenic sons and/or daughters. Stressors consisted of three social variables (burden of care, economic strain, undesirable life events) and one physical variable (poor physical health). Stress mediators consisted of coping and social support resources; the outcome variable was defined as depression. The results indicated support for the resource deterioration model with regard to a physical stressor and coping resources, but not for social stressors and social support resources.
Asunto(s)
Cuidadores/psicología , Depresión/psicología , Esquizofrenia , Estrés Psicológico , Adaptación Psicológica , Negro o Afroamericano , Anciano , Depresión/etiología , Femenino , Predicción , Humanos , Persona de Mediana Edad , Modelos Psicológicos , Relaciones Madre-Hijo , Factores de Riesgo , Apoyo SocialRESUMEN
The specificity and rate of cleavage of adrenocorticotrophic hormone (ACTH) peptide bonds by endoproteinase Arg C were analyzed using capillary electrophoresis (CE) and reversed-phase (C18) high-performance liquid chromatography (HPLC). Acidic cleavage products were readily resolved by CE in uncoated capillaries using low ionic strength electrolytes. However, products predicted to have a net positive charge greater than 2 or more than 4 positively charged groups per peptide did not migrate out from the capillary at low ionic strength. Addition of salts and zwitterions to the electrolyte decreased capillary-peptide interactions such that all of the ACTH peptides examined were eluted with high efficiency separation by CE. Commercially obtained endoproteinase Arg C preparations exhibited peptidase activity at Lys-15-Lys16 and at Lys16-Arg17 in addition to the expected cleavage at Arg-X bonds. ACTH peptide bond cleavage rates for Arg8-Trp9, Arg17-Arg-18, Lys15-Lys16, and Lys16-Arg17 were 1.46, 0.096, 0.57, and 0.029 mumol min-1 mg-1 respectively. CE separations generally exhibited better resolution and were accomplished in shorter times than C18 HPLC separations. These properties make CE a particularly appropriate method for kinetic analysis of proteolytic enzyme action on peptide substrates.
Asunto(s)
Hormona Adrenocorticotrópica/química , Endopeptidasas/química , Serina Endopeptidasas , Secuencia de Aminoácidos , Animales , Cromatografía Líquida de Alta Presión , Electroforesis , Concentración de Iones de Hidrógeno , Cinética , Datos de Secuencia Molecular , Péptidos/aislamiento & purificación , PorcinosAsunto(s)
Educación Especial , Generalización Psicológica , Lectura , Niño , Femenino , Humanos , Masculino , Educación Compensatoria/métodosAsunto(s)
Terapia Conductista , Educación Especial , Esquema de Refuerzo , Animales , Concienciación , Niño , Perros , Femenino , Humanos , MasculinoRESUMEN
A token economy designed to modify the behavior of 125 adolescent males committed to a state correctional institution was implemented in the boys' cottages, focusing on social behavior (peer interaction), rule following, and task completion. The program was sequentially introduced in a multiple-baseline design in three independent cottages; a fourth group served as a comparison cottage. Appropriate behavior increased when the token program was introduced in each cottage. Data were collected for 14 months. Thus, the long-term effects of initial behavior change were assessed.