Program variation in treatment outcomes among women in residential drug treatment

Multilevel modeling was used to assess the program characteristics associated with treatment retention among 637 women in 16 residential drug treatment programs in the Drug Abuse Treatment Outcome Study. Women who were pregnant or had dependent children had higher rates of retention in programs in which there were higher percentages of other such women. Longer retention was associated with higher rates of posttreatment abstinence. Bivariate analyses showed that programs with higher proportions of pregnant and parenting women provided more services related to women's needs. The findings support the provision of specialized services and programs for women in order to improve outcomes of drug abuse treatment.     

国内生活垃圾处理的发展趋势及对天津垃圾处理工作的对策

垃圾处理是生态环境建设的重要内容,是发展循环经济和再生资源的重要组成部分,也是保护环境、提高城市环境质量、改善居民生活质量的重要工作内容,对城市经济、社会可持续健康发展和人民群众健康安全具有重大意义。随着我国国民经济的快速发展,     

Predictors of treatment attrition and treatment length in Parent‐Child Interaction Therapy in Taiwanese families

Parent–Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent–child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver–child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.     

Theory and method in treatment evaluation

We outline a conceptual model of evaluation research that has both guided and flowed from our research on the process and outcome of treatment for alcohol abuse and for depression. The conceptual model encompasses three basic processes: the process of treatment selection, the process of treatment, and the process underlying the onset and course of the disorder or problem being treated. A theory guiding a program evaluation can focus on one or more of these processes, and findings from evaluations can contribute to the development of better theories of these processes. We discuss how theories can guide both experimental and naturalistic evaluations, as well as aid in the estimation of treatment effects with either type of design. We then consider the role of theory and method in exploring patient-treatment matching. Finally, we discuss the implications of theory-guidance for the utility of evaluations—particularly the utility for evaluation researchers.     

Tobacco use in the treatment trenches

As reported here (see “Dirty Words: Smoker, Vaper, Harm Reductionist?” ADAW, Oct. 14, 2019; https://onlinelibrary.wiley.com/doi/10.1002/adaw.32509 ), recently I have focused much of my time on raising alarms about the very high rates of smoking among addiction treatment and recovery populations. In addition to archival research, I have conducted a series of key informant interviews to better understand the roots of our field's ongoing reluctance to address this issue. These interviews with national leaders in the alcohol and drug field confirmed that when presented with statistics about the very high rates of cigarette smoking among treatment and recovery populations, there is widespread consternation about the resulting tobacco‐related mortality and morbidity. Paradoxically, however, this concern has not translated into strong remedial action.     

Psychopathology in pathological gamblers seeking treatment

High rates of psychiatric symptoms have been reported in pathological gamblers. This study of psychiatric comorbidity in pathological gamblers is the first to use structured psychiatric interviews assessing DSM-III-R Axis I and II disorders. The Structured Clinical Interview for DSM III-R (SCID-P, SCID-II) was administered to 40 (25 male, 15 male) pathological gamblers seeking outpatient treatment in Minnesota for gambling, and 64 (41 male, 23 female) controls. High lifetime rates of Axis I (92%) but not Axis II (25%) psychopathology were found in pathological gamblers as compared to controls. No differences between male and female gamblers were found in rates of affective, substance use or personality disorders. Females had higher rates of anxiety disorders and histories of physical/sexual abuse. Possible associations between psychiatric disorders and pathological gambling are discussed along with gambler typologies and implications for future research.The authors wish to gratefully acknowledge the assistance of: Gary Christenson, M.D., Carol Peterson, Ph.D., William Meller, M.D., Thomas Mackenzie, M.D.     

Drama therapy in diagnosis and treatment

The author examines the use of drama therapy as a therapeutic and diagnostic tool that can help provide insights into personality and character and aid in the exploration of conflicts of children in therapy.     

Perceptions by treatment staff of critical tasks in the treatment of the compulsive gambler

Seventy-five clinicians who treat compulsive gamblers were surveyed. Each rated 89 clinical tasks and responsibilities for importance in the treatment of this population. Analysis of those items for which a plurality of clinicians rated the item as critical was chosen as the criteria of importance. A principal components analysis was conducted to determine the underlying structure of clinical perceptions of importance. An eight-dimensional model was found to describe perceptions in the most satisfactory way. The analysis revealed five major and three minor clusters of tasks and responsibilities. The major dimensions were labeled as (1) self-help/social support, (2) crisis interventions, (3) behavioral resources for change, (4) psychodynamics of treatment, and (5) crisis severity. The minor dimensions were (6) knowledge and training, (7) ethics and sensitivity to needs, and (8) confidentiality and regulations. A brief discussion of the implications are presented.This research was supported in part by a grant from the Massachusetts Department of Public Health.     

Is aspiration and sclerotherapy treatment for hydroceles in the aging male an evidence-based treatment?

Symptomatic hydroceles are commonly treated with surgical repair. They are associated with sexual dysfunction in the aging male. Patients who are not fit for surgery often undergo aspiration and sclerotherapy of the hydrocele. There is a range of sclerosing agents used in the literature. I performed a literature search to assess whether one sclerosant was better than the others. STDS is the sclerosing agent with the best cure rate after a single injection and low side effect rates. The cure rates of sodium tetradecyl sulphate (STDS) after a single aspiration and injection were 76%. After multiple treatments 94% achieved a cure. Patient satisfaction rates at mean 40 months were 95%. Complication rates were generally low and much lower than surgical repair. Aspiration and sclerotherapy have a role in treating symptomatic hydroceles. This literature review shows that this is over and above its current use in the UK, where it is used for patients unfit for general anaesthetic. If the patients are carefully selected for this procedure, they can have a good outcome and avoid the higher complication rate and longer recovery rates of surgical repair. Patients should be counselled about aspiration and sclerotherapy as part of the informed consent process.     

天津市污水处理市场化研究

一、天津市污水处理的现状分析 天津市是我国严重缺水的城市之一.水量保证率只有75%.人均水资源占有量仅为160立方米.是全国人均占有量的1/15,位居全国各省市之末.水资源短缺已经成为制约天津市社会经济发展的重要因素之一.污水处理显得尤为重要.     

小城镇污水治理研究--以天津市汉沽区为例

一、概述 城镇污水是造成我国水环境污染的主要原因之一.我国现有城镇2万多个,星罗棋布,绝大多数都没有污水处理设施,对水资源构成严重威胁.根据"十五"计划纲要和<"十五"城镇化发展重点专项规划>,"十五"期间要新增城市污水处理能力2600万立方米,2005年城市污水集中处理率要达到45%,50万人口以上的城市要达到60%.据统计,到2005年要建550座城市污水处理厂,其中日处理能力5万立方米以下的污水处理厂278座,日处理能力5万～8万立方米的污水处理厂90座,小城镇污水集中处理设施将呈高速增长的态势.