Third generation information systems: integrating costs and outcomes. Tools for professional development and program evaluation.

The authors present specific procedures for obtaining cost per closed case and a case outcome rating for each closed case, computer generated, yielding a cost-outcome report for single cases and aggregated cases. The procedures are illustrated with field data from an alcohol and drug addiction service. Cost per closed case is seen as the new unit cost datum. Combined with case outcome information, the cost-outcome report is seen as a promising new measure of efficiency. The potential of the cost-outcome report as a new basis for professional self-development, increased treatment effectiveness, and program evaluation is discussed.

Effect of dietary tryptophan on plasma and brain tryptophan, brain serotonin, and brain 5-hydroxyindoleacetic acid in rainbow trout.

In order to determine the effect of dietary tryptophan level on plasma and brain tryptophan, brain serotonin, and brain 5-hydroxyindoleacetic acid levels, juvenile rainbow trout (Salmo gairdneri) were raised for 16 weeks on semipurified diets containing 0.06%, 0.16%, 0.21%, 0.26%, 0.39%, or 0.59% tryptophan. After 14 weeks, feed intake was depressed in fish fed the diets containing 0.06% or 0.16% tryptophan. No further differences in feed intake were noted between the remaining treatments. In addition, body weight was lower in fish fed diets containing 0.06%, 0.16%, or 0.21% tryptophan compared with fish fed higher levels. After 16 weeks of feeding the test diets, plasma tryptophan levels were found to be directly related to dietary tryptophan levels. Similarly, increased dietary levels of tryptophan resulted in increased brain levels of tryptophan, serotonin, and 5-hydroxyindoleacetic acid. These results demonstrate that in rainbow trout, as in mammals, altered dietary levels of tryptophan result in alterations in plasma and brain tryptophan, brain serotonin, and brain 5-hydroxyindoleacetic acid.