RÉSUMÉ
The prediction of a reaction mechanism and the identification of the corresponding chemical intermediates is a major challenge in surface science and heterogeneous catalysis, due to a complex network of elementary steps and surface species. Here we demonstrate how to overcome this difficulty by tracking the temperature dependent formation of the initial reaction intermediates and identifying the decomposition pathways in the case of prenal, an α,ß-unsaturated aldehyde, on the Pt(111) model catalyst surface by combining vibrational spectroscopy, thermal reaction/desorption spectroscopy (TPRS) experiments and detailed theoretical analysis. TPRS characterization of this reaction up to 600 K shows a series of desorption states of H(2) (â¼280 K, 410 K and 473 K) and CO (â¼414 K), giving valuable insights into the sequence of elementary steps suggesting that the loss of hydrogen and the carbonyl functions are among the first elementary steps. HREELS experiments recorded after annealing to specific temperatures result in complex spectra, which can be assigned to several subsequently formed and transformed surface intermediates. Starting from stable prenal adsorption structures, complementary DFT calculations allow the determination of the most likely reaction pathway for the initial decomposition steps and the identification of the corresponding intermediates by comparison with HREELS. The decomposition occurs from the strongly bonded prenal adsorption structures via a dehydro-η(3)-triσ(CCC)-H1 intermediate to the highly stable η(1)-isobutylidyne species at high temperatures.
RÉSUMÉ
The Alcohol and Drug Addiction Treatment and Support Act (ADATSA) created a treatment program for indigent clients in Washington State. This research assesses the relationship between the level of treatment services received and subsequent employment outcomes. Clients who completed their plan of treatment earned more than those who did not, controlling for other factors. Those clients who received vocational services, in addition to completing treatment, earned more than those who completed treatment only. While on average wages were low, this study does show that clients once deemed 'unemployable' can become productive.
Sujet(s)
Emploi/économie , Troubles liés à une substance/rééducation et réadaptation , Adulte , Emploi/psychologie , Femelle , Humains , Mâle , Pauvreté , Analyse de régression , Salaires et prestations accessoires , Troubles liés à une substance/économie , Troubles liés à une substance/psychologie , Résultat thérapeutique , Washington/épidémiologieRÉSUMÉ
This report compares services utilization pre-admission and post-discharge in 735 consecutive persons involuntarily committed to a chemical dependency treatment program in Washington State. Patients entering treatment were in their late 30s, had multiple health problems, previous arrests for misdemeanors or felonies, and minimal structured daily activities. Post discharge, there were decreases in the use of costly acute care services including detox, psychiatric hospitalization, and mental health crisis services. Patients who completed the program were less likely to use acute care services and were more likely to participate in outpatient treatment after discharge. The overall death rate of 29.4 per 1000 persons per year was 4 times greater than the age adjusted death rate for the US adult population. Further studies of other involuntary chemical dependency treatment programs are needed to evaluate the results of this report.
Sujet(s)
Post-cure/statistiques et données numériques , Alcoolisme/rééducation et réadaptation , Internement d'un malade mental/statistiques et données numériques , Services communautaires en santé mentale/statistiques et données numériques , Sortie du patient/statistiques et données numériques , Troubles liés à une substance/rééducation et réadaptation , Adulte , Alcoolisme/mortalité , Soins ambulatoires/statistiques et données numériques , Femelle , Études de suivi , Humains , Mâle , Réadmission du patient/statistiques et données numériques , Troubles liés à une substance/mortalité , Taux de survie , Bilan opérationnel , WashingtonRÉSUMÉ
A benefit-cost analysis of full continuum (FC) and partial continuum (PC) care was conducted on a sample of substance abusers from the State of Washington. Economic benefits were derived from client self-reported information at treatment entry and at 9 months postadmission using an augmented version of the Addiction Severity Index (ASI). Average (i.e., per client) economic benefits of treatment from baseline to follow-up for both FC and PC were statistically significant for most variables and in the aggregate. The overall difference in average economic benefit between FC and PC was positive ($8,053) and statistically significant, favoring FC over PC. The average cost of treatment amounted to $2,530 for FC and $1,138 for PC (p < .01). Average net benefits were estimated to be $17,833 (9.70) for FC and $11,173 (23.33) for PC, with values showing statistical significance (p < .05). Results strongly indicate that both treatment options generated positive and significant net benefits to society.
Sujet(s)
Soins ambulatoires/économie , Coûts des soins de santé , /économie , Établissements de soins de long séjour/économie , Centres de traitement de la toxicomanie/économie , Troubles liés à une substance/rééducation et réadaptation , Analyse coût-bénéfice , Femelle , Humains , Durée du séjour/économie , Mâle , Indice de gravité de la maladie , Troubles liés à une substance/économie , WashingtonRÉSUMÉ
In 1996, Congress passed sweeping welfare reform, abolishing the Aid to Families with Dependent Children (AFDC) program. Each state now administers its own welfare-to-work program under broad federal guidelines, which require eligible adult recipients to work or perform community service. High-risk welfare recipients, especially those with chemical dependency problems, face significant obstacles in their efforts to achieve greater self-sufficiency under the new welfare-to-work programs. State databases were used to track employment outcomes for AFDC clients admitted to treatment for chemical dependency in Washington State during a two-year period. Exposure to treatment was associated with a greater likelihood of becoming employed and with increased earnings for those who became employed. Ensuring that welfare recipients with substance abuse problems have access to appropriate treatment and vocational services is critical if welfare-to-work programs are to promote greater economic self-sufficiency.
Sujet(s)
Aide sociale aux familles avec enfants à charge , Emploi/statistiques et données numériques , Troubles liés à une substance , Adulte , Bases de données factuelles , Emploi/psychologie , Humains , Revenu , Modèles logistiques , Troubles liés à une substance/thérapie , WashingtonRÉSUMÉ
The purpose of this study was to use administrative records of admissions to substance abuse treatment to construct episodes of care for publicly funded clients in Washington State, and then to analyze readmissions to treatment after an index episode. The study population was those clients who began and ended an index episode in 1995 (N = 10,284). The population was divided into two groups, which were separately analyzed based on programs run by the Washington State Division of Alcohol and Substance Abuse (DASA) [Alcohol and Drug Abuse Treatment and Support Act (ADATSA) and Non-ADATSA, named for legislation defining these programs]. Clients in each program were followed for 13 months, and proportional hazards regression was used to estimate the relationship between our treatment measures and readmission, controlling for several covariates. We compared clients based on several aspects of treatment, but our primary interest was in comparing clients that completed the index episode with those that did not complete it. For both ADATSA and Non-ADATSA clients, those completing their episode of treatment had significantly lower risks for readmission. Females and those arrested in the year prior to treatment had increased risks of readmission, while males and those receiving a combination of inpatient and outpatient treatments had lower risks of readmission. The discussion concludes with suggestions for improving statewide systems of care.
Sujet(s)
Centres de traitement de la toxicomanie , Troubles liés à une substance/thérapie , Adolescent , Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Récidive , Troubles liés à une substance/physiopathologie , Facteurs temps , Résultat thérapeutique , WashingtonRÉSUMÉ
Little is known about outcomes of treatment for individuals with mental illness and chemical dependencies. This article compares services utilization preadmission and postdischarge in 534 patients discharged from a residential treatment program in Washington State. A number of services, including chemical dependency detoxification, mental health crisis, inpatient psychiatric, medical emergency, and general medical inpatient hospitalization, were used less frequently in the period after discharge. The total reimbursement for all Medicaid services decreased by 44% from $5 million in the year prior to discharge to $2.8 million in the year after discharge. Also, individuals (32%) who completed the program were less likely to use costly, acute care services. This study was limited by the absence of a control group and posttreatment alcohol and drug use data. In addition, other unmeasured factors could have explained the association between program completion and better outcomes.
Sujet(s)
Post-cure/statistiques et données numériques , Soins ambulatoires/statistiques et données numériques , Troubles liés à une substance/thérapie , Adulte , Loi du khi-deux , Femelle , Humains , Mâle , Medicaid (USA)/statistiques et données numériques , Couplage des dossiers médicaux , Analyse de régression , Traitement résidentiel , Études rétrospectives , Troubles liés à une substance/épidémiologie , Résultat thérapeutique , États-Unis , Washington/épidémiologieRÉSUMÉ
OBJECTIVES: The primary goal of this study was to analyze completion rates of clients in drug and alcohol abuse treatment programs in Washington State and to assess the factors associated with treatment completion. A secondary goal was to examine the utility of a state information system as a source of evaluative data. METHODS: Analyses were conducted of 5827 client records contained in the Washington State Substance Abuse Monitoring System, representing a census of public clients discharged during the last quarter of 1990 from all state-funded alcohol and drug treatment programs in four treatment modalities. Logistic regression was performed to determine the independent predictors of treatment completion. RESULTS: Completion rates were highest for intensive inpatient alcohol treatment (75%) and lowest for intensive outpatient drug programs (18%). Factors associated with treatment completion included screening at a referral assessment center, education, age, ethnicity, and existence of a secondary drug problem. CONCLUSIONS: The fit between clients and treatment programs may be an important factor explaining why some clients complete treatment and others drop out. State client information systems are an important source of data for analyzing treatment completion and other outcomes.
Sujet(s)
Alcoolisme/thérapie , Sortie du patient , Abandon des soins par les patients , Troubles liés à une substance/thérapie , Adolescent , Adulte , Soins ambulatoires , Enfant , Femelle , Hospitalisation , Humains , Modèles logistiques , Mâle , Adulte d'âge moyen , Sortie du patient/statistiques et données numériques , Abandon des soins par les patients/statistiques et données numériques , Facteurs socioéconomiques , WashingtonSujet(s)
Attention , Incapacités d'apprentissage/psychologie , Enfant , Cognition , Femelle , Humains , Mâle , Facteurs tempsRÉSUMÉ
Retarded children are frequently characterized as more distractible and/or more outerdirected than are nonretarded children. In this study behavior thought to reflect these processes was described and the relationship of this kind of behavior to task demands was examined. Retarded and nonretarded children were observed while they worked on academic classroom tasks; retarded children were also observed while they worked on nonacademic tasks. Results indicated that retarded children were less attentive than were nonretarded children during academic periods: They spent less time on task, more time out of their seats, and more time "looking busy" but not working. Little support was found for the notion that retarded children are more outerdirected than are nonretarded children. Retarded children responded differently in nonacademic and academic situations, suggesting that behavior reflecting attention is task-related. Results were discussed in terms of previous conceptualizations of retarded persons' attention processes. Implications for future research and for educational practice were also discussed.
Sujet(s)
Attention , Déficience intellectuelle/psychologie , Enfant , Enseignement aux personnes ayant une déficience intellectuelle , Femelle , Humains , Mâle , Facteurs sexuels , Analyse et exécution des tâchesRÉSUMÉ
This study was designed to explore overt indices of attending behavior during a simple reaction-time (RT) task in order to assess the nature of attention problems that presumably serve to impair efficient RT performance in retarded individuals. In order to achieve this purpose, RT scores and degree of off-task glancing during the preparatory interval were compared for groups of mentally retarded and nonretarded adolescents. Results indicated that retarded participants were significantly slower in RT performance and also exhibited a greater degree of off-task glancing than did nonretarded participants. The frequent off-task glancing exhibited by retarded participants was interpreted to be reflective of inattention to task; it was suggested that this form of inattention was at least partially responsible for their slower RT performance. Suggestions for future research and methodological implications of these findings were discussed.