ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05347.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05348.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05349.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

We describe the strategy of constructive confrontation present in most job‐based alcoholism programs, and conclude that it is compatible with the major concepts and practices of discipline in the workplace. We review past evaluation studies of these programs, noting the rather remarkable positive outcomes often reported. We then review reasons for both accepting and rejecting these unusual findings. One of the major biases that could produce the favorable findings–selectivity bias–is then examined, using both field data and record data from a large national corporation. Samples from records in the review period 1964 through 1977 generated 377 case histories. The study also used field interviews in the same corporation in a national sample of 19 locations. We interviewed supervisors who had experienced an employee in the alcoholism program (A sample = 154) and a sample of all other supervisors (B sample = 351) who described a nonalcoholic problem employee and how he/she had been managed. The remainder of the report focuses upon two possible sources of selection bias: suspected but not referred cases in the field data, and incomplete, “lost,” cases in the record data. In both instances, the selectivity seemed to be quite minimal, insufficient to damage the conclusion that the program intervention had produced significant positive changes in job pe

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05350.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Benefit‐cost analysis is an economic evaluation methodology which can readily be applied to the analysis of small individual alcoholism programs as well as to large alcoholism service delivery systems. Computational examples are given using information routinely collected at intake and follow‐up by the Oklahoma management information system. Only minor modifications are required for programs using NIAAA's National Alcoholism Program Information System (NAPIS). Suggestions are made for improving the validity of the benefit estimates. The potential information gain through the use of benefit‐cost analysis is demonstrated in worked exa

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05351.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The Elmhurst Alcoholism Program data system relate* fraction of time patients are in remission to length of time they are known, and permits a systematic search for groups of variables which predict greater abstinence rates. Our program (inpatient detoxification ward, multidisciplinary outpatient clinic, and halfway house) sets abstinence as a goal. After initial data collection (social and demographic variables, income, education, residence, drinking and drug history, legal problems, and prior treatment), we collect data at 30 days after admission and at 2‐ or 3‐month intervals thereafter from all patients who remain in contact. Forty‐five percent of all patients are lost before 30 days. Only 32% of those still under observation at 1 yr and 27% of those still under observation at 2 yr claim continual abstinence. From among many combinations of variables examined for predictive power, a group of five was chosen as best. Patients who at their first follow‐up interview reported attending AA meetings and taking Antabuse and who in addition had a job at admission, were older, and were admitted through the clinic rather than through inpatient detoxification had a greater fraction of time abstinent. Nevertheless, the best cluster of predictor variables did not account for more than 25% of the variation in rates of abstinence. Many social variables are not independent, and some may merely be indicators of duration or severity of alcoholism. Contemporary alcoholism treatment is, at best, of limited effect

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05352.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05353.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

4‐Methylpyrazole (4‐MP), an inhibitor of alcchol dehydrogenase, rapidly abolished the accumulation of acetaldehyde following alcohol ingestion both in volunteers pretreated with the Antabuse analog calcium carbimide and in an Antabuse‐treated alcoholic. 4‐MP also attenuated other typical symptoms, including facial flushing and tachycardia, thus suggesting its usefulness in the acute treatment of severe disulfiram‐alcohol

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05354.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Central nervous system (CNS) infarcts were present at autopsy in 10 of 23 alcoholic patients and in 9 of 36 nonalcoholic patients. There were more males than expected in the infarct population and in the alcoholic population. Male subjects comprised the entire population of alcoholics with infarcts. In addition, a history of alcohol abuse was present in every case of cerebral infarction dying before age 75. The incidence of cardiomegaly was increased among the alcoholics. There were no differences between alcoholics and nonalcoholics in the incidence of diagnosed hypertension, moderate‐to‐severe coronary atherosclerosis, or adult onset diabetes. However, CNS infarction was more likely to occur at an earlier age in alcoholics than in nonalcoholics. Excessive alcohol consumption may be a risk factor in the premature development of cerebrovascular disease in ma

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05355.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The influence of ethanol on cardiac lipid metabolism has been investigated in the rat. Acute in vitro ethanol significantly stimulated the incorporation of14C‐1‐acetate but not14C‐U‐glucose into cardiac lipid in rats fed a diet free of ethanol for 3 weeks. Stimulation of incorporation was not uniform but was confined to the diglyceride and triglyceride fractions. This response of cardiac tissue lipid metabolism to acute ethanol was not observed in rats pair fed an isocaloric diet containing 36% of calories as ethanol. Chronic ethanol feeding significantly increased cardiac triglyceride content when compared with pair‐fed controls. It also stimulated oxidation of labeled palmitate, but did not affect in vitro li

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1981.tb05356.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY