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The article presents a study which aims at evaluating presumably therapeutic components within a therapeutic community in terms of received helpfulness by patients and staff of an alcohol treatment unit. Eighteen male patients and 18 staff members participated. A nonparametric statistic was used as an index of treatment philosophy articulation or degree of value-sharing. A core of activities valued congruently by patients and staff was identified. A decision was made on the basis of all the information at hand to modify the activity to make it psychologically therapeutic. Art therapy, with a structured format and individualized feedback, was substituted for art classes. Patients recognize its value as one component in the overall program, and so there is better attendance and less dissatisfaction.

This study is a replication and extension an earlier study which generated a screening interview for alcoholism with computer assistance. Its goals were to assess the degree of concordant validation (agreement between screening interview decision and clinical diagnosis) and to lest the validity of an exit-path x severity hypothesis. Fifty Veterans Administration Hospital patients on an Alcohol Treatment Unit were interviewed with a standardized 22-item inventory which included the eight items comprising the screening inventory. Eighty-four per cent concordance of screening interview and clinical diagnosis was obtained. Fifty-four percent of the sample was identified with only two items (i.e., positive responses to morning drinking? and blackouts?). The exit-path x severity hypothesis gained general support although the first two alcoholic exit-paths showed considerable overlap. The screening inventory, appeared to be an efficient instrument and is recommended for further use. It may lead to underdiagnosis, especially with schizophrenic drinkers and episodic-stress drinkers. It validity as a prognostic device has yet to be tested. [ABSTRACT FROM AUTHOR]

Based on an investigation of the literature from 1951 to 1975, it can be generalized that alcoholism programs featuring multiple treatment components and dealing with a patient class of good prognosis might be expected to achieve a 50% success rate at l-yr follow-up, in contrast to programs with limited resources and poor-prognosis patients, which can expect a success rate of only 15%. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to examine temporal nationwide utilization patterns and predictors for use of positron emission tomography/computed tomography (PET/CT) in comparison with magnetic resonance imaging (MRI) and computed tomography (CT) among patients diagnosed with bladder cancer., Materials and Methods: A total of 36,855 patients aged 66 years or older diagnosed with clinical stage TI-IV, N0M0 bladder cancer from 2004 to 2011 were analyzed. We used multivariable logistic regression analyses to discern factors associated with receipt of imaging within 12 months from diagnosis. The Cochran-Armitage test for trend was used to determine changes in the proportion of patients receiving imaging after cancer diagnosis., Results: Independent of clinical stage, there was marked increase in use of PET/CT throughout the study period (2011 vs. 2004: odds ratio, 17.55; 95% confidence interval, 10.14-30.38; P < .001). Although use of CT imaging remained stable during the study period, there was significantly decreased utilization of MRI (odds ratio, 0.60; 95% confidence interval, 0.49-0.75; P < .001) in 2011 versus 2004. The mean incremental cost of PET/CT versus CT and MRI was $1040 and $612 (in 2016 dollars), respectively. Extrapolating these findings to the patients with bladder cancer in the United States results in excess spending of $11.6 million for PET/CT imaging., Conclusion: We identified rapid adoption of PET/CT imaging independent of clinical stage, resulting in excess national spending of $11.6 million for this imaging modality alone. Further value-based research discerning the clinical versus economic benefits of advanced imaging among patients with bladder cancer are needed., (Copyright © 2017 Elsevier Inc. All rights reserved.)