The purpose of this exploratory study was to describe a group of African American women who smoke crack. Using aggregate data from 208 interviews with women crack smokers, we randomly selected 25 women's interview data to create the 25 life-lines. These life-lines were developed in a similar manner to the time-line analysis described by Fullilove and her colleagues (1992); we focused on events that are either extraordinarily disturbing (e.g., rape, incest, death of a child, etc.), events that are usual but often stressful (e.g., birth of a child, death of a parent, etc.), and on periods of drug use. We chose this method of analysis so as to highlight the context in which many women come to use crack cocaine. The life-lines provided a retrospective (but time-ordered) perspective and in several ways provided preliminary support for a stress-diathesis perspective.

Adult↗

PubMedDate not supplied

Xestospongin C is an equally potent inhibitor of the inositol 1,4,5-trisphosphate receptor and the endoplasmic-reticulum Ca(2+) pumps.

Xestospongins, a group of macrocyclic bis-1-oxaquinolizidines isolated from the Australian sponge, Xestospongia species, are potent blockers of the inositol 1,4,5-trisphosphate (IP(3))-induced Ca2+ release in bi-directional Ca2+-flux conditions. We have now studied the effects of xestospongin C on the (45)Ca2+ uptake and the uni-directional (45)Ca2+ efflux in permeabilized A7r5 smooth-muscle cells. Xestospongin C not only inhibits the IP(3)-induced Ca2+ release, but is also an equally potent blocker of the endoplasmic-reticulum Ca2+ pump, while it has no effect on the passive Ca2+ leak. The inhibition of the IP(3) receptor did not depend on the IP(3), Ca2+ or ATP concentration. Xestospongin C can, therefore, not be considered as a selective blocker of IP(3) receptors.

Animals↗

PubMedDate not supplied

The impact of managed behavorial healthcare on the costs of psychiatric and chemical dependency treatment.

As Congress debates the Health Security Act, a key issue centers on whether and how to include mental health and substance abuse benefits and how to contain costs if and when these benefits are paid at parity with general healthcare. Previous studies estimating the average annual cost of providing behavioral healthcare services have shown considerable divergence, depending on the nature of the defined population and the inclusion of various benefit categories, out-of-pocket expense and administrative costs. Experience from 14 members of the American Managed Behavioral Healthcare Association (AMBHA) is used to define the key features of managed behavioral healthcare, and to demonstrate that a properly managed behavioral healthcare benefit can be significantly less costly than the current reform debate would admit. AMBHA companies (which have many years of experience and presently manage the cost and quality of care for over 65 million people in the United States) [See Table 3, page 28], have shown that a specialty managed care approach can achieve not only significant savings to healthcare providers, payers and society, but also improve quality and access to care. Traditional attempts at reducing mental illness benefit coverage costs have entailed limitations on the availability or access to care. These approaches, however, ignored the larger implications to society of untreated mental illness and chemical dependency. When traditional coverages have offered more extensive benefits, they have primarily favored inpatient treatment, thus increasing costs by overemphasizing care of patients at expensive inpatient settings. AMBHA's proposed principles of healthcare reform and recommended benefit packages for behavioral healthcare can be found on page 80 of this magazine.

Cost Control↗

PubMedDate not supplied

The next generation of E/M (evaluation and management) guidelines.

Explore the source record for details and available documents.

Centers for Medicare and Medicaid Services, U.S.↗