Search PubMed⌕ Search

Biomedical subjects

M M Wolf

Publications and source records attributed to M M Wolf.

At least 55 records · Page 3Linked to original sources

Effects of community-based group-home treatment programs on male juvenile offenders' use and abuse of drugs and alcohol.

The research literature suggests that adolescents placed in residential programs due to their delinquent behavior are at high risk for drug and alcohol use and abuse. Research is rare, however, on the effects of residential delinquency-treatment programs on drug- and alcohol-related behaviors. This study examined the comparative effects of community-based, group-home, delinquency-treatment programs in Kansas on participants' self-report measures of drug and alcohol use and abuse, and of some prosocial behaviors. The results indicated that youths (n = 82) participating in group homes using the broadly disseminated Teaching-Family approach had better during-treatment outcomes than youths (n = 103) participating in a set of comparison group homes. Corroboratively, a sample of Teaching-Family youths (n = 28) also had better during-treatment outcomes than a matched no-treatment comparison group of their friends (n = 28), while, in contrast, a sample of youths (n = 33) in the comparison group homes did not differ on during-treatment measures from a matched no-treatment comparison group of their friends (n = 33). In the post-treatment year, however, no outcome difference was evident for any of the comparisons. Regression analyses were conducted to attempt to account for variation in the during treatment drug use and prosocial behavior measures. Significant regression coefficients were found for some measures of treatment process and for measures of youths' pretreatment behavior. In a second set of regression equations, the process and pretreatment measures were less effective in accounting for variance in posttreatment outcomes. The limitations of the research and its implications for the treatment and prevention of drug and alcohol use and abuse in group-home delinquency-treatment programs are discussed.

Adolescent↗

Lorazepam: a randomized, double-blind, crossover study of a new antiemetic in patients receiving cytotoxic chemotherapy and prochlorperazine.

Lorazepam was compared to placebo to assess its control of nausea and vomiting in patients receiving cytotoxic chemotherapy and prochlorperazine. The study design was a randomized, double-blind crossover in which three consecutive chemotherapy courses were compared so that each patient acted as his or her own control. Of 107 patients entered, 80 were evaluable for analysis. Lorazepam significantly reduced the severity and duration of nausea, the severity of vomiting, and the number of vomiting episodes when compared to placebo. Anxiety was reduced during lorazepam courses but not significantly when compared to placebo. There was significantly more sedation with lorazepam courses. Overall, patients preferred lorazepam courses although this preference was significant only in the patient subset receiving doxorubicin and cyclophosphamide. Lorazepam is a useful adjunct to prochlorperazine in patients receiving cytotoxic chemotherapy.

Adolescent↗

Adriamycin combinations as salvage therapy in advanced MOPP-resistant Hodgkin's disease.

Thirty one patients with advanced MOPP-resistant Hodgkin's disease were treated with adriamycin, bleomycin, vinca alkaloid and prednisolone (ABVP). Sixteen patients received vinblastine, seven received vincristine and in eight VM26 was substituted for the vinca. Of 28 patients evaluable for response 17 (61%) achieved an objective response with five (18%) complete responders. Response was significantly inferior in patients receiving VM26. Patients with a prolonged interval since previous chemotherapy had a greater chance of complete response (p less than 0.02) as did those with previous complete response to MOPP therapy (p less than 0.05). Response to treatment did not affect overall survival (p = 0.8) although relapse free survival was significantly longer for those achieving complete response (p less than 0.01). The regimen produced minimal gastrointestinal toxicity, but significant myelosuppression. ABVP is a well tolerated salvage therapy in advanced MOPP-resistant Hodgkin's disease.

Adolescent↗

Diagnostic information derived from immunotyping 1000 patients with leukemia and lymphoma.

Immunotyping analysis has been performed on cells from 1000 patients with leukemia or lymphoma using 14 markers of cell lineage or differentiation stage over a 4 yr period. Results showed considerable heterogeneity of cell type among these groups of malignant diseases not readily apparent by morphology and histochemistry. Immunotyping contributed additional diagnostic information in 30% of patients and should be a routine procedure in 8 disease categories. These are: acute leukemia, cell type not determined; acute lymphoblastic leukemia; lymphocytosis of undetermined origin; chronic myeloid leukemia-terminal blast crisis; chronic lymphocytic leukemia; malignant lymphoma-leukemic phase; Sézary syndrome, mycosis fungoides and chronic T cell leukemia; malignant lymphoma and lymphadenopathy- ? lymphoma. Immunotyping provided information on cell lineage and differentiation stage of major leukemic cell populations. Abnormal monoclonal proliferations of B lymphocytes and the presence of primitive cells amongst normally mature tissue cells were identified. Disturbances in normal lymphoid and monocytic cell populations in blood, marrow or tissues could also be demonstrated. Many of the reagents used in this period are now replaced by monoclonal antibody reagents to human lineage and differentiation antigens. These are expected to increase diagnostic usefulness of these techniques.

Adolescent↗

An evaluation of Teaching-Family (Achievement Place) group homes for juvenile offenders.

Juvenile crime is a serious problem for which treatment approach has been found to be reliably effective. This outcome evaluation assessed during and posttreatment effectiveness of Teaching-Family group home treatment programs for juvenile offenders. The evaluation included the original Achievement Place program, which was the prototype for the development of the Teaching-Family treatment approach, 12 replications of Achievement Place, and 9 comparison group home programs. Primary dependent measures were retrieved from court and police files and included number of alleged offenses, percentage of youths involved in those alleged offenses, and percentage of youths institutionalized. Other dependent measures were subjective ratings of effectiveness obtained from the program consumers, including the group home residents. The results showed difference during treatment favoring the Teaching-Family programs on rate of alleged criminal offenses, percentage of youths involved in those offenses, and consumer ratings of the programs. The consumer ratings provided by the youths and their school teachers were found to be inversely and significantly correlated with the reduction of criminal offenses during treatment. There were no significant differences during treatment on measures of noncriminal offenses (e.g., truancy, runaway, and curfew violations). In the posttreatment year, none of the differences between the groups was significant on any of the outcome measures. The results are discussed in terms of measurement and design issues in the evaluation of delinquency treatment programs and in relation to the evaluation; of Teaching-Family group homes by Richard Jones and his colleagues.

Achievement↗

The relationship between parent-youth interaction and delinquency in group homes.

Interactions between the youths and group home parents in 10 group homes were directly observed during a 2-hour session in each home. These observations were compared to questionnaire measures of the youths' self-reported delinquency while in the group home, and their evaluation of the group home program. The results indicated that over the 10 homes there was a strong inverse correlation between mean self-reported delinquency and the average amount of time youths spent taking to (rs = -.95) and in proximity to (rs = -.81) their group home parents. Talking to group home parents also showed a positive correlation with the youths' evaluation of their group home program. Similar trends were found when the correlations were computed over individual youths, although the magnitudes were reduced. These data may have implications for our understanding of the relationship between parenting behaviors and delinquency, as well as for the improvement of group-home treatment programs.

Adolescent↗

Bone marrow necrosis diagnosed during life: clinical and laboratory features of extensive involvement.

Bone marrow necrosis occurred in two patients with non-Hodgkin's lymphoma. One had a four-year history of lymphoma for which he received combination chemotherapy. Severe bone pain, abdominal pain and fever occurred during the terminal part of his illness. The other patient presented initially with symptoms of bone pain and lymphadenopathy. At bone marrow examinations, both had anatomically extensive bone marrow necrosis with associated evidence of involvement by lymphoma. The previously recognized clinical features of bone marrow necrosis and its complications occurred in one or both of these illustrative cases, with the exception that bone tenderness was absent in both. Attempts were made to correlate the technetium-99m sulphur colloid scans with sites of disease as determined by the bone marrow examinations.

Aged↗

Hodgkin's disease terminating in acute leukaemia: report of seven cases.

Acute nonlymphocytic leukaemia developed in seven patients treated for Hodgkin's disease. All had received intensive radiotherapy and chemotherapy. One patient had clinical evidence of active Hodgkin's disease at the time of diagnosis of acute leukaemia, and of four other patients who had a post mortem examination another showed evidence of Hodgkin's disease. The median time from the first presentation with Hodgkin's disease to the development of acute leukaemia was 7.7 years. Chromosomal abnormalities were found in four patients. A preleukaemic phase was present in three patients. Survival following diagnosis of acute leukaemia was short (median four weeks) and only one patient achieved a complete remission. Although published data suggests that radiation exposure is an important aetiologic factor in the induction of acute leukaemia in patients with Hodgkin's disease, it appears likely that additional chemotherapy may have a significant potentiating effect.

Acute Disease↗

Sinus arrhythmia in acute myocardial infarction.

Sinus arrhythmia, defined by means of a calculation of variance of the R-R interval on admission to hospital, was present in 73 of 176 patients admitted to a coronary care unit with acute myocardial infarction. These patients had a lower hospital mortality. They tended to have a higher incidence of inferior infarction, and a lower incidence of anterior infarction, and to have smaller infarcts as measured by the Norris index. The main difference between patients with sinus arrhythmia and without sinus arrhythmia related to heart rates on admission to hospital, the patients with the former having slower heart rates at that time.

Acute Disease↗

The training and validation of youth-preferred social behaviors of child-care personnel.

This research sought to identify, train, and validate social behaviors preferred by youths to be used by youth-care personnel (called teaching-parents). With training, consistent increases in seven preferred behaviors were observed for the six teaching-parent trainees. These behaviors included offering to help, "getting to the point", giving reasons why a behavior is important to a youth, providing descriptions of alternative behaviors, positive feedback, smiling, and positive motivational incentives (i.e., points for task mastery exchanged for tangible reinforcers). Increases in these behaviors correlated with increases in the youths' ratings of the quality of the trainees' interactions. Posttraining levels of preferred social behavior and youth ratings for trainees also compared favorably with levels for successful professional teaching-parents. These results suggest that teaching-parents can be successfully trained to interact with youths in ways that are preferred by the youths.

Journal Article↗

Teaching children appropriate shopping behavior through parent training in the supermarket setting.

The shopping behavior of three elementary school-age boys was analyzed and parent-child interactions assessed for one boy and his mother. Estimates of parent of consumer satisfaction with child shopping behavior were also obtained. The effects of a parent-mediated treatment package on child behavior were assessed using a multiple-baseline design. Treatment produced significant increases in appropriate shopping behavior in all three children and parents became increasingly satisfied with improved child behavior. Analysis of data for one mother also revealed that her manner of interacting with her child became more positive.

Behavior Therapy↗

The social validation and training of conversational skills.

Three reliably measured components of conversation-questioning, providing positive feedback, and proportion of time spent talking-were identified and validated as to their social importance. The social validity of the three conversational behaviors was established with five female university students and five female junior-high students. Each was videotaped in conversations with previously unknown adults. The conversational ability of each girl was evaluated by a group of 13 adult judges who viewed each tape and rated each conversant "poor" to "excellent" on a seven-point rating scale. The average ratings of the girls correlated at r = 0.85 with the specified behavioral measures. These procedures were replicated with additional subjects and judges and yielded a correlation of r = 0.84. The high correlations between ratings and the objective measures suggested that the specified conversational behaviors were socially important aspects of conversational ability. Employing a multiple-baseline design across the behaviors of asking questions and providing positive feedback, an attempt was made to train four girls who used these behaviors minimally to engage in the behaviors in conversations with adults. Adult judges were again employed to rate randomly selected samples of the girls' skills in pre- and posttraining conversations. The average ratings of the girls before training were lower than both the university girls and the junior high-school girls. After training, the girls' conversational abilities were rated substantially higher than those of their junior high-school peers. These rating data validated the benefits of the training and the social importance of the behavioral components of questions and feedback in conversation. The authors suggest that it may be necessary for traditional behavior analysis measurement systems to be supplemented by social-validation procedures in order to establish the relationship between "objectively" measured behaviors and complex classes of behavior of interest to society.

Journal Article↗

Achievement Place: experiments in self-government with pre-delinquents.

One of the goals of many treatment programs for pre-delinquent youths is the development of the skills involved in the democratic decision-making process. At Achievement Place, one aspect of the treatment program is a semi-self-government system whereby the seven pre-delinquent youths can democratically establish many of their own rules of behavior, monitor their peers' behavior to detect violations of their rules, and conduct a "trial" to determine a rule violator's guilt or innocence, and to determine the consequences for a youth who violates a rule. Two experiments were carried out to determine the role of some of the procedures in the boys' participation in the self-government system. Experiment I showed that more boys participated in the discussion of consequences for a rule violation when they had complete responsibility for setting the consequence during the trials than when the teaching-parents set the consequence for each rule violation before the trial. An analysis of the rule violations in this experiment indicated that the boys in Achievement Place reported more of the rule violations that resulted in trials than reported by the teaching-parents or school personnel. The boys reported rule violations that occurred in the community and school as well as at Achievement Place, including most of the serious rule violations that came to the attention of the teaching-parents. In Experiment II, the results indicated that more trials were called when the teaching-parents were responsible for calling trials on rule violations reported by the peers than when the boys were responsible for calling trials. When the youths earned points for calling trials the average number of trials per day increased, but more trivial rule violations were reported. These results suggest that aspects of the democratic decision-making process in a small group of pre-delinquents can be studied and variables that affect participation can be identified and evaluated.

Journal Article↗