Physicians and health care reform--a perspective.
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Biomedical subjects
Publications and source records attributed to T Dean.
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Two versions of cognitive-behavioral therapy (CBT), one with religious content (RCT) and one with standard protocol (NRCT), were used to treat 19-20 religious patients each. Fifty-nine religious patients who met the Research Diagnostic Criteria for nonpsychotic, nonbipolar depression were treated in 18-20 1-hr sessions over 3 months. Religious and nonreligious therapists were used in each CBT group. Pastoral counseling (PCT) treatment-as-usual and waiting-list control (WLC) conditions each contained 10-11 patients. RCT and PCT patients reported significantly lower posttreatment depression and adjustment scores than did either the NRCT or the WLC condition. The CBT difference was due largely to superior performance of the nonreligious therapists (with dissimilar values to the patients) in the RCT over the NRCT condition. Improvement in the three treatment conditions was equal at 3-month and 2-year follow-ups and greater than posttreatment WLC improvement levels.
A series of 100 consecutive psychiatric in-patients who absconded from a psychiatric hospital a total of 231 times over ten months was studied. The reasons given for absconding, duration of absence, and mode of return are described. The legal status and ethnic origins of absconders differed significantly from those of the base hospital population.
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The thermal characteristics as a function of cooling rate of mannitol solutions were studied by Differential Scanning Calorimetry (DSC). The exotherm appearing during warming at -25 +/- 1 degree C could be correlated with the temperature at which frozen mannitol solutions broke vials during warming. This temperature was also consistent with the temperature at which a sharp increase in resistance was reported in a preceding paper. The DSC exotherm did not appear to be due to crystallization of amorphous mannitol but rather to some other type of solid state transition. The peak was initially broadened and then obliterated by increasing amounts of additives such as lactose, glycine, potassium chloride, and sodium chloride. The presence of these ingredients in small amounts (less than 1% of the mannitol concentration) significantly reduced or prevented breakage. Other stereoisomers of mannitol, e.g., sorbitol and dulcitol, did not show any exotherm or break vials on freezing and thawing. It was also found that different types of vials exhibited different susceptibilities to breakage.