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Results for “Program Design”

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Death by design. Programmed cell death in cardiovascular biology and disease.

Programmed cell death (apoptosis) is recognized, increasingly, as a contributing cause of cardiac myocyte loss with ischemia/reperfusion injury, myocardial infarction, and long-standing heart failure. Although the exact mechanisms initiating apoptosis in these in vivo settings remain unproven, insights into the molecular circuitry controlling apoptosis more widely suggest the potential to protect mammalian ventricular muscle from apoptosis through one or more of these pathways, by pharmacological means or, conceivably, gene transfer.

Animals↗

Barriers to employability among substance dependent and nonsubstance-affected women on federal welfare: implications for program design.

OBJECTIVE: This study examined barriers to employability among women meeting criteria for a substance dependence disorder who were identified by routine screening conducted in welfare offices. The characteristics of these women were compared to other women on welfare who did not have a substance use disorder. METHOD: A sample of 214 substance dependent women on federal welfare were recruited to participate in a substance use disorders welfare demonstration project. An additional 69 nonsubstance-affected women on welfare served as a comparison sample. All participants were assessed in welfare settings through a standardized battery of measures. RESULTS: Substance dependent women reported moderate to severe substance use problems. They also reported significantly higher rates than the women with no substance use disorder of other barriers such as domestic violence, mental health problems, legal problems, child welfare investigations and fewer job skills. CONCLUSIONS: Findings raise questions about the likely effectiveness of existing welfare reform services in addressing the needs of substance dependent women.

Diagnostic and Statistical Manual of Mental Disord↗

Containing mental health treatment costs through program design: a Massachusetts study.

A single site pre-post study of seriously mentally ill patients treated in a public mental health system shows that annual treatment costs can be substantially reduced with the use of day hospital treatment. Two cohorts of psychiatric patients--282 consecutive admissions to a traditional public inpatient unit in 1980, and 340 consecutive admissions to a combination of inpatient and day hospital care in 1984--were followed 12 months after admission. The substitution of the day hospital is made possible because the facility provided a dormitory residence for those who could not go home at night. Cost savings per hospital episode are about 31 per cent when the additional costs of day hospital and residence are considered. Cost shifting from inpatient to residential sites is noted, but overall mean annual costs, when all other treatment (including additional admissions), residential and family costs were included, are reduced. Readmission rates did not rise. The generalizability of the findings is limited to public mental health centers and state hospitals.

Adult↗