Availability analysis of an HTGR fuel recycle facility. Summary report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sharmahd, J.N.

1979-11-01

An availability analysis of reprocessing systems in a high-temperature gas-cooled reactor (HTGR) fuel recycle facility was completed. This report summarizes work done to date to define and determine reprocessing system availability for a previously planned HTGR recycle reference facility (HRRF). Schedules and procedures for further work during reprocessing development and for HRRF design and construction are proposed in this report. Probable failure rates, transfer times, and repair times are estimated for major system components. Unscheduled down times are summarized.

Progress report on the k{sub infinity} measurements of HTGR type lattices with the oscillation technique at zero reactivity; Rapport d'advancement sur les mesures de K {sub infinite} des reseaux du type HTGR avec la technique de l'oscillateur a'reactivite' nulle (in French)

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1971-01-15

The principles of measuring k {sub infinity} for a HTGR lattice using the oscillation technique with zero reactivity were already presented at the ''9th reactor physics meeting of countries participating in the Dragon project''. A brief summary of the essential characteristics of the experiment is followed by a status report on present work.

The Shock and Vibration Digest. Volume 13, Number 4

DTIC Science & Technology

1981-04-01

Brazil to find and develop their offshore oil resources. Much detailed planning and organization have gone into this program . Given as background in...summer program is a specially developed course of study which is based on two regular MIT subjects (one graduate level and one undergraduate level...Seal on an HTGR Core Subjected to Seianic Support Motions A. Chuang General Atomic Co., San Diego, CA, ASME Paper No. 80-C2/PVP-21 Key Words

Safety and licensing of a small modular gas-cooled reactor system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, N.W.; Kelley, A.P. Jr.

A modular side-by-side high-temperature gas-cooled reactor (SBS-HTGR) is being developed by Interatom/Kraftwerk Union (KWU). The General Electric Company and Interatom/KWU entered into a proprietary working agreement to continue develop jointly of the SBS-HTGR. A study on adapting the SBS-HTGR for application in the US has been completed. The study investigated the safety characteristics and the use of this type of design in an innovative approach to licensing. The safety objective guiding the design of the modular SBS-HTGR is to control radionuclide release by the retention of fission products within the fuel particles with minimal reliance on active design features. Themore » philosophy on which this objective is predicated is that by providing a simple safety case, the safety criteria can be demonstrated as being met with high confidence through conduct of a full-scale module safety test.« less

Neutron dose rate analysis on HTGR-10 reactor using Monte Carlo code

NASA Astrophysics Data System (ADS)

Suwoto; Adrial, H.; Hamzah, A.; Zuhair; Bakhri, S.; Sunaryo, G. R.

2018-02-01

The HTGR-10 reactor is cylinder-shaped core fuelled with kernel TRISO coated fuel particles in the spherical pebble with helium cooling system. The outlet helium gas coolant temperature outputted from the reactor core is designed to 700 °C. One advantage HTGR type reactor is capable of co-generation, as an addition to generating electricity, the reactor was designed to produce heat at high temperature can be used for other processes. The spherical fuel pebble contains 8335 TRISO UO2 kernel coated particles with enrichment of 10% and 17% are dispersed in a graphite matrix. The main purpose of this study was to analysis the distribution of neutron dose rates generated from HTGR-10 reactors. The calculation and analysis result of neutron dose rate in the HTGR-10 reactor core was performed using Monte Carlo MCNP5v1.6 code. The problems of double heterogeneity in kernel fuel coated particles TRISO and spherical fuel pebble in the HTGR-10 core are modelled well with MCNP5v1.6 code. The neutron flux to dose conversion factors taken from the International Commission on Radiological Protection (ICRP-74) was used to determine the dose rate that passes through the active core, reflectors, core barrel, reactor pressure vessel (RPV) and a biological shield. The calculated results of neutron dose rate with MCNP5v1.6 code using a conversion factor of ICRP-74 (2009) for radiation workers in the radial direction on the outside of the RPV (radial position = 220 cm from the center of the patio HTGR-10) provides the respective value of 9.22E-4 μSv/h and 9.58E-4 μSv/h for enrichment 10% and 17%, respectively. The calculated values of neutron dose rates are compliant with BAPETEN Chairman’s Regulation Number 4 Year 2013 on Radiation Protection and Safety in Nuclear Energy Utilization which sets the limit value for the average effective dose for radiation workers 20 mSv/year or 10μSv/h. Thus the protection and safety for radiation workers to be safe from the radiation source has been fulfilled. From the result analysis, it can be concluded that the model of calculation result of neutron dose rate for HTGR-10 core has met the required radiation safety standards.

Preparation of high temperature gas-cooled reactor fuel element

DOEpatents

Bradley, Ronnie A.; Sease, John D.

1976-01-01

This invention relates to a method for the preparation of high temperature gas-cooled reactor (HTGR) fuel elements wherein uncarbonized fuel rods are inserted in appropriate channels of an HTGR fuel element block and the entire block is inserted in an autoclave for in situ carbonization under high pressure. The method is particularly applicable to remote handling techniques.

AGR-1 Compact 1-3-1 Post-Irradiation Examination Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Demkowicz, Paul Andrew

The Advanced Gas Reactor (AGR) Fuel Development and Qualification Program was established to perform the requisite research and development on tristructural isotropic (TRISO) coated particle fuel to support deployment of a high-temperature gas-cooled reactor (HTGR). The work continues as part of the Advanced Reactor Technologies (ART) TRISO Fuel program. The overarching program goal is to provide a baseline fuel qualification data set to support licensing and operation of an HTGR. To achieve these goals, the program includes the elements of fuel fabrication, irradiation, post-irradiation examination (PIE) and safety testing, fuel performance modeling, and fission product transport (INL 2015). A seriesmore » of fuel irradiation experiments is being planned and conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL). These experiments will provide data on fuel performance under irradiation, support fuel process development, qualify the fuel for normal operating conditions, provide irradiated fuel for safety testing, and support the development of fuel performance and fission product transport models. The first of these irradiation tests, designated AGR-1, began in the ATR in December 2006 and ended in November 2009. This experiment was conducted primarily to act as a shakedown test of the multicapsule test train design and provide early data on fuel performance for use in fuel fabrication process development. It also provided samples for post-irradiation safety testing, where fission product retention of the fuel at high temperatures will be experimentally measured. The capsule design and details of the AGR-1 experiment have been presented previously (Grover, Petti, and Maki 2010, Maki 2009).« less

AGR-1 Compact 5-3-1 Post-Irradiation Examination Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Demkowicz, Paul; Harp, Jason; Winston, Phil

The Advanced Gas Reactor (AGR) Fuel Development and Qualification Program was established to perform the requisite research and development on tristructural isotropic (TRISO) coated particle fuel to support deployment of a high-temperature gas-cooled reactor (HTGR). The work continues as part of the Advanced Reactor Technologies (ART) TRISO Fuel program. The overarching program goal is to provide a baseline fuel qualification data set to support licensing and operation of an HTGR. To achieve these goals, the program includes the elements of fuel fabrication, irradiation, post-irradiation examination (PIE) and safety testing, fuel performance, and fission product transport (INL 2015). A series ofmore » fuel irradiation experiments is being planned and conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL). These experiments will provide data on fuel performance under irradiation, support fuel process development, qualify the fuel for normal operating conditions, provide irradiated fuel for safety testing, and support the development of fuel performance and fission product transport models. The first of these irradiation tests, designated AGR-1, began in the ATR in December 2006 and ended in November 2009. This experiment was conducted primarily to act as a shakedown test of the multicapsule test train design and provide early data on fuel performance for use in fuel fabrication process development. It also provided samples for post-irradiation safety testing, where fission product retention of the fuel at high temperatures will be experimentally measured. The capsule design and details of the AGR-1 experiment have been presented previously.« less

HTGR fuels and core development program. Quarterly progress report for the period ending August 31, 1975

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1975-09-30

Studies of reactions between core materials and coolant impurities, basic fission product transport mechanisms, core graphite development and testing, the development and testing of recyclable fuel systems, and physics and fuel management studies are described. Materials studies include irradiation capsule tests of both fuel and graphite. Experimental procedures and results are discussed and, where appropriate, the data are presented in tables, graphs, and photographs. (auth)

HVAC [Heating, Ventilation and Air Conditioning] subsystem design description: 4 x 350 MW(t) Modular HTGR [High-Temperature Gas-Cooled Reactor] Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1986-06-01

The HVAC system is a subsystem within the Mechanical Services Group (MSG). The HVAC system for the 4 x 350 MW(t) Modular HTGR Plant presently consists of ten, nonsafety-related subsystems located in the Nuclear Island (NI) and Energy Conversion Area (ECA) of the plant.

Very high temperature behavior of HTGR core materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soo, P.; Uneberg, G.; Sabatini, R.

1978-01-01

A description is given of experiments to investigate the behavior of HTGR core materials during hypothetical heatup accidents in which the core temperature is assumed to reach values between 2400/sup 0/C and the graphite sublimation range (>3600/sup 0/C). The work includes BISO coated fuel particle failure, simulated fission product migration in core graphite, and graphite sublimation behavior.

Assessment of the SRI Gasification Process for Syngas Generation with HTGR Integration -- White Paper

DOE Office of Scientific and Technical Information (OSTI.GOV)

A.M. Gandrik

2012-04-01

This white paper is intended to compare the technical and economic feasibility of syngas generation using the SRI gasification process coupled to several high-temperature gas-cooled reactors (HTGRs) with more traditional HTGR-integrated syngas generation techniques, including: (1) Gasification with high-temperature steam electrolysis (HTSE); (2) Steam methane reforming (SMR); and (3) Gasification with SMR with and without CO2 sequestration.

IAEA Coordinated Research Project on HTGR Reactor Physics, Thermal-hydraulics and Depletion Uncertainty Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Strydom, Gerhard; Bostelmann, F.

The continued development of High Temperature Gas Cooled Reactors (HTGRs) requires verification of HTGR design and safety features with reliable high fidelity physics models and robust, efficient, and accurate codes. The predictive capability of coupled neutronics/thermal-hydraulics and depletion simulations for reactor design and safety analysis can be assessed with sensitivity analysis (SA) and uncertainty analysis (UA) methods. Uncertainty originates from errors in physical data, manufacturing uncertainties, modelling and computational algorithms. (The interested reader is referred to the large body of published SA and UA literature for a more complete overview of the various types of uncertainties, methodologies and results obtained).more » SA is helpful for ranking the various sources of uncertainty and error in the results of core analyses. SA and UA are required to address cost, safety, and licensing needs and should be applied to all aspects of reactor multi-physics simulation. SA and UA can guide experimental, modelling, and algorithm research and development. Current SA and UA rely either on derivative-based methods such as stochastic sampling methods or on generalized perturbation theory to obtain sensitivity coefficients. Neither approach addresses all needs. In order to benefit from recent advances in modelling and simulation and the availability of new covariance data (nuclear data uncertainties) extensive sensitivity and uncertainty studies are needed for quantification of the impact of different sources of uncertainties on the design and safety parameters of HTGRs. Only a parallel effort in advanced simulation and in nuclear data improvement will be able to provide designers with more robust and well validated calculation tools to meet design target accuracies. In February 2009, the Technical Working Group on Gas-Cooled Reactors (TWG-GCR) of the International Atomic Energy Agency (IAEA) recommended that the proposed Coordinated Research Program (CRP) on the HTGR Uncertainty Analysis in Modelling (UAM) be implemented. This CRP is a continuation of the previous IAEA and Organization for Economic Co-operation and Development (OECD)/Nuclear Energy Agency (NEA) international activities on Verification and Validation (V&V) of available analytical capabilities for HTGR simulation for design and safety evaluations. Within the framework of these activities different numerical and experimental benchmark problems were performed and insight was gained about specific physics phenomena and the adequacy of analysis methods.« less

The Shock and Vibration Digest. Volume 17, Number 2

DTIC Science & Technology

1985-02-01

phenomena relative to A computer program has been developed to -.- buildings, bridges, dams, and other struc- simulate the motions of bodies subjected to...1982). (57) Ikushima, T., Honma, T., and Ishiz- uka, H., "Seismic Research on Block-Type (47) Kadle, D.S. and Chwang, A.T., "Hy- HTGR Core ," Nucl...T., "A Seismic Study of High Temperature Gas-Cooled Reactor Core - (48) Yang, C.Y., Chiarito, V., and Dressel, with Block-Type Fuel ; 2nd Rept: An Ana

Improvement of Modeling HTGR Neutron Physics by Uncertainty Analysis with the Use of Cross-Section Covariance Information

NASA Astrophysics Data System (ADS)

Boyarinov, V. F.; Grol, A. V.; Fomichenko, P. A.; Ternovykh, M. Yu

2017-01-01

This work is aimed at improvement of HTGR neutron physics design calculations by application of uncertainty analysis with the use of cross-section covariance information. Methodology and codes for preparation of multigroup libraries of covariance information for individual isotopes from the basic 44-group library of SCALE-6 code system were developed. A 69-group library of covariance information in a special format for main isotopes and elements typical for high temperature gas cooled reactors (HTGR) was generated. This library can be used for estimation of uncertainties, associated with nuclear data, in analysis of HTGR neutron physics with design codes. As an example, calculations of one-group cross-section uncertainties for fission and capture reactions for main isotopes of the MHTGR-350 benchmark, as well as uncertainties of the multiplication factor (k∞) for the MHTGR-350 fuel compact cell model and fuel block model were performed. These uncertainties were estimated by the developed technology with the use of WIMS-D code and modules of SCALE-6 code system, namely, by TSUNAMI, KENO-VI and SAMS. Eight most important reactions on isotopes for MHTGR-350 benchmark were identified, namely: 10B(capt), 238U(n,γ), ν5, 235U(n,γ), 238U(el), natC(el), 235U(fiss)-235U(n,γ), 235U(fiss).

An Overview of Reactor Concepts, a Survey of Reactor Designs.

DTIC Science & Technology

1985-02-01

may be very different. HTGRs may use highly enriched uranium, thereby yielding better fuel economy and a reduc- tion of the actual core size for a...specific power level. The HTGR core may have fuel and control rods placed in graphite arrays similar to PWR core con- figuration, or they may have fuel ...rods are pulled out. A Peach Bottom core design is another HTGR design. This design is featured by the fuel pin’s ability to purge itself of fission

Master Logic Diagram: An Approach to Identify Initiating Events of HTGRs

NASA Astrophysics Data System (ADS)

Purba, J. H.

2018-02-01

Initiating events of a nuclear power plant being evaluated need to be firstly identified prior to applying probabilistic safety assessment on that plant. Various types of master logic diagrams (MLDs) have been proposedforsearching initiating events of the next generation of nuclear power plants, which have limited data and operating experiences. Those MLDs are different in the number of steps or levels and different in the basis for developing them. This study proposed another type of MLD approach to find high temperature gas cooled reactor (HTGR) initiating events. It consists of five functional steps starting from the top event representing the final objective of the safety functions to the basic event representing the goal of the MLD development, which is an initiating event. The application of the proposed approach to search for two HTGR initiating events, i.e. power turbine generator trip and loss of offsite power, is provided. The results confirmed that the proposed MLD is feasiblefor finding HTGR initiating events.

Determining the minimum required uranium carbide content for HTGR UCO fuel kernels

DOE PAGES

McMurray, Jacob W.; Lindemer, Terrence B.; Brown, Nicholas R.; ...

2017-03-10

There are three important failure mechanisms that must be controlled in high-temperature gas-cooled reactor (HTGR) fuel for certain higher burnup applications are SiC layer rupture, SiC corrosion by CO, and coating compromise from kernel migration. All are related to high CO pressures stemming from free O generated when uranium present as UO 2 fissions and the O is not subsequently bound by other elements. Furthermore, in the HTGR UCO kernel design, CO buildup from excess O is controlled by the inclusion of additional uranium in the form of a carbide, UC x. An approach for determining the minimum UC xmore » content to ensure negligible CO formation was developed and demonstrated using CALPHAD models and the Serpent 2 reactor physics and depletion analysis tool. Our results are intended to be more accurate than previous estimates by including more nuclear and chemical factors, in particular the effect of transmutation products on the oxygen distribution as the fuel kernel composition evolves with burnup.« less

Development of a coolant channel helium and nitrogen gas ratio sensor for a high temperature gas reactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cadell, S. R.; Woods, B. G.

2012-07-01

To measure the changing gas composition of the coolant during a postulated High Temperature Gas Reactor (HTGR) accident, an instrument is needed. This instrument must be compact enough to measure the ratio of the coolant versus the break gas in an individual coolant channel. This instrument must minimally impact the fluid flow and provide for non-direct signal routing to allow minimal disturbance to adjacent channels. The instrument must have a flexible geometry to allow for the measurement of larger volumes such as in the upper or lower plenum of a HTGR. The instrument must be capable of accurately functioning throughmore » the full operating temperature and pressure of a HTGR. This instrument is not commercially available, but a literature survey has shown that building off of the present work on Capacitance Sensors and Cross-Capacitors will provide a basis for the development of the desired instrument. One difficulty in developing and instrument to operate at HTGR temperatures is acquiring an electrical conductor that will not melt at 1600 deg. C. This requirement limits the material selection to high temperature ceramics, graphite, and exotic metals. An additional concern for the instrument is properly accounting for the thermal expansion of both the sensing components and the gas being measured. This work covers the basic instrument overview with a thorough discussion of the associated uncertainty in making these measurements. (authors)« less

MFPG. The Role of Coatings in the Prevention of Mechanical Failures. Proceedings of the 23rd Meeting of the Mechanical Failures Prevention Group, Held at the National Bureau of Standards, Gaithersburg, Maryland on October 29-31, 1975

DTIC Science & Technology

1976-09-01

testing evaluation and production process development . This coated microspherical fuel particle has been successfully developed over a period of...this reliable concept began with attempts to blend ceramic (oxide or carbide) fuel powders into a graphite matrix in the early concepts of ROVER, HTGR ...lubricants. An ongoing program at the Naval Air Development Center is investigating how some parameters affect corro- sion between solid film

HTGR technology economic/ business analysis and trade studies impacts. Impacts of HTGR commericialization on the U.S. economy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silady, Fred

The approach to this task was to initially review the 2012 Business Plan and supporting analyses for the above impacts. With that understanding as a base, the Business Plan impacts are updated in terms of the GDP and job creation as a result of additional studies and inputs such as the revised market assessment from Task 1.1. For the impacts on U.S. competitiveness, the NGNP Industry Alliance team members have been utilized to provide inputs on supplier infrastructure development and on vendor capability.

Coupling a Supercritical Carbon Dioxide Brayton Cycle to a Helium-Cooled Reactor.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Middleton, Bobby; Pasch, James Jay; Kruizenga, Alan Michael

2016-01-01

This report outlines the thermodynamics of a supercritical carbon dioxide (sCO 2) recompression closed Brayton cycle (RCBC) coupled to a Helium-cooled nuclear reactor. The baseline reactor design for the study is the AREVA High Temperature Gas-Cooled Reactor (HTGR). Using the AREVA HTGR nominal operating parameters, an initial thermodynamic study was performed using Sandia's deterministic RCBC analysis program. Utilizing the output of the RCBC thermodynamic analysis, preliminary values of reactor power and of Helium flow rate through the reactor were calculated in Sandia's HelCO 2 code. Some research regarding materials requirements was then conducted to determine aspects of corrosion related tomore » both Helium and to sCO 2 , as well as some mechanical considerations for pressures and temperatures that will be seen by the piping and other components. This analysis resulted in a list of materials-related research items that need to be conducted in the future. A short assessment of dry heat rejection advantages of sCO 2> Brayton cycles was also included. This assessment lists some items that should be investigated in the future to better understand how sCO 2 Brayton cycles and nuclear can maximally contribute to optimizing the water efficiency of carbon free power generation« less

Studies of the use of high-temperature nuclear heat from an HTGR for hydrogen production

NASA Technical Reports Server (NTRS)

Peterman, D. D.; Fontaine, R. W.; Quade, R. N.; Halvers, L. J.; Jahromi, A. M.

1975-01-01

The results of a study which surveyed various methods of hydrogen production using nuclear and fossil energy are presented. A description of these methods is provided, and efficiencies are calculated for each case. The process designs of systems that utilize the heat from a general atomic high temperature gas cooled reactor with a steam methane reformer and feed the reformer with substitute natural gas manufactured from coal, using reforming temperatures, are presented. The capital costs for these systems and the resultant hydrogen production price for these cases are discussed along with a research and development program.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Richards, Matt; Hamilton, Chris

This report provides supplemental information to the assessment of target markets provided in Appendix A of the 2012 Next Generation Nuclear Plant (NGNP) Industry Alliance (NIA) business plan [NIA 2012] for deployment of High Temperature Gas-Cooled Reactors (HTGRs) in the 2025 – 2050 time frame. This report largely reiterates the [NIA 2012] assessment for potential deployment of 400 to 800 HTGR modules (100 to 200 HTGR plants with 4 reactor modules) in the 600-MWt class in North America by 2050 for electricity generation, co-generation of steam and electricity, oil sands operations, hydrogen production, and synthetic fuels production (e.g., coal tomore » liquids). As the result of increased natural gas supply from hydraulic fracturing, the current and historically low prices of natural gas remain a significant barrier to deployment of HTGRs and other nuclear reactor concepts in the U.S. However, based on U.S. Department of Energy (DOE) Energy Information Agency (EIA) data, U.S. natural gas prices are expected to increase by the 2030 – 2040 timeframe when a significant number of HTGR modules could be deployed. An evaluation of more recent EIA 2013 data confirms the assumptions in [NIA 2012] of future natural gas prices in the range of approximately $7/MMBtu to $10/MMBtu during the 2030 – 2040 timeframe. Natural gas prices in this range will make HTGR energy prices competitive with natural gas, even in the absence of carbon-emissions penalties. Exhibit ES-1 presents the North American projections in each market segment including a characterization of the market penetration logic. Adjustments made to the 2012 data (and reflected in Exhibit ES-1) include normalization to the slightly larger 625MWt reactor module, segregation between steam cycle and more advanced (higher outlet temperature) modules, and characterization of U.S. synthetic fuel process applications as a separate market segment.« less

The IAEA coordinated research programme on HTGR uncertainty analysis: Phase I status and Ex. I-1 prismatic reference results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bostelmann, Friederike; Strydom, Gerhard; Reitsma, Frederik

The quantification of uncertainties in design and safety analysis of reactors is today not only broadly accepted, but in many cases became the preferred way to replace traditional conservative analysis for safety and licensing analysis. The use of a more fundamental methodology is also consistent with the reliable high fidelity physics models and robust, efficient, and accurate codes available today. To facilitate uncertainty analysis applications a comprehensive approach and methodology must be developed and applied, in contrast to the historical approach where sensitivity analysis were performed and uncertainties then determined by a simplified statistical combination of a few important inputmore » parameters. New methodologies are currently under development in the OECD/NEA Light Water Reactor (LWR) Uncertainty Analysis in Best-Estimate Modelling (UAM) benchmark activity. High Temperature Gas-cooled Reactor (HTGR) designs require specific treatment of the double heterogeneous fuel design and large graphite quantities at high temperatures. The IAEA has therefore launched a Coordinated Research Project (CRP) on HTGR Uncertainty Analysis in Modelling (UAM) in 2013 to study uncertainty propagation specifically in the HTGR analysis chain. Two benchmark problems are defined, with the prismatic design represented by the General Atomics (GA) MHTGR-350 and a 250 MW modular pebble bed design similar to the Chinese HTR-PM. Work has started on the first phase and the current CRP status is reported in the paper. A comparison of the Serpent and SCALE/KENO-VI reference Monte Carlo results for Ex. I-1 of the MHTGR-350 design is also included. It was observed that the SCALE/KENO-VI Continuous Energy (CE) k ∞ values were 395 pcm (Ex. I-1a) to 803 pcm (Ex. I-1b) higher than the respective Serpent lattice calculations, and that within the set of the SCALE results, the KENO-VI 238 Multi-Group (MG) k ∞ values were up to 800 pcm lower than the KENO-VI CE values. The use of the latest ENDF-B-VII.1 cross section library in Serpent lead to ~180 pcm lower k ∞ values compared to the older ENDF-B-VII.0 dataset, caused by the modified graphite neutron capture cross section. Furthermore, the fourth beta release of SCALE 6.2 likewise produced lower CE k∞ values when compared to SCALE 6.1, and the improved performance of the new 252-group library available in SCALE 6.2 is especially noteworthy. A SCALE/TSUNAMI uncertainty analysis of the Hot Full Power variant for Ex. I-1a furthermore concluded that the 238U(n,γ) (capture) and 235U(View the MathML source) cross-section covariance matrices contributed the most to the total k ∞ uncertainty of 0.58%.« less

The IAEA coordinated research programme on HTGR uncertainty analysis: Phase I status and Ex. I-1 prismatic reference results

DOE PAGES

Bostelmann, Friederike; Strydom, Gerhard; Reitsma, Frederik; ...

2016-01-11

The quantification of uncertainties in design and safety analysis of reactors is today not only broadly accepted, but in many cases became the preferred way to replace traditional conservative analysis for safety and licensing analysis. The use of a more fundamental methodology is also consistent with the reliable high fidelity physics models and robust, efficient, and accurate codes available today. To facilitate uncertainty analysis applications a comprehensive approach and methodology must be developed and applied, in contrast to the historical approach where sensitivity analysis were performed and uncertainties then determined by a simplified statistical combination of a few important inputmore » parameters. New methodologies are currently under development in the OECD/NEA Light Water Reactor (LWR) Uncertainty Analysis in Best-Estimate Modelling (UAM) benchmark activity. High Temperature Gas-cooled Reactor (HTGR) designs require specific treatment of the double heterogeneous fuel design and large graphite quantities at high temperatures. The IAEA has therefore launched a Coordinated Research Project (CRP) on HTGR Uncertainty Analysis in Modelling (UAM) in 2013 to study uncertainty propagation specifically in the HTGR analysis chain. Two benchmark problems are defined, with the prismatic design represented by the General Atomics (GA) MHTGR-350 and a 250 MW modular pebble bed design similar to the Chinese HTR-PM. Work has started on the first phase and the current CRP status is reported in the paper. A comparison of the Serpent and SCALE/KENO-VI reference Monte Carlo results for Ex. I-1 of the MHTGR-350 design is also included. It was observed that the SCALE/KENO-VI Continuous Energy (CE) k ∞ values were 395 pcm (Ex. I-1a) to 803 pcm (Ex. I-1b) higher than the respective Serpent lattice calculations, and that within the set of the SCALE results, the KENO-VI 238 Multi-Group (MG) k ∞ values were up to 800 pcm lower than the KENO-VI CE values. The use of the latest ENDF-B-VII.1 cross section library in Serpent lead to ~180 pcm lower k ∞ values compared to the older ENDF-B-VII.0 dataset, caused by the modified graphite neutron capture cross section. Furthermore, the fourth beta release of SCALE 6.2 likewise produced lower CE k∞ values when compared to SCALE 6.1, and the improved performance of the new 252-group library available in SCALE 6.2 is especially noteworthy. A SCALE/TSUNAMI uncertainty analysis of the Hot Full Power variant for Ex. I-1a furthermore concluded that the 238U(n,γ) (capture) and 235U(View the MathML source) cross-section covariance matrices contributed the most to the total k ∞ uncertainty of 0.58%.« less

Baseline Concept Description of a Small Modular High Temperature Reactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hans Gougar

2014-05-01

The objective of this report is to provide a description of generic small modular high temperature reactors (herein denoted as an smHTR), summarize their distinguishing attributes, and lay out the research and development (R&D) required for commercialization. The generic concepts rely heavily on the modular high temperature gas-cooled reactor designs developed in the 1980s which were never built but for which pre-licensing or certification activities were conducted. The concept matured more recently under the Next Generation Nuclear Plant (NGNP) project, specifically in the areas of fuel and material qualification, methods development, and licensing. As all vendor-specific designs proposed under NGNPmore » were all both ‘small’ or medium-sized and ‘modular’ by International Atomic Energy Agency (IAEA) and Department of Energy (DOE) standards, the technical attributes, challenges, and R&D needs identified, addressed, and documented under NGNP are valid and appropriate in the context of Small Modular Reactor (SMR) applications. Although the term High Temperature Reactor (HTR) is commonly used to denote graphite-moderated, thermal spectrum reactors with coolant temperatures in excess of 650oC at the core outlet, in this report the historical term High Temperature Gas-Cooled Reactor (HTGR) will be used to distinguish the gas-cooled technology described herein from its liquid salt-cooled cousin. Moreover, in this report it is to be understood that the outlet temperature of the helium in an HTGR has an upper limit of 950 degrees C which corresponds to the temperature to which certain alloys are currently being qualified under DOE’s ARC program. Although similar to the HTGR in just about every respect, the Very High Temperature Reactor (VHTR) may have an outlet temperature in excess of 950 degrees C and is therefore farther from commercialization because of the challenges posed to materials exposed to these temperatures. The VHTR is the focus of R&D under the Generation IV program and its specific R&D needs will be included in this report when appropriate for comparison. The distinguishing features of the HTGR are the refractory (TRISO) coated particle fuel, the low-power density, graphite-moderated core, and the high outlet temperature of the inert helium coolant. The low power density and fuel form effectively eliminate the possibility of core melt, even upon a complete loss of coolant pressure and flow. The graphite, which constitutes the bulk of the core volume and mass, provides a large thermal buffer that absorbs fission heat such that thermal transients occur over a timespan of hours or even days. As chemically-inert helium is already a gas, there is no coolant temperature or void feedback on the neutronics and no phase change or corrosion product that could degrade heat transfer. Furthermore, the particle coatings and interstitial graphite retain fission products such that the source terms at the plant boundary remain well below actionable levels under all anticipated nominal and off-normal operating conditions. These attributes enable the reactor to supply process heat to a collocated industrial plant with negligible risk of contamination and minimal dynamic coupling of the facilities (Figure 1). The exceptional retentive properties of coated particle fuel in a graphite matrix were first demonstrated in the DRAGON reactor, a European research facility that began operation in 1964.« less

Baseline Concept Description of a Small Modular High Temperature Reactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gougar, Hans D.

2014-10-01

The objective of this report is to provide a description of generic small modular high temperature reactors (herein denoted as an smHTR), summarize their distinguishing attributes, and lay out the research and development (R&D) required for commercialization. The generic concepts rely heavily on the modular high temperature gas-cooled reactor designs developed in the 1980s which were never built but for which pre-licensing or certification activities were conducted. The concept matured more recently under the Next Generation Nuclear Plant (NGNP) project, specifically in the areas of fuel and material qualification, methods development, and licensing. As all vendor-specific designs proposed under NGNPmore » were all both ‘small’ or medium-sized and ‘modular’ by International Atomic Energy Agency (IAEA) and Department of Energy (DOE) standards, the technical attributes, challenges, and R&D needs identified, addressed, and documented under NGNP are valid and appropriate in the context of Small Modular Reactor (SMR) applications. Although the term High Temperature Reactor (HTR) is commonly used to denote graphite-moderated, thermal spectrum reactors with coolant temperatures in excess of 650oC at the core outlet, in this report the historical term High Temperature Gas-Cooled Reactor (HTGR) will be used to distinguish the gas-cooled technology described herein from its liquid salt-cooled cousin. Moreover, in this report it is to be understood that the outlet temperature of the helium in an HTGR has an upper limit of 950 degrees C which corresponds to the temperature to which certain alloys are currently being qualified under DOE’s ARC program. Although similar to the HTGR in just about every respect, the Very High Temperature Reactor (VHTR) may have an outlet temperature in excess of 950 degrees C and is therefore farther from commercialization because of the challenges posed to materials exposed to these temperatures. The VHTR is the focus of R&D under the Generation IV program and its specific R&D needs will be included in this report when appropriate for comparison. The distinguishing features of the HTGR are the refractory (TRISO) coated particle fuel, the low-power density, graphite-moderated core, and the high outlet temperature of the inert helium coolant. The low power density and fuel form effectively eliminate the possibility of core melt, even upon a complete loss of coolant pressure and flow. The graphite, which constitutes the bulk of the core volume and mass, provides a large thermal buffer that absorbs fission heat such that thermal transients occur over a timespan of hours or even days. As chemically-inert helium is already a gas, there is no coolant temperature or void feedback on the neutronics and no phase change or corrosion product that could degrade heat transfer. Furthermore, the particle coatings and interstitial graphite retain fission products such that the source terms at the plant boundary remain well below actionable levels under all anticipated nominal and off-normal operating conditions. These attributes enable the reactor to supply process heat to a collocated industrial plant with negligible risk of contamination and minimal dynamic coupling of the facilities (Figure 1). The exceptional retentive properties of coated particle fuel in a graphite matrix were first demonstrated in the DRAGON reactor, a European research facility that began operation in 1964.« less

ICP-MS measurement of silver diffusion coefficient in graphite IG-110 between 1048K and 1284K

NASA Astrophysics Data System (ADS)

Carter, L. M.; Seelig, J. D.; Brockman, J. D.; Robertson, J. D.; Loyalka, S. K.

2018-01-01

Silver-110m has been shown to permeate intact silicon carbide and pyrolytic carbon coating layers of the TRISO fuel particles during normal High Temperature Gas-Cooled Reactor (HTGR) operational conditions. The diffusion coefficients for silver in graphite IG-110 measured using a release method designed to simulate HTGR conditions of high temperature and flowing helium in the temperature range 1048-1253 K are reported. The measurements were made using spheres milled from IG-110 graphite that were infused with silver using a pressure vessel technique. The Ag diffusion was measured using a time release technique with an ICP-MS instrument for detection. The results of this work are:

HTGR plant availability and reliability evaluations. Volume I. Summary of evaluations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cadwallader, G.J.; Hannaman, G.W.; Jacobsen, F.K.

1976-12-01

The report (1) describes a reliability assessment methodology for systematically locating and correcting areas which may contribute to unavailability of new and uniquely designed components and systems, (2) illustrates the methodology by applying it to such components in a high-temperature gas-cooled reactor (Public Service Company of Colorado's Fort St. Vrain 330-MW(e) HTGR), and (3) compares the results of the assessment with actual experience. The methodology can be applied to any component or system; however, it is particularly valuable for assessments of components or systems which provide essential functions, or the failure or mishandling of which could result in relatively largemore » economic losses.« less

Irradiation performance of HTGR fuel rods in HFIR experiments HRB-7 and -8

DOE Office of Scientific and Technical Information (OSTI.GOV)

Valentine, K.H.; Homan, F.J.; Long, E.L. Jr.

1977-05-01

The HRB-7 and -8 experiments were designed as a comprehensive test of mixed thorium-uranium oxide fissile particles with Th:U ratios from 0 to 8 for HTGR recycle application. In addition, fissile particles derived from Weak-Acid Resin (WAR) were tested as a potential backup type of fissile particle for HTGR recycle. These experiments were conducted at two temperatures (1250 and 1500/sup 0/C) to determine the influence of operating temperature on the performance parameters studied. The minor objectives were comparison of advanced coating designs where ZrC replaced SiC in the Triso design, testing of fuel coated in laboratory-scale equipment with fuel coatedmore » in production-scale coaters, comparison of the performance of /sup 233/U-bearing particles with that of /sup 235/U-bearing particles, comparison of the performance of Biso coatings with Triso coatings for particles containing the same type of kernel, and testing of multijunction tungsten-rhenium thermocouples. All objectives were accomplished. As a result of these experiments the mixed thorium-uranium oxide fissile kernel was replaced by a WAR-derived particle in the reference recycle design. A tentative decision to make this change had been reached before the HRB-7 and -8 capsules were examined, and the results of the examination confirmed the accuracy of the previous decision. Even maximum dilution (Th/U approximately equal to 8) of the mixed thorium-uranium oxide kernel was insufficient to prevent amoeba of the kernels at rates that are unacceptable in a large HTGR. Other results showed the performance of /sup 233/U-bearing particles to be identical to that of /sup 235/U-bearing particles, the performance of fuel coated in production-scale equipment to be at least as good as that of fuel coated in laboratory-scale coaters, the performance of ZrC coatings to be very promising, and Biso coatings to be inferior to Triso coatings relative to fission product retention.« less

ICP-MS analysis of fission product diffusion in graphite for High-Temperature Gas-Cooled Reactors

NASA Astrophysics Data System (ADS)

Carter, Lukas M.

Release of radioactive fission products from nuclear fuel during normal reactor operation or in accident scenarios is a fundamental safety concern. Of paramount importance are the understanding and elucidation of mechanisms of chemical interaction, nuclear interaction, and transport phenomena involving fission products. Worldwide efforts to reduce fossil fuel dependence coupled with an increasing overall energy demand have generated renewed enthusiasm toward nuclear power technologies, and as such, these mechanisms continue to be the subjects of vigorous research. High-Temperature Gas-Cooled Reactors (HTGRs or VHTRs) remain one of the most promising candidates for the next generation of nuclear power reactors. An extant knowledge gap specific to HTGR technology derives from an incomplete understanding of fission product transport in major core materials under HTGR operational conditions. Our specific interest in the current work is diffusion in reactor graphite. Development of methods for analysis of diffusion of multiple fission products is key to providing accurate models for fission product release from HTGR core components and the reactor as a whole. In the present work, a specialized diffusion cell has been developed and constructed to facilitate real-time diffusion measurements via ICP-MS. The cell utilizes a helium gas-jet system which transports diffusing fission products to the mass spectrometer using carbon nanoparticles. The setup was designed to replicate conditions present in a functioning HTGR, and can be configured for real-time release or permeation measurements of single or multiple fission products from graphite or other core materials. In the present work, we have analyzed release rates of cesium in graphite grades IG-110, NBG-18, and a commercial grade of graphite, as well as release of iodine in IG-110. Additionally we have investigated infusion of graphite samples with Cs, I, Sr, Ag, and other surrogate fission products for use in release or profile measurements of diffusion coefficients.

Fabrication methods and anisotropic properties of graphite matrix compacts for use in HTGR

NASA Astrophysics Data System (ADS)

Yeo, Sunghwan; Yun, Jihae; Kim, Sungok; Cho, Moon Sung; Lee, Young-Woo

2018-02-01

This study investigated the anisotropic microstructural, mechanical, and thermal properties of fabricated graphite matrix prismatic compacts for High Temperature Gas Cooled Reactor (HTGR) fuel. When the observed alignment of graphite grains and the coke derived from phenolic resin is in the transverse direction, the result is severely anisotropic thermal properties. Compacts with such orientation in the transverse direction exhibited increases of thermal expansion and conductivity up to 5.8 times and 4.82 times, respectively, more than those in the axial direction. The formation of pores due to the pyrolysis of phenolic resin was observed predominantly on upper region of the fabricated compacts. This anisotropic pore formation created anisotropic Vickers hardness on the planes with different directions.

Station Blackout Analysis of HTGR-Type Experimental Power Reactor

NASA Astrophysics Data System (ADS)

Syarip; Zuhdi, Aliq; Falah, Sabilul

2018-01-01

The National Nuclear Energy Agency of Indonesia has decided to build an experimental power reactor of high-temperature gas-cooled reactor (HTGR) type located at Puspiptek Complex. The purpose of this project is to demonstrate a small modular nuclear power plant that can be operated safely. One of the reactor safety characteristics is the reliability of the reactor to the station blackout (SBO) event. The event was observed due to relatively high disturbance frequency of electricity network in Indonesia. The PCTRAN-HTR functional simulator code was used to observe fuel and coolant temperature, and coolant pressure during the SBO event. The reactor simulated at 10 MW for 7200 s then the SBO occurred for 1-3 minutes. The analysis result shows that the reactor power decreases automatically as the temperature increase during SBO accident without operator’s active action. The fuel temperature increased by 36.57 °C every minute during SBO and the power decreased by 0.069 MW every °C fuel temperature rise at the condition of anticipated transient without reactor scram. Whilst, the maximum coolant (helium) temperature and pressure are 1004 °C and 9.2 MPa respectively. The maximum fuel temperature is 1282 °C, this value still far below the fuel temperature limiting condition i.e. 1600 °C, its mean that the HTGR has a very good inherent safety system.

Integrating Nuclear Energy to Oilfield Operations – Two Case Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eric P. Robertson; Lee O. Nelson; Michael G. McKellar

2011-11-01

Fossil fuel resources that require large energy inputs for extraction, such as the Canadian oil sands and the Green River oil shale resource in the western USA, could benefit from the use of nuclear power instead of power generated by natural gas combustion. This paper discusses the technical and economic aspects of integrating nuclear energy with oil sands operations and the development of oil shale resources. A high temperature gas reactor (HTGR) that produces heat in the form of high pressure steam (no electricity production) was selected as the nuclear power source for both fossil fuel resources. Both cases weremore » based on 50,000 bbl/day output. The oil sands case was a steam-assisted, gravity-drainage (SAGD) operation located in the Canadian oil sands belt. The oil shale development was an in-situ oil shale retorting operation located in western Colorado, USA. The technical feasibility of the integrating nuclear power was assessed. The economic feasibility of each case was evaluated using a discounted cash flow, rate of return analysis. Integrating an HTGR to both the SAGD oil sands operation and the oil shale development was found to be technically feasible for both cases. In the oil sands case, integrating an HTGR eliminated natural gas combustion and associated CO2 emissions, although there were still some emissions associated with imported electrical power. In the in situ oil shale case, integrating an HTGR reduced CO2 emissions by 88% and increased natural gas production by 100%. Economic viabilities of both nuclear integrated cases were poorer than the non-nuclear-integrated cases when CO2 emissions were not taxed. However, taxing the CO2 emissions had a significant effect on the economics of the non-nuclear base cases, bringing them in line with the economics of the nuclear-integrated cases. As we move toward limiting CO2 emissions, integrating non-CO2-emitting energy sources to the development of energy-intense fossil fuel resources is becoming increasingly important. This paper attempts to reduce the barriers that have traditionally separated fossil fuel development and application of nuclear power and to promote serious discussion of ideas about hybrid energy systems.« less

Fission product palladium-silicon carbide interaction in htgr fuel particles

NASA Astrophysics Data System (ADS)

Minato, Kazuo; Ogawa, Toru; Kashimura, Satoru; Fukuda, Kousaku; Shimizu, Michio; Tayama, Yoshinobu; Takahashi, Ishio

1990-07-01

Interaction of fission product palladium (Pd) with the silicon carbide (SiC) layer was observed in irradiated Triso-coated uranium dioxide particles for high temperature gas-cooled reactors (HTGR) with an optical microscope and electron probe microanalyzers. The SiC layers were attacked locally or the reaction product formed nodules at the attack site. Although the main element concerned with the reaction was palladium, rhodium and ruthenium were also detected at the corroded areas in some particles. Palladium was detected on both the hot and cold sides of the particles, but the corroded areas and the palladium accumulations were distributed particularly on the cold side of the particles. The observed Pd-SiC reaction depths were analyzed on the assumption that the release of palladium from the fuel kernel controls the whole Pd-SiC reaction.

Energy alternative for industry: the high-temperature gas-cooled reactor steamer

DOE Office of Scientific and Technical Information (OSTI.GOV)

McMain, A.T. Jr.; Blok, F.J.

1978-04-01

Large industrial complexes are faced with new requirements that will lead to a transition from such fluid fuels as natural gas and oil to such solid fuels as coal and uranium for supply of industrial energy. Power plants using these latter fuels will be of moderate size (800 to 1200 MW(thermal)) and will generally have the capability of co-generating electric power and process steam. A study has been made regarding use of the 840-MW(thermal) Fort St. Vrain high-temperature gas-cooled reactor (HTGR) design for industrial applications. The initial conceptual design (referred to as the HTGR Steamer) is substantially simplified relative tomore » Fort St. Vrain in that outlet helium and steam temperatures are lower and the reheat section is deleted from the steam generators. The Steamer has four independent steam generating loops producing a total of 277 kg/s (2.2 x 10/sup 6/ lb/h) of prime steam at 4.5 MPa/672 K (650 psia/750/sup 0/F). The unit co-generates 46 MW(electric) and provides process steam at 8.31 MPa/762 K(1200 psia/912/sup 0/F). The basic configuration and much of the equipment are retained from the Fort St. Vrain design. The system has inherent safety features important for industrial applications. These and other features indicate that the HTGR Steamer is an industrial energy option deserving additional evaluation. Subsequent work will focus on parallel design optimization and application studies.« less

Uranium extraction from TRISO-coated fuel particles using supercritical CO2 containing tri-n-butyl phosphate.

PubMed

Zhu, Liyang; Duan, Wuhua; Xu, Jingming; Zhu, Yongjun

2012-11-30

High-temperature gas-cooled reactors (HTGRs) are advanced nuclear systems that will receive heavy use in the future. It is important to develop spent nuclear fuel reprocessing technologies for HTGR. A new method for recovering uranium from tristructural-isotropic (TRISO-) coated fuel particles with supercritical CO(2) containing tri-n-butyl phosphate (TBP) as a complexing agent was investigated. TRISO-coated fuel particles from HTGR fuel elements were first crushed to expose UO(2) pellet fuel kernels. The crushed TRISO-coated fuel particles were then treated under O(2) stream at 750°C, resulting in a mixture of U(3)O(8) powder and SiC shells. The conversion of U(3)O(8) into solid uranyl nitrate by its reaction with liquid N(2)O(4) in the presence of a small amount of water was carried out. Complete conversion was achieved after 60 min of reaction at 80°C, whereas the SiC shells were not converted by N(2)O(4). Uranyl nitrate in the converted mixture was extracted with supercritical CO(2) containing TBP. The cumulative extraction efficiency was above 98% after 20 min of online extraction at 50°C and 25 MPa, whereas the SiC shells were not extracted by TBP. The results suggest an attractive strategy for reprocessing spent nuclear fuel from HTGR to minimize the generation of secondary radioactive waste. Copyright © 2012 Elsevier B.V. All rights reserved.

Analyzing the impact of reactive transport on the repository performance of TRISO fuel

NASA Astrophysics Data System (ADS)

Schmidt, Gregory

One of the largest determiners of the amount of electricity generated by current nuclear reactors is the efficiency of the thermodynamic cycle used for power generation. Current light water reactors (LWR) have an efficiency of 35% or less for the conversion of heat energy generated by the reactor to electrical energy. If this efficiency could be improved, more power could be generated from equivalent volumes of nuclear fuel. One method of improving this efficiency is to use a coolant flow that operates at a much higher temperature for electricity production. A reactor design that is currently proposed to take advantage of this efficiency is a graphite-moderated, helium-cooled reactor known as a High Temperature Gas Reactor (HTGR). There are significant differences between current LWR's and the proposed HTGR's but most especially in the composition of the nuclear fuel. For LWR's, the fuel elements consist of pellets of uranium dioxide or plutonium dioxide that are placed in long tubes made of zirconium metal alloys. For HTGR's, the fuel, known as TRISO (TRIstructural-ISOtropic) fuel, consists of an inner sphere of fissile material, a layer of dense pyrolytic carbon (PyC), a ceramic layer of silicon carbide (SiC) and a final dense outer layer of PyC. These TRISO particles are then compacted with graphite into fuel rods that are then placed in channels in graphite blocks. The blocks are then arranged in an annular fashion to form a reactor core. However, this new fuel form has unanswered questions on the environmental post-burn-up behavior. The key question for current once-through fuel operations is how these large irradiated graphite blocks with spent fuel inside will behave in a repository environment. Data in the literature to answer this question is lacking, but nevertheless this is an important question that must be answered before wide-spread adoption of HTGR's could be considered. This research has focused on answering the question of how the large quantity of graphite surrounding the spent HTGR fuel will impact the release of aqueous uranium from the TRISO fuel. In order to answer this question, the sorption and partitioning behavior of uranium to graphite under a variety of conditions was investigated. Key systematic variables that were analyzed include solution pH, dissolved carbonate concentration, uranium metal concentration and ionic strength. The kinetics and desorption characteristics of uranium/graphite partitioning were studied as well. The graphite used in these experiments was also characterized by a variety of techniques and conclusions are drawn about the relevant surface chemistry of graphite. This data was then used to generate a model for the reactive transport of uranium in a graphite matrix. This model was implemented with the software code CXTFIT and validated through the use of column studies mirroring the predicted system.

Irradiation performance of HTGR recycle fissile fuel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Homan, F.J.; Long, E.L. Jr.

1976-08-01

The irradiation performance of candidate HTGR recycle fissile fuel under accelerated testing conditions is reviewed. Failure modes for coated-particle fuels are described, and the performance of candidate recycle fissile fuels is discussed in terms of these failure modes. The bases on which UO/sub 2/ and (Th,U)O/sub 2/ were rejected as candidate recycle fissile fuels are outlined, along with the bases on which the weak-acid resin (WAR)-derived fissile fuel was selected as the reference recycle kernel. Comparisons are made relative to the irradiation behavior of WAR-derived fuels of varying stoichiometry and conclusions are drawn about the optimum stoichiometry and the rangemore » of acceptable values. Plans for future testing in support of specification development, confirmation of the results of accelerated testing by real-time experiments, and improvement in fuel performance and reliability are described.« less

Proposed Advanced Reactor Adaptation of the Standard Review Plan NUREG-0800 Chapter 4 (Reactor) for Sodium-Cooled Fast Reactors and Modular High-Temperature Gas-Cooled Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Belles, Randy; Poore, III, Willis P.; Brown, Nicholas R.

2017-03-01

This report proposes adaptation of the previous regulatory gap analysis in Chapter 4 (Reactor) of NUREG 0800, Standard Review Plan (SRP) for the Review of Safety Analysis Reports for Nuclear Power Plants: LWR [Light Water Reactor] Edition. The proposed adaptation would result in a Chapter 4 review plan applicable to certain advanced reactors. This report addresses two technologies: the sodium-cooled fast reactor (SFR) and the modular high temperature gas-cooled reactor (mHTGR). SRP Chapter 4, which addresses reactor components, was selected for adaptation because of the possible significant differences in advanced non-light water reactor (non-LWR) technologies compared with the current LWR-basedmore » description in Chapter 4. SFR and mHTGR technologies were chosen for this gap analysis because of their diverse designs and the availability of significant historical design detail.« less

Design and evaluation of a nondestructive fissile assay device for HTGR fuel samples

DOE Office of Scientific and Technical Information (OSTI.GOV)

McNeany, S. R.; Knoll, R. W.; Jenkins, J. D.

1979-02-01

Nondestructive assay of fissile material plays an important role in nuclear fuel processing facilities. Information for product quality control, plant criticality safety, and nuclear materials accountability can be obtained from assay devices. All of this is necessary for a safe, efficient, and orderly operation of a production plant. Presented here is a design description and an operational evaluation of a device developed to nondestructively assay small samples of High-Temperature Gas-Cooled Reactor (HTGR) fuel. The measurement technique employed consists in thermal-neutron irradiation of a sample followed by pneumatic transfer to a high-efficiency neutron detector where delayed neutrons are counted. In general,more » samples undergo several irradiation and count cycles during a measurement. The total number of delayed-neutron counts accumulated is translated into grams of fissile mass through comparison with the counts accumulated in an identical irradiation and count sequence of calibration standards. Successful operation of the device through many experiments over a one-year period indicates high operational reliability. Tests of assay precision show this to be better than 0.25% for measurements of 10 min. Assay biases may be encountered if calibration standards are not representative of unknown samples, but reasonable care in construction and control of standards should lead to no more than 0.2% bias in the measurements. Nondestructive fissile assay of HTGR fuel samples by thermal-neutron irradiation and delayed-neutron detection has been demonstrated to be a rapid and accurate analysis technique. However, careful attention and control must be given to calibration standards to see that they remain representative of unknown samples.« less

LARC-1: a Los Alamos release calculation program for fission product transport in HTGRs during the LOFC accident

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carruthers, L.M.; Lee, C.E.

1976-10-01

The theoretical and numerical data base development of the LARC-1 code is described. Four analytical models of fission product release from an HTGR core during the loss of forced circulation accident are developed. Effects of diffusion, adsorption and evaporation of the metallics and precursors are neglected in this first LARC model. Comparison of the analytic models indicates that the constant release-renormalized model is adequate to describe the processes involved. The numerical data base for release constants, temperature modeling, fission product release rates, coated fuel particle failure fraction and aged coated fuel particle failure fractions is discussed. Analytic fits and graphicmore » displays for these data are given for the Ft. St. Vrain and GASSAR models.« less

FINAL PROJECT REPORT - EVALUATION AND TESTING OF HTGR REACTOR BUILDING RESPONSE TO DEPRESSURIZATION ACCIDENTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

ALLIANCE LIMITED, NGNP INDUSTRY

This report provides a description of the project, summarizes each phase of the project, and ends with project conclusions. In addition, the report contains a descriptive index of the technical reports generated during the course of the project.

Nuclear fuels status

NASA Technical Reports Server (NTRS)

Kania, Michael

1991-01-01

A discussion on coated particle fuel performance from a modular High Temperature Gas Reactor (HTGR) is presented along with experimental results. The following topics are covered: (1) the coated particle fuel concept; (2) the functional requirements; (3) performance limiting mechanisms; (4) fuel performance; and (5) methods/techniques for characterizing performance.

ICP-MS measurement of iodine diffusion in IG-110 graphite for HTGR/VHTR

NASA Astrophysics Data System (ADS)

Carter, L. M.; Brockman, J. D.; Robertson, J. D.; Loyalka, S. K.

2016-05-01

Graphite functions as a structural material and as a barrier to fission product release in HTGR/VHTR designs, and elucidation of transport parameters for fission products in reactor-grade graphite is thus required for reactor source terms calculations. We measured iodine diffusion in spheres of IG-110 graphite using a release method based on Fickain diffusion kinetics. Two sources of iodine were loaded into the graphite spheres; molecular iodine (I2) and cesium iodide (CsI). Measurements of the diffusion coefficient were made over a temperature range of 873-1293 K. We have obtained the following Arrhenius expressions for iodine diffusion:DI , CsI infused =(6 ×10-12 2/s) exp(30,000 J/mol RT) And,DI , I2 infused =(4 ×10-10 m2/s) exp(-11,000 J/mol RT ) The results indicate that iodine diffusion in IG-110 graphite is not well-described by Fickan diffusion kinetics. To our knowledge, these are the first measurements of iodine diffusion in IG-110 graphite.

AGR-2 and AGR-3/4 Release-to-Birth Ratio Data Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pham, Binh T.; Einerson, Jeffrey J.; Scates, Dawn M.

A series of Advanced Gas Reactor (AGR) irradiation tests is being conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL) in support of development and qualification of tristructural isotropic (TRISO) low enriched fuel used in the High Temperature Gas-cooled Reactor (HTGR). Each AGR test consists of multiple independently controlled and monitored capsules containing fuel compacts placed in a graphite cylinder shrouded by a steel shell. These capsules are instrumented with thermocouples embedded in the graphite enabling temperature control. AGR configuration and irradiation conditions are based on prismatic HTGR technology that is distinguished primarily through use of heliummore » coolant, a low-power-density ceramic core capable of withstanding very high temperatures, and TRISO coated particle fuel. Thus, these tests provide valuable irradiation performance data to support fuel process development, qualify fuel for normal operating conditions, and support development and validation of fuel performance and fission product transport models and codes.« less

High-temperature Gas Reactor (HTGR)

NASA Astrophysics Data System (ADS)

Abedi, Sajad

2011-05-01

General Atomics (GA) has over 35 years experience in prismatic block High-temperature Gas Reactor (HTGR) technology design. During this period, the design has recently involved into a modular have been performed to demonstrate its versatility. This versatility is directly related to refractory TRISO coated - particle fuel that can contain any type of fuel. This paper summarized GA's fuel cycle studies individually and compares each based upon its cycle sustainability, proliferation-resistance capabilities, and other performance data against pressurized water reactor (PWR) fuel cycle data. Fuel cycle studies LEU-NV;commercial HEU-Th;commercial LEU-Th;weapons-grade plutonium consumption; and burning of LWR waste including plutonium and minor actinides in the MHR. results show that all commercial MHR options, with the exception of HEU-TH, are more sustainable than a PWR fuel cycle. With LEU-NV being the most sustainable commercial options. In addition, all commercial MHR options out perform the PWR with regards to its proliferation-resistance, with thorium fuel cycle having the best proliferation-resistance characteristics.

DOE Office of Scientific and Technical Information (OSTI.GOV)

McMurray, Jacob W.; Lindemer, Terrence B.; Brown, Nicholas R.

There are three important failure mechanisms that must be controlled in high-temperature gas-cooled reactor (HTGR) fuel for certain higher burnup applications are SiC layer rupture, SiC corrosion by CO, and coating compromise from kernel migration. All are related to high CO pressures stemming from free O generated when uranium present as UO 2 fissions and the O is not subsequently bound by other elements. Furthermore, in the HTGR UCO kernel design, CO buildup from excess O is controlled by the inclusion of additional uranium in the form of a carbide, UC x. An approach for determining the minimum UC xmore » content to ensure negligible CO formation was developed and demonstrated using CALPHAD models and the Serpent 2 reactor physics and depletion analysis tool. Our results are intended to be more accurate than previous estimates by including more nuclear and chemical factors, in particular the effect of transmutation products on the oxygen distribution as the fuel kernel composition evolves with burnup.« less

A preliminary systems-engineering study of an advanced nuclear-electrolytic hydrogen-production facility

NASA Technical Reports Server (NTRS)

Escher, W. J. D.; Donakowski, T. D.; Tison, R. R.

1975-01-01

An advanced nuclear-electrolytic hydrogen-production facility concept was synthesized at a conceptual level with the objective of minimizing estimated hydrogen-production costs. The concept is a closely-integrated, fully-dedicated (only hydrogen energy is produced) system whose components and subsystems are predicted on ''1985 technology.'' The principal components are: (1) a high-temperature gas-cooled reactor (HTGR) operating a helium-Brayton/ammonia-Rankine binary cycle with a helium reactor-core exit temperature of 980 C, (2) acyclic d-c generators, (3) high-pressure, high-current-density electrolyzers based on solid-polymer electrolyte technology. Based on an assumed 3,000 MWt HTGR the facility is capable of producing 8.7 million std cu m/day of hydrogen at pipeline conditions, 6,900 kPa. Coproduct oxygen is also available at pipeline conditions at one-half this volume. It has further been shown that the incorporation of advanced technology provides an overall efficiency of about 43 percent, as compared with 25 percent for a contemporary nuclear-electric plant powering close-coupled contemporary industrial electrolyzers.

Criticality calculations of the Very High Temperature reactor Critical Assembly benchmark with Serpent and SCALE/KENO-VI

DOE PAGES

Bostelmann, Friederike; Hammer, Hans R.; Ortensi, Javier; ...

2015-12-30

Within the framework of the IAEA Coordinated Research Project on HTGR Uncertainty Analysis in Modeling, criticality calculations of the Very High Temperature Critical Assembly experiment were performed as the validation reference to the prismatic MHTGR-350 lattice calculations. Criticality measurements performed at several temperature points at this Japanese graphite-moderated facility were recently included in the International Handbook of Evaluated Reactor Physics Benchmark Experiments, and represent one of the few data sets available for the validation of HTGR lattice physics. Here, this work compares VHTRC criticality simulations utilizing the Monte Carlo codes Serpent and SCALE/KENO-VI. Reasonable agreement was found between Serpent andmore » KENO-VI, but only the use of the latest ENDF cross section library release, namely the ENDF/B-VII.1 library, led to an improved match with the measured data. Furthermore, the fourth beta release of SCALE 6.2/KENO-VI showed significant improvements from the current SCALE 6.1.2 version, compared to the experimental values and Serpent.« less

System Evaluation and Economic Analysis of a HTGR Powered High-Temperature Electrolysis Hydrogen Production Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michael G. McKellar; Edwin A. Harvego; Anastasia A. Gandrik

2010-10-01

A design for a commercial-scale high-temperature electrolysis (HTE) plant for hydrogen production has been developed. The HTE plant is powered by a high-temperature gas-cooled reactor (HTGR) whose configuration and operating conditions are based on the latest design parameters planned for the Next Generation Nuclear Plant (NGNP). The current HTGR reference design specifies a reactor power of 600 MWt, with a primary system pressure of 7.0 MPa, and reactor inlet and outlet fluid temperatures of 322°C and 750°C, respectively. The power conversion unit will be a Rankine steam cycle with a power conversion efficiency of 40%. The reference hydrogen production plantmore » operates at a system pressure of 5.0 MPa, and utilizes a steam-sweep system to remove the excess oxygen that is evolved on the anode (oxygen) side of the electrolyzer. The overall system thermal-to-hydrogen production efficiency (based on the higher heating value of the produced hydrogen) is 40.4% at a hydrogen production rate of 1.75 kg/s and an oxygen production rate of 13.8 kg/s. An economic analysis of this plant was performed with realistic financial and cost estimating assumptions. The results of the economic analysis demonstrated that the HTE hydrogen production plant driven by a high-temperature helium-cooled nuclear power plant can deliver hydrogen at a cost of $3.67/kg of hydrogen assuming an internal rate of return, IRR, of 12% and a debt to equity ratio of 80%/20%. A second analysis shows that if the power cycle efficiency increases to 44.4%, the hydrogen production efficiency increases to 42.8% and the hydrogen and oxygen production rates are 1.85 kg/s and 14.6 kg/s respectively. At the higher power cycle efficiency and an IRR of 12% the cost of hydrogen production is $3.50/kg.« less

Capital cost estimate

NASA Technical Reports Server (NTRS)

1975-01-01

The capital cost estimate for the nuclear process heat source (NPHS) plant was made by: (1) using costs from the current commercial HTGR for electricity production as a base for items that are essentially the same and (2) development of new estimates for modified or new equipment that is specifically for the process heat application. Results are given in tabular form and cover the total investment required for each process temperature studied.

Nuclear Engineering Computer Modules, Thermal-Hydraulics, TH-3: High Temperature Gas Cooled Reactor Thermal-Hydraulics.

ERIC Educational Resources Information Center

Reihman, Thomas C.

This learning module is concerned with the temperature field, the heat transfer rates, and the coolant pressure drop in typical high temperature gas-cooled reactor (HTGR) fuel assemblies. As in all of the modules of this series, emphasis is placed on developing the theory and demonstrating its use with a simplified model. The heart of the module…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rouxelin, Pascal Nicolas; Strydom, Gerhard

Best-estimate plus uncertainty analysis of reactors is replacing the traditional conservative (stacked uncertainty) method for safety and licensing analysis. To facilitate uncertainty analysis applications, a comprehensive approach and methodology must be developed and applied. High temperature gas cooled reactors (HTGRs) have several features that require techniques not used in light-water reactor analysis (e.g., coated-particle design and large graphite quantities at high temperatures). The International Atomic Energy Agency has therefore launched the Coordinated Research Project on HTGR Uncertainty Analysis in Modeling to study uncertainty propagation in the HTGR analysis chain. The benchmark problem defined for the prismatic design is represented bymore » the General Atomics Modular HTGR 350. The main focus of this report is the compilation and discussion of the results obtained for various permutations of Exercise I 2c and the use of the cross section data in Exercise II 1a of the prismatic benchmark, which is defined as the last and first steps of the lattice and core simulation phases, respectively. The report summarizes the Idaho National Laboratory (INL) best estimate results obtained for Exercise I 2a (fresh single-fuel block), Exercise I 2b (depleted single-fuel block), and Exercise I 2c (super cell) in addition to the first results of an investigation into the cross section generation effects for the super-cell problem. The two dimensional deterministic code known as the New ESC based Weighting Transport (NEWT) included in the Standardized Computer Analyses for Licensing Evaluation (SCALE) 6.1.2 package was used for the cross section evaluation, and the results obtained were compared to the three dimensional stochastic SCALE module KENO VI. The NEWT cross section libraries were generated for several permutations of the current benchmark super-cell geometry and were then provided as input to the Phase II core calculation of the stand alone neutronics Exercise II 1a. The steady state core calculations were simulated with the INL coupled-code system known as the Parallel and Highly Innovative Simulation for INL Code System (PHISICS) and the system thermal-hydraulics code known as the Reactor Excursion and Leak Analysis Program (RELAP) 5 3D using the nuclear data libraries previously generated with NEWT. It was observed that significant differences in terms of multiplication factor and neutron flux exist between the various permutations of the Phase I super-cell lattice calculations. The use of these cross section libraries only leads to minor changes in the Phase II core simulation results for fresh fuel but shows significantly larger discrepancies for spent fuel cores. Furthermore, large incongruities were found between the SCALE NEWT and KENO VI results for the super cells, and while some trends could be identified, a final conclusion on this issue could not yet be reached. This report will be revised in mid 2016 with more detailed analyses of the super-cell problems and their effects on the core models, using the latest version of SCALE (6.2). The super-cell models seem to show substantial improvements in terms of neutron flux as compared to single-block models, particularly at thermal energies.« less

JPRS Report, Science & Technology, China: Energy

DTIC Science & Technology

1989-06-26

certain areas such as modular HTGR technology. In nuclear power develop - ment we currently face both challenges and opportunities, both risks and...22161 JmC QUALITY EJSPSÜSED 3 Science & Technology China: Energy JPRS-CEN-89-006 CONTENTS 26 June 1989 NATIONAL DEVELOPMENTS No Easy Solution Seen...Be Developed [XINHUA, 16 May 89] 21 National Oil Firm Sets 5-Year Goals [CEI Database, 9 May 89] , 21 Zhongyuan Oil Field Is Among Fastest

PIE on Safety-Tested AGR-1 Compact 5-1-1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hunn, John D.; Morris, Robert Noel; Baldwin, Charles A.

Post-irradiation examination (PIE) is being performed in support of tristructural isotropic (TRISO) coated particle fuel development and qualification for High-Temperature Gas-cooled Reactors (HTGRs). AGR-1 was the first in a series of TRISO fuel irradiation experiments initiated in 2006 under the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program; this work continues to be funded by the Department of Energy's Office of Nuclear Energy as part of the Advanced Reactor Technologies (ART) initiative. AGR-1 fuel compacts were fabricated at Oak Ridge National Laboratory (ORNL) in 2006 and irradiated for three years in the Idaho National Laboratory (INL) Advanced Test Reactormore » (ATR) to demonstrate and evaluate fuel performance under HTGR irradiation conditions. PIE is being performed at INL and ORNL to study how the fuel behaved during irradiation, and to examine fuel performance during exposure to elevated temperatures at or above temperatures that could occur during a depressurized conduction cooldown event. This report summarizes safety testing of irradiated AGR-1 Compact 5-1-1 in the ORNL Core Conduction Cooldown Test Facility (CCCTF) and post-safety testing PIE.« less

TUNABLE IRRADIATION TESTBED

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wootan, David W.; Casella, Andrew M.; Asner, David M.

PNNL has developed and continues to develop innovative methods for characterizing irradiated materials from nuclear reactors and particle accelerators for various clients and collaborators around the world. The continued development of these methods, in addition to the ability to perform unique scientific investigations of the effects of radiation on materials could be greatly enhanced with easy access to irradiation facilities. A Tunable Irradiation Testbed with customized targets (a 30 MeV, 1mA cyclotron or similar coupled to a unique target system) is shown to provide a much more flexible and cost-effective source of irradiating particles than a test reactor or isotopicmore » source. The configuration investigated was a single shielded building with multiple beam lines from a small, flexible, high flux irradiation source. Potential applications investigated were the characterization of radiation damage to materials applicable to advanced reactors, fusion reactor, legacy waste, (via neutron spectra tailored to HTGR, molten salt, LWR, LMR, fusion environments); 252Cf replacement; characterization of radiation damage to materials of interest to High Energy Physics to enable the neutrino program; and research into production of short lived isotopes for potential medical and other applications.« less

Detection and Monitoring of Airborne Nuclear Waste Materials. Annual Report to Department of Energy.

DTIC Science & Technology

1979-12-04

an active core , its detection by counting techniques is often slow and impractical. For these reasons NRL under contract with DoE undertook develop ...Protection and Measurements, Tritium Measurement Techniques NCRP Report No. 47 (1976). 2. " Development of a Continuous Tritium Monitor for Fuel Reprocessing...Trans. Am. Nucl. Soc. 21, 91 (1975). 146. "Process Behavior of and Environmental Assessments of C Releases from an HTGR Fuel Reprocessing Facility" J. W

Thermal-Hydraulic Transient Analysis of a Packed Particle Bed Reactor Fuel Element

DTIC Science & Technology

1990-06-01

long fuel elements, arranged to form a core , were analyzed for an up-power transient from 0 MWt to approximately 18 MWt. The simple model significantly...VARIATIONS IN FUEL ELEMENT GEOMETRY ............. 60 4.4 VARIATIONS IN THE MANNER OF TRANSIENT CONTROL ..... 62 4.5 CORE REPRESENTATION BY MULTIPLE FUEL ...the HTGR , however, the PBR packs small fuel particles between inner and outer retention elements, designated as frits. The PBR is appropriate for a

Kinetics of Chronic Oxidation of NBG-17 Nuclear Graphite by Water Vapor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Contescu, Cristian I; Burchell, Timothy D; Mee, Robert

2015-05-01

This report presents the results of kinetic measurements during accelerated oxidation tests of NBG-17 nuclear graphite by low concentration of water vapor and hydrogen in ultra-high purity helium. The objective is to determine the parameters in the Langmuir-Hinshelwood (L-H) equation describing the oxidation kinetics of nuclear graphite in the helium coolant of high temperature gas-cooled reactors (HTGR). Although the helium coolant chemistry is strictly controlled during normal operating conditions, trace amounts of moisture (predictably < 0.2 ppm) cannot be avoided. Prolonged exposure of graphite components to water vapor at high temperature will cause very slow (chronic) oxidation over the lifetimemore » of graphite components. This behavior must be understood and predicted for the design and safe operation of gas-cooled nuclear reactors. The results reported here show that, in general, oxidation by water of graphite NBG-17 obeys the L-H mechanism, previously documented for other graphite grades. However, the characteristic kinetic parameters that best describe oxidation rates measured for graphite NBG-17 are different than those reported previously for grades H-451 (General Atomics, 1978) and PCEA (ORNL, 2013). In some specific conditions, certain deviations from the generally accepted L-H model were observed for graphite NBG-17. This graphite is manufactured in Germany by SGL Carbon Group and is a possible candidate for the fuel elements and reflector blocks of HTGR.« less

Development Program of IS Process Pilot Test Plant for Hydrogen Production With High-Temperature Gas-Cooled Reactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jin Iwatsuki; Atsuhiko Terada; Hiroyuki Noguchi

2006-07-01

At the present time, we are alarmed by depletion of fossil energy and effects on global environment such as acid rain and global warming, because our lives depend still heavily on fossil energy. So, it is universally recognized that hydrogen is one of the best energy media and its demand will be increased greatly in the near future. In Japan, the Basic Plan for Energy Supply and Demand based on the Basic Law on Energy Policy Making was decided upon by the Cabinet on 6 October, 2003. In the plan, efforts for hydrogen energy utilization were expressed as follows; hydrogenmore » is a clean energy carrier without carbon dioxide (CO{sub 2}) emission, and commercialization of hydrogen production system using nuclear, solar and biomass, not fossil fuels, is desired. However, it is necessary to develop suitable technology to produce hydrogen without CO{sub 2} emission from a view point of global environmental protection, since little hydrogen exists naturally. Hydrogen production from water using nuclear energy, especially the high-temperature gas-cooled reactor (HTGR), is one of the most attractive solutions for the environmental issue, because HTGR hydrogen production by water splitting methods such as a thermochemical iodine-sulfur (IS) process has a high possibility to produce hydrogen effectively and economically. The Japan Atomic Energy Agency (JAEA) has been conducting the HTTR (High-Temperature Engineering Test Reactor) project from the view to establishing technology base on HTGR and also on the IS process. In the IS process, raw material, water, is to be reacted with iodine (I{sub 2}) and sulfur dioxide (SO{sub 2}) to produce hydrogen iodide (HI) and sulfuric acid (H{sub 2}SO{sub 4}), the so-called Bunsen reaction, which are then decomposed endo-thermically to produce hydrogen (H{sub 2}) and oxygen (O{sub 2}), respectively. Iodine and sulfur dioxide produced in the decomposition reactions can be used again as the reactants in the Bunsen reaction. In JAEA, continuous hydrogen production was demonstrated with the hydrogen production rate of about 30 NL/hr for one week using a bench-scale test apparatus made of glass. Based on the test results and know-how obtained through the bench-scale tests, a pilot test plant that can produce hydrogen of about 30 Nm{sup 3}/hr is being designed. The test plant will be fabricated with industrial materials such as glass coated steel, SiC ceramics etc, and operated under high pressure condition up to 2 MPa. The test plant will consist of a IS process plant and a helium gas (He) circulation facility (He loop). The He loop can simulate HTTR operation conditions, which consists of a 400 kW-electric heater for He hating, a He circulator and a steam generator working as a He cooler. In parallel to the design study, key components of the IS process such as the sulfuric acid (H{sub 2}SO{sub 4}) and the sulfur trioxide (SO{sub 3}) decomposers working under-high temperature corrosive environments have been designed and test-fabricated to confirm their fabricability. Also, other R and D's are under way such as corrosion, processing of HIx solutions. This paper describes present status of these activities. (authors)« less

Status of Chronic Oxidation Studies of Graphite

DOE Office of Scientific and Technical Information (OSTI.GOV)

Contescu, Cristian I.; Mee, Robert W.

Graphite will undergo extremely slow, but continuous oxidation by traces of moisture that will be present, albeit at very low levels, in the helium coolant of HTGR. This chronic oxidation may cause degradation of mechanical strength and thermal properties of graphite components if a porous oxidation layer penetrates deep enough in the bulk of graphite components during the lifetime of the reactor. The current research on graphite chronic oxidation is motivated by the acute need to understand the behavior of each graphite grade during prolonged exposure to high temperature chemical attack by moisture. The goal is to provide the elementsmore » needed to develop predictive models for long-time oxidation behavior of graphite components in the cooling helium of HTGR. The tasks derived from this goal are: (1) Oxidation rate measurements in order to determine and validate a comprehensive kinetic model suitable for prediction of intrinsic oxidation rates as a function of temperature and oxidant gas composition; (2) Characterization of effective diffusivity of water vapor in the graphite pore system in order to account for the in-pore transport of moisture; and (3) Development and validation of a predictive model for the penetration depth of the oxidized layer, in order to assess the risk of oxidation caused damage of particular graphite grades after prolonged exposure to the environment of helium coolant in HTGR. The most important and most time consuming of these tasks is the measurement of oxidation rates in accelerated oxidation tests (but still under kinetic control) and the development of a reliable kinetic model. This report summarizes the status of chronic oxidation studies on graphite, and then focuses on model development activities, progress of kinetic measurements, validation of results, and improvement of the kinetic models. Analysis of current and past results obtained with three grades of showed that the classical Langmuir-Hinshelwood model cannot reproduce all data collected so far. Starting from here we propose a modification of the LH model to include temperature activation of graphite surface as a Boltzmann activation function. The enhanced Boltzmann-Langmuir-Hinshelwood model (BLH) was tested successfully on three grades of graphite. The model is a robust, comprehensive mathematical function that allows better fitting of experimental results spanning a wide range of temperature and partial pressures of water vapor and hydrogen. However, the model did not fit satisfactorily the data extracted from the old report on graphite H-451 oxidation by water.« less

PIE on Safety-Tested Loose Particles from Irradiated Compact 4-4-2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hunn, John D.; Gerczak, Tyler J.; Morris, Robert Noel

2016-04-01

Post-irradiation examination (PIE) is being performed in support of tristructural isotropic (TRISO) coated particle fuel development and qualification for High Temperature Gas-cooled Reactors (HTGRs). This work is sponsored by the Department of Energy Office of Nuclear Energy (DOE-NE) through the Advanced Reactor Technologies (ART) Office under the Advanced Gas Reactor Fuel Development and Qualification (AGR) Program. The AGR-1 experiment was the first in a series of TRISO fuel irradiation tests initiated in 2006. The AGR-1 TRISO particles and fuel compacts were fabricated at Oak Ridge National Laboratory (ORNL) in 2006 using laboratory-scale equipment and irradiated for 3 years in themore » Advanced Test Reactor (ATR) at Idaho National Laboratory (INL) to demonstrate and evaluate fuel performance under HTGR irradiation conditions. Post-irradiation examination was performed at INL and ORNL to study how the fuel behaved during irradiation, and to test fuel performance during exposure to elevated temperatures at or above temperatures that could occur during a depressurized conduction cooldown event. This report summarizes safety testing and post-safety testing PIE conducted at ORNL on loose particles extracted from irradiated AGR-1 Compact 4-4-2.« less

A summary of the results from the DOE advanced gas reactor (AGR) fuel development and qualification program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Petti, David Andrew

2017-04-01

Modular high temperature gas-cooled reactor (HTGR) designs were developed to provide natural safety, which prevents core damage under all licensing basis events. The principle that guides their design concepts is to passively maintain core temperatures below fission product release thresholds under all accident scenarios. The required level of fuel performance and fission product retention reduces the radioactive source term by many orders of magnitude relative to source terms for other reactor types and allows a graded approach to emergency planning and the potential elimination of the need for evacuation and sheltering beyond a small exclusion area. Achieving this level, however,more » is predicated on exceptionally high coated-particle fuel fabrication quality and excellent performance under normal operation and accident conditions. The design goal of modular HTGRs is to meet the Environmental Protection Agency (EPA) Protective Action Guides (PAGs) for offsite dose at the Exclusion Area Boundary (EAB). To achieve this, the reactor design concepts require a level of fuel integrity that is far better than that achieved for all prior U.S.-manufactured tristructural isotropic (TRISO) coated particle fuel.« less

Comparison between instrumented precracked Charpy and compact specimen tests of carbon steels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nanstad, R.K.

1980-01-01

The General Atomic Company High Temperature Gas-Cooled Reactor (HTGR) is housed within a prestressed concrete reactor vessel (PCRV). Various carbon steel structural members serve as closures at penetrations in the vessel. A program of testing and evaluation is underway to determine the need for reference fracture toughness (K/sub IR/) and indexing procedures for these materials as described in Appendix G to Section III, ASME Code for light water reactor steels. The materials of interest are carbon steel forgings (SA508, Class 1) and plates (SA537, Classes 1 and 2) as well as weldments of these steels. The fracture toughness behavior ismore » characterized with instrumented precracked Charpy V-votch specimens (PCVN) - slow-bend and dynamic - and compact specimens (10-mm and 25-mm thicknesses) using both linear elastic (ASTM E399) and elastic-plastic (equivalent Energy and J-Integral) analytical procedures. For the dynamic PCVN tests, force-time traces are analyzed according to the procedures of the Pressure Vessel Research Council (PVRC)/Metal Properties Council (MPC). Testing and analytical procedures are discussed and PCVN results are compared to those obtained with compact specimens.« less

Briefing Book. Volume 1: The Evolution of the Nuclear Non-Proliferation Regime (Fourth Edition).

DTIC Science & Technology

1998-01-01

usually termed) nuclear reactors. The first of these is that they contain a core or mass of fissile material (the fuel ) which may weigh tens of tons... HTGR is cooled with helium gas and moderated with graphite. Highly enriched uranium is used as fuel (93 per cent U-235), though this may be mixed with...to convert U-238 in a blanket around the core into Pu-239 at a rate faster than its own consumption of fissile material. They thus produce more fuel

Investigation of the Feasibility of Utilizing Gamma Emission Computed Tomography in Evaluating Fission Product Migration in Irradiated TRISO Fuel Experiments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jason M. Harp; Paul A. Demkowicz

2014-10-01

In the High Temperature Gas-Cooled Reactor (HTGR) the TRISO particle fuel serves as the primary fission product containment. However the large number of TRISO particles present in proposed HTGRs dictates that there will be a small fraction (~10 -4 to 10 -5) of as manufactured and in-pile particle failures that will lead to some fission product release. The matrix material surrounding the TRISO particles in fuel compacts and the structural graphite holding the TRISO particles in place can also serve as sinks for containing any released fission products. However data on the migration of solid fission products through these materialsmore » is lacking. One of the primary goals of the AGR-3/4 experiment is to study fission product migration from failed TRISO particles in prototypic HTGR components such as structural graphite and compact matrix material. In this work, the potential for a Gamma Emission Computed Tomography (GECT) technique to non-destructively examine the fission product distribution in AGR-3/4 components and other irradiation experiments is explored. Specifically, the feasibility of using the Idaho National Laboratory (INL) Hot Fuels Examination Facility (HFEF) Precision Gamma Scanner (PGS) system for this GECT application is considered. To test the feasibility, the response of the PGS system to idealized fission product distributions has been simulated using Monte Carlo radiation transport simulations. Previous work that applied similar techniques during the AGR-1 experiment will also be discussed as well as planned uses for the GECT technique during the post irradiation examination of the AGR-2 experiment. The GECT technique has also been applied to other irradiated nuclear fuel systems that were currently available in the HFEF hot cell including oxide fuel pins, metallic fuel pins, and monolithic plate fuel.« less

Methods for making a porous nuclear fuel element

DOEpatents

Youchison, Dennis L; Williams, Brian E; Benander, Robert E

2014-12-30

Porous nuclear fuel elements for use in advanced high temperature gas-cooled nuclear reactors (HTGR's), and to processes for fabricating them. Advanced uranium bi-carbide, uranium tri-carbide and uranium carbonitride nuclear fuels can be used. These fuels have high melting temperatures, high thermal conductivity, and high resistance to erosion by hot hydrogen gas. Tri-carbide fuels, such as (U,Zr,Nb)C, can be fabricated using chemical vapor infiltration (CVI) to simultaneously deposit each of the three separate carbides, e.g., UC, ZrC, and NbC in a single CVI step. By using CVI, the nuclear fuel may be deposited inside of a highly porous skeletal structure made of, for example, reticulated vitreous carbon foam.

Summary of the Advanced Reactor Design Criteria (ARDC) Phase 2 Activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holbrook, Mark Raymond

This report provides an end-of-year summary reflecting the progress and status of proposed regulatory design criteria for advanced non-LWR designs in accordance with the Level 3 milestone in M3AT-15IN2001017 in work package AT-15IN200101. These criteria have been designated as ARDC, and they provide guidance to future applicants for addressing the GDC that are currently applied specifically to LWR designs. The report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of example adaptations of ARDC for Sodium Fast Reactor (SFR) and modular High Temperature Gas-cooled Reactor (HTGR) designs.

The "trapped fraction" and interfacial jumps of concentration in fission products release from coated fuel particles

NASA Astrophysics Data System (ADS)

Ivanov, A. S.; Rusinkevich, A. A.; Taran, M. D.

2018-01-01

The FP Kinetics computer code [1] designed for calculation of fission products release from HTGR coated fuel particles was modified to allow consideration of chemical bonding, effects of limited solubility and component concentration jumps at interfaces between coating layers. Curves of Cs release from coated particles calculated with the FP Kinetics and PARFUME [2] codes were compared. It has been found that the consideration of concentration jumps at silicon carbide layer interfaces allows giving an explanation of some experimental data on Cs release obtained from post-irradiation heating tests. The need to perform experiments for measurement of solubility limits in coating materials was noted.

Comparisons of RELAP5-3D Analyses to Experimental Data from the Natural Convection Shutdown Heat Removal Test Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bucknor, Matthew; Hu, Rui; Lisowski, Darius

2016-04-17

The Reactor Cavity Cooling System (RCCS) is an important passive safety system being incorporated into the overall safety strategy for high temperature advanced reactor concepts such as the High Temperature Gas- Cooled Reactors (HTGR). The Natural Convection Shutdown Heat Removal Test Facility (NSTF) at Argonne National Laboratory (Argonne) reflects a 1/2-scale model of the primary features of one conceptual air-cooled RCCS design. The project conducts ex-vessel, passive heat removal experiments in support of Department of Energy Office of Nuclear Energy’s Advanced Reactor Technology (ART) program, while also generating data for code validation purposes. While experiments are being conducted at themore » NSTF to evaluate the feasibility of the passive RCCS, parallel modeling and simulation efforts are ongoing to support the design, fabrication, and operation of these natural convection systems. Both system-level and high fidelity computational fluid dynamics (CFD) analyses were performed to gain a complete understanding of the complex flow and heat transfer phenomena in natural convection systems. This paper provides a summary of the RELAP5-3D NSTF model development efforts and provides comparisons between simulation results and experimental data from the NSTF. Overall, the simulation results compared favorably to the experimental data, however, further analyses need to be conducted to investigate any identified differences.« less

Methods for manufacturing porous nuclear fuel elements for high-temperature gas-cooled nuclear reactors

DOEpatents

Youchison, Dennis L [Albuquerque, NM; Williams, Brian E [Pocoima, CA; Benander, Robert E [Pacoima, CA

2010-02-23

Methods for manufacturing porous nuclear fuel elements for use in advanced high temperature gas-cooled nuclear reactors (HTGR's). Advanced uranium bi-carbide, uranium tri-carbide and uranium carbonitride nuclear fuels can be used. These fuels have high melting temperatures, high thermal conductivity, and high resistance to erosion by hot hydrogen gas. Tri-carbide fuels, such as (U,Zr,Nb)C, can be fabricated using chemical vapor infiltration (CVI) to simultaneously deposit each of the three separate carbides, e.g., UC, ZrC, and NbC in a single CVI step. By using CVI, a thin coating of nuclear fuel may be deposited inside of a highly porous skeletal structure made, for example, of reticulated vitreous carbon foam.

Porous nuclear fuel element for high-temperature gas-cooled nuclear reactors

DOEpatents

Youchison, Dennis L [Albuquerque, NM; Williams, Brian E [Pacoima, CA; Benander, Robert E [Pacoima, CA

2011-03-01

Porous nuclear fuel elements for use in advanced high temperature gas-cooled nuclear reactors (HTGR's), and to processes for fabricating them. Advanced uranium bi-carbide, uranium tri-carbide and uranium carbonitride nuclear fuels can be used. These fuels have high melting temperatures, high thermal conductivity, and high resistance to erosion by hot hydrogen gas. Tri-carbide fuels, such as (U,Zr,Nb)C, can be fabricated using chemical vapor infiltration (CVI) to simultaneously deposit each of the three separate carbides, e.g., UC, ZrC, and NbC in a single CVI step. By using CVI, the nuclear fuel may be deposited inside of a highly porous skeletal structure made of, for example, reticulated vitreous carbon foam.

Porous nuclear fuel element with internal skeleton for high-temperature gas-cooled nuclear reactors

DOEpatents

Youchison, Dennis L.; Williams, Brian E.; Benander, Robert E.

2013-09-03

Porous nuclear fuel elements for use in advanced high temperature gas-cooled nuclear reactors (HTGR's), and to processes for fabricating them. Advanced uranium bi-carbide, uranium tri-carbide and uranium carbonitride nuclear fuels can be used. These fuels have high melting temperatures, high thermal conductivity, and high resistance to erosion by hot hydrogen gas. Tri-carbide fuels, such as (U,Zr,Nb)C, can be fabricated using chemical vapor infiltration (CVI) to simultaneously deposit each of the three separate carbides, e.g., UC, ZrC, and NbC in a single CVI step. By using CVI, the nuclear fuel may be deposited inside of a highly porous skeletal structure made of, for example, reticulated vitreous carbon foam.

Optimizing the implementation of the target motion sampling temperature treatment technique - How fast can it get?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tuomas, V.; Jaakko, L.

This article discusses the optimization of the target motion sampling (TMS) temperature treatment method, previously implemented in the Monte Carlo reactor physics code Serpent 2. The TMS method was introduced in [1] and first practical results were presented at the PHYSOR 2012 conference [2]. The method is a stochastic method for taking the effect of thermal motion into account on-the-fly in a Monte Carlo neutron transport calculation. It is based on sampling the target velocities at collision sites and then utilizing the 0 K cross sections at target-at-rest frame for reaction sampling. The fact that the total cross section becomesmore » a distributed quantity is handled using rejection sampling techniques. The original implementation of the TMS requires 2.0 times more CPU time in a PWR pin-cell case than a conventional Monte Carlo calculation relying on pre-broadened effective cross sections. In a HTGR case examined in this paper the overhead factor is as high as 3.6. By first changing from a multi-group to a continuous-energy implementation and then fine-tuning a parameter affecting the conservativity of the majorant cross section, it is possible to decrease the overhead factors to 1.4 and 2.3, respectively. Preliminary calculations are also made using a new and yet incomplete optimization method in which the temperature of the basis cross section is increased above 0 K. It seems that with the new approach it may be possible to decrease the factors even as low as 1.06 and 1.33, respectively, but its functionality has not yet been proven. Therefore, these performance measures should be considered preliminary. (authors)« less

Water NSTF Design, Instrumentation, and Test Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lisowski, Darius D.; Gerardi, Craig D.; Hu, Rui

The following report serves as a formal introduction to the water-based Natural convection Shutdown heat removal Test Facility (NSTF) program at Argonne. Since 2005, this US Department of Energy (DOE) sponsored program has conducted large scale experimental testing to generate high-quality and traceable validation data for guiding design decisions of the Reactor Cavity Cooling System (RCCS) concept for advanced reactor designs. The most recent facility iteration, and focus of this report, is the operation of a 1/2 scale model of a water-RCCS concept. Several features of the NSTF prototype align with the conceptual design that has been publicly released formore » the AREVA 625 MWt SC-HTGR. The design of the NSTF also retains all aspects common to a fundamental boiling water thermosiphon, and thus is well poised to provide necessary experimental data to advance basic understanding of natural circulation phenomena and contribute to computer code validation. Overall, the NSTF program operates to support the DOE vision of aiding US vendors in design choices of future reactor concepts, advancing the maturity of codes for licensing, and ultimately developing safe and reliable reactor technologies. In this report, the top-level program objectives, testing requirements, and unique considerations for the water cooled test assembly are discussed, and presented in sufficient depth to support defining the program’s overall scope and purpose. A discussion of the proposed 6-year testing program is then introduced, which outlines the specific strategy and testing plan for facility operations. The proposed testing plan has been developed to meet the toplevel objective of conducting high-quality test operations that span across a broad range of single- and two-phase operating conditions. Details of characterization, baseline test cases, accident scenario, and parametric variations are provided, including discussions of later-stage test cases that examine the influence of geometric variations and off-normal configurations. The facility design follows, including as-built dimensions and specifications of the various mechanical and liquid systems, design choices for the test section, water storage tank, and network piping. Specifications of the instrumentation suite are then presented, along with specific information on performance windows, measurement uncertainties, and installation locations. Finally, descriptions of the control systems and heat removal networks are provided, which have been engineered to support precise quantification of energy balances and facilitate well-controlled test operations.« less

Pre-test CFD Calculations for a Bypass Flow Standard Problem

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rich Johnson

The bypass flow in a prismatic high temperature gas-cooled reactor (HTGR) is the flow that occurs between adjacent graphite blocks. Gaps exist between blocks due to variances in their manufacture and installation and because of the expansion and shrinkage of the blocks from heating and irradiation. Although the temperature of fuel compacts and graphite is sensitive to the presence of bypass flow, there is great uncertainty in the level and effects of the bypass flow. The Next Generation Nuclear Plant (NGNP) program at the Idaho National Laboratory has undertaken to produce experimental data of isothermal bypass flow between three adjacentmore » graphite blocks. These data are intended to provide validation for computational fluid dynamic (CFD) analyses of the bypass flow. Such validation data sets are called Standard Problems in the nuclear safety analysis field. Details of the experimental apparatus as well as several pre-test calculations of the bypass flow are provided. Pre-test calculations are useful in examining the nature of the flow and to see if there are any problems associated with the flow and its measurement. The apparatus is designed to be able to provide three different gap widths in the vertical direction (the direction of the normal coolant flow) and two gap widths in the horizontal direction. It is expected that the vertical bypass flow will range from laminar to transitional to turbulent flow for the different gap widths that will be available.« less

DESIGN CHARACTERISTICS OF THE IDAHO NATIONAL LABORATORY HIGH-TEMPERATURE GAS-COOLED TEST REACTOR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sterbentz, James; Bayless, Paul; Strydom, Gerhard

2016-11-01

Uncertainty and sensitivity analysis is an indispensable element of any substantial attempt in reactor simulation validation. The quantification of uncertainties in nuclear engineering has grown more important and the IAEA Coordinated Research Program (CRP) on High-Temperature Gas Cooled Reactor (HTGR) initiated in 2012 aims to investigate the various uncertainty quantification methodologies for this type of reactors. The first phase of the CRP is dedicated to the estimation of cell and lattice model uncertainties due to the neutron cross sections co-variances. Phase II is oriented towards the investigation of propagated uncertainties from the lattice to the coupled neutronics/thermal hydraulics core calculations.more » Nominal results for the prismatic single block (Ex.I-2a) and super cell models (Ex.I-2c) have been obtained using the SCALE 6.1.3 two-dimensional lattice code NEWT coupled to the TRITON sequence for cross section generation. In this work, the TRITON/NEWT-flux-weighted cross sections obtained for Ex.I-2a and various models of Ex.I-2c is utilized to perform a sensitivity analysis of the MHTGR-350 core power densities and eigenvalues. The core solutions are obtained with the INL coupled code PHISICS/RELAP5-3D, utilizing a fixed-temperature feedback for Ex. II-1a.. It is observed that the core power density does not vary significantly in shape, but the magnitude of these variations increases as the moderator-to-fuel ratio increases in the super cell lattice models.« less

Safety philosophy of gas turbine high temperature reactor (GTHTR300)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shoji Katanishi; Kazuhiko Kunitomi; Shusaku Shiozawa

2002-07-01

Japan Atomic Energy Research Institute (JAERI) has undertaken the study of an original design concept of gas turbine high temperature reactor, the GTHTR300. The general concept of this study is development of a greatly simplified design that leads to substantially reduced technical and cost requirements. Newly proposed design features enable the GTHTR300 to be an efficient and economically competitive reactor in 2010's. Also, the GTHTR300 fully takes advantage of its inherent safety characteristics. The safety philosophy of the GTHTR300 is developed based on the HTTR (High Temperature Engineering Test Reactor) of JAERI which is the first HTGR in Japan. Majormore » features of the newly proposed safety philosophy for the GTHTR300 are described in this article. (authors)« less

Control of stacking loads in final waste disposal according to the borehole technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feuser, W.; Barnert, E.; Vijgen, H.

1996-12-01

The semihydrostatic model has been developed in order to assess the mechanical toads acting on heat-generating ILW(Q) and HTGR fuel element waste packages to be emplaced in vertical boreholes according to the borehole technique in underground rock salt formations. For the experimental validation of the theory, laboratory test stands reduced in scale are set up to simulate the bottom section of a repository borehole. A comparison of the measurement results with the data computed by the model, a correlation between the test stand results, and a systematic determination of material-typical crushed salt parameters in a separate research project will servemore » to derive a set of characteristic equations enabling a description of real conditions in a future repository.« less

Closed Brayton Cycle power system with a high temperature pellet bed reactor heat source for NEP applications

NASA Technical Reports Server (NTRS)

Juhasz, Albert J.; El-Genk, Mohamed S.; Harper, William B., Jr.

1992-01-01

Capitalizing on past and future development of high temperature gas reactor (HTGR) technology, a low mass 15 MWe closed gas turbine cycle power system using a pellet bed reactor heating helium working fluid is proposed for Nuclear Electric Propulsion (NEP) applications. Although the design of this directly coupled system architecture, comprising the reactor/power system/space radiator subsystems, is presented in conceptual form, sufficient detail is included to permit an assessment of overall system performance and mass. Furthermore, an attempt is made to show how tailoring of the main subsystem design characteristics can be utilized to achieve synergistic system level advantages that can lead to improved reliability and enhanced system life while reducing the number of parasitic load driven peripheral subsystems.

A method for development of efficient 3D models for neutronic calculations of ASTRA critical facility using experimental information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balanin, A. L.; Boyarinov, V. F.; Glushkov, E. S.

The application of experimental information on measured axial distributions of fission reaction rates for development of 3D numerical models of the ASTRA critical facility taking into account azimuthal asymmetry of the assembly simulating a HTGR with annular core is substantiated. Owing to the presence of the bottom reflector and the absence of the top reflector, the application of 2D models based on experimentally determined buckling is impossible for calculation of critical assemblies of the ASTRA facility; therefore, an alternative approach based on the application of the extrapolated assembly height is proposed. This approach is exemplified by the numerical analysis ofmore » experiments on measurement of efficiency of control rods mockups and protection system (CPS).« less

PHISICS/RELAP5-3D RESULTS FOR EXERCISES II-1 AND II-2 OF THE OECD/NEA MHTGR-350 BENCHMARK

DOE Office of Scientific and Technical Information (OSTI.GOV)

Strydom, Gerhard

2016-03-01

The Idaho National Laboratory (INL) Advanced Reactor Technologies (ART) High-Temperature Gas-Cooled Reactor (HTGR) Methods group currently leads the Modular High-Temperature Gas-Cooled Reactor (MHTGR) 350 benchmark. The benchmark consists of a set of lattice-depletion, steady-state, and transient problems that can be used by HTGR simulation groups to assess the performance of their code suites. The paper summarizes the results obtained for the first two transient exercises defined for Phase II of the benchmark. The Parallel and Highly Innovative Simulation for INL Code System (PHISICS), coupled with the INL system code RELAP5-3D, was used to generate the results for the Depressurized Conductionmore » Cooldown (DCC) (exercise II-1a) and Pressurized Conduction Cooldown (PCC) (exercise II-2) transients. These exercises require the time-dependent simulation of coupled neutronics and thermal-hydraulics phenomena, and utilize the steady-state solution previously obtained for exercise I-3 of Phase I. This paper also includes a comparison of the benchmark results obtained with a traditional system code “ring” model against a more detailed “block” model that include kinetics feedback on an individual block level and thermal feedbacks on a triangular sub-mesh. The higher spatial fidelity that can be obtained by the block model is illustrated with comparisons of the maximum fuel temperatures, especially in the case of natural convection conditions that dominate the DCC and PCC events. Differences up to 125 K (or 10%) were observed between the ring and block model predictions of the DCC transient, mostly due to the block model’s capability of tracking individual block decay powers and more detailed helium flow distributions. In general, the block model only required DCC and PCC calculation times twice as long as the ring models, and it therefore seems that the additional development and calculation time required for the block model could be worth the gain that can be obtained in the spatial resolution« less

Monte Carlo Techniques for Nuclear Systems - Theory Lectures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Forrest B.

These are lecture notes for a Monte Carlo class given at the University of New Mexico. The following topics are covered: course information; nuclear eng. review & MC; random numbers and sampling; computational geometry; collision physics; tallies and statistics; eigenvalue calculations I; eigenvalue calculations II; eigenvalue calculations III; variance reduction; parallel Monte Carlo; parameter studies; fission matrix and higher eigenmodes; doppler broadening; Monte Carlo depletion; HTGR modeling; coupled MC and T/H calculations; fission energy deposition. Solving particle transport problems with the Monte Carlo method is simple - just simulate the particle behavior. The devil is in the details, however. Thesemore » lectures provide a balanced approach to the theory and practice of Monte Carlo simulation codes. The first lectures provide an overview of Monte Carlo simulation methods, covering the transport equation, random sampling, computational geometry, collision physics, and statistics. The next lectures focus on the state-of-the-art in Monte Carlo criticality simulations, covering the theory of eigenvalue calculations, convergence analysis, dominance ratio calculations, bias in Keff and tallies, bias in uncertainties, a case study of a realistic calculation, and Wielandt acceleration techniques. The remaining lectures cover advanced topics, including HTGR modeling and stochastic geometry, temperature dependence, fission energy deposition, depletion calculations, parallel calculations, and parameter studies. This portion of the class focuses on using MCNP to perform criticality calculations for reactor physics and criticality safety applications. It is an intermediate level class, intended for those with at least some familiarity with MCNP. Class examples provide hands-on experience at running the code, plotting both geometry and results, and understanding the code output. The class includes lectures & hands-on computer use for a variety of Monte Carlo calculations. Beginning MCNP users are encouraged to review LA-UR-09-00380, "Criticality Calculations with MCNP: A Primer (3nd Edition)" (available at http:// mcnp.lanl.gov under "Reference Collection") prior to the class. No Monte Carlo class can be complete without having students write their own simple Monte Carlo routines for basic random sampling, use of the random number generator, and simplified particle transport simulation.« less

Role of nuclear grade graphite in controlling oxidation in modular HTGRs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Windes, Willaim; Strydom, G.; Kane, J.

2014-11-01

The passively safe High Temperature Gas-cooled Reactor (HTGR) design is one of the primary concepts considered for Generation IV and Small Modular Reactor (SMR) programs. The helium cooled, nuclear grade graphite moderated core achieves extremely high operating temperatures allowing either industrial process heat or electricity generation at high efficiencies. In addition to their neutron moderating properties, nuclear grade graphite core components provide excellent high temperature stability, thermal conductivity, and chemical compatibility with the high temperature nuclear fuel form. Graphite has been continuously used in nuclear reactors since the 1940’s and has performed remarkably well over a wide range of coremore » environments and operating conditions. Graphite moderated, gas-cooled reactor designs have been safely used for research and power production purposes in multiple countries since the inception of nuclear energy development. However, graphite is a carbonaceous material, and this has generated a persistent concern that the graphite components could actually burn during either normal or accident conditions [ , ]. The common assumption is that graphite, since it is ostensibly similar to charcoal and coal, will burn in a similar manner. While charcoal and coal may have the appearance of graphite, the internal microstructure and impurities within these carbonaceous materials are very different. Volatile species and trapped moisture provide a source of oxygen within coal and charcoal allowing them to burn. The fabrication process used to produce nuclear grade graphite eliminates these oxidation enhancing impurities, creating a dense, highly ordered form of carbon possessing high thermal diffusivity and strongly (covalently) bonded atoms.« less

Promethus Hot Leg Piping Concept

DOE Office of Scientific and Technical Information (OSTI.GOV)

AM Girbik; PA Dilorenzo

2006-01-24

The Naval Reactors Prime Contractor Team (NRPCT) recommended the development of a gas cooled reactor directly coupled to a Brayton energy conversion system as the Space Nuclear Power Plant (SNPP) for NASA's Project Prometheus. The section of piping between the reactor outlet and turbine inlet, designated as the hot leg piping, required unique design features to allow the use of a nickel superalloy rather than a refractory metal as the pressure boundary. The NRPCT evaluated a variety of hot leg piping concepts for performance relative to SNPP system parameters, manufacturability, material considerations, and comparison to past high temperature gas reactormore » (HTGR) practice. Manufacturability challenges and the impact of pressure drop and turbine entrance temperature reduction on cycle efficiency were discriminators between the piping concepts. This paper summarizes the NRPCT hot leg piping evaluation, presents the concept recommended, and summarizes developmental issues for the recommended concept.« less

Next Generation Nuclear Plant Defense-in-Depth Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edward G. Wallace; Karl N. Fleming; Edward M. Burns

2009-12-01

The purpose of this paper is to (1) document the definition of defense-in-depth and the pproach that will be used to assure that its principles are satisfied for the NGNP project and (2) identify the specific questions proposed for preapplication discussions with the NRC. Defense-in-depth is a safety philosophy in which multiple lines of defense and conservative design and evaluation methods are applied to assure the safety of the public. The philosophy is also intended to deliver a design that is tolerant to uncertainties in knowledge of plant behavior, component reliability or operator performance that might compromise safety. This papermore » includes a review of the regulatory foundation for defense-in-depth, a definition of defense-in-depth that is appropriate for advanced reactor designs based on High Temperature Gas-cooled Reactor (HTGR) technology, and an explanation of how this safety philosophy is achieved in the NGNP.« less

Impact of New Nuclear Data Libraries on Small Sized Long Life CANDLE HTGR Design Parameters

NASA Astrophysics Data System (ADS)

Liem, Peng Hong; Hartanto, Donny; Tran, Hoai Nam

2017-01-01

The impact of new evaluated nuclear data libraries (JENDL-4.0, ENDF/B-VII.0 and JEFF-3.1) on the core characteristics of small-sized long-life CANDLE High Temperature Gas-Cooled Reactors (HTGRs) with uranium and thorium fuel cycles was investigated. The most important parameters of the CANDLE core characteristics investigated here covered (1) infinite multiplication factor of the fresh fuel containing burnable poison, (2) the effective multiplication factor of the equilibrium core, (3) the moving velocity of the burning region, (4) the attained discharge burnup, and (5) the maximum power density. The reference case was taken from the current JENDL-3.3 results. For the uranium fuel cycle, the impact of the new libraries was small, while significant impact was found for thorium fuel cycle. The findings indicated the needs of more accurate nuclear data libraries for nuclides involved in thorium fuel cycle in the future.

UO{sub 2} and PuO{sub 2} utilization in high temperature engineering test reactor with helium coolant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waris, Abdul, E-mail: awaris@fi.itb.ac.id; Novitrian,; Pramuditya, Syeilendra

High temperature engineering test reactor (HTTR) is one of high temperature gas cooled reactor (HTGR) types which has been developed by Japanese Atomic Energy Research Institute (JAERI). The HTTR is a graphite moderator, helium gas coolant, 30 MW thermal output and 950 °C outlet coolant temperature for high temperature test operation. Original HTTR uses UO{sub 2} fuel. In this study, we have evaluated the use of UO{sub 2} and PuO{sub 2} in form of mixed oxide (MOX) fuel in HTTR. The reactor cell calculation was performed by using SRAC 2002 code, with nuclear data library was derived from JENDL3.2. Themore » result shows that HTTR can obtain its criticality condition if the enrichment of {sup 235}U in loaded fuel is 18.0% or above.« less

Hydrogen production from coal using a nuclear heat source

NASA Technical Reports Server (NTRS)

Quade, R. N.

1976-01-01

A strong candidate for hydrogen production in the intermediate time frame of 1985 to 1995 is a coal-based process using a high-temperature gas-cooled reactor (HTGR) as a heat source. Expected process efficiencies in the range of 60 to 70% are considerably higher than all other hydrogen production processes except steam reforming of a natural gas. The process involves the preparation of a coal liquid, hydrogasification of that liquid, and steam reforming of the resulting gaseous or light liquid product. A study showing process efficiency and cost of hydrogen vs nuclear reactor core outlet temperature has been completed, and shows diminishing returns at process temperatures above about 1500 F. A possible scenario combining the relatively abundant and low-cost Western coal deposits with the Gulf Coast hydrogen users is presented which provides high-energy density transportation utilizing coal liquids and uranium.

Metallic impurities-silicon carbide interaction in HTGR fuel particles

NASA Astrophysics Data System (ADS)

Minato, Kazuo; Ogawa, Toru; Kashimura, Satoru; Fukuda, Kousaku; Shimizu, Michio; Tayama, Yoshinobu; Takahashi, Ishio

1990-12-01

Corrosion of the coating layers of silicon carbide (SiC) by metallic impurities was observed in irradiated Triso-coated uranium dioxide particles for high temperature gas-cooled reactors with an optical microscope and an electron probe micro-analyzer. The SiC layers were attacked from the outside of the particles. The main element observed in the corroded areas was iron, but sometimes iron and nickel were found. These elements must have been contained as impurities in the graphite matrix in which the coated particles were dispersed. Since these elements are more stable thermodynamically in the presence of SiC than in the presence of graphite at irradiation temperatures, they were transferred to the SiC layer to form more stable silicides. During fuel manufacturing processes, intensive care should be taken to prevent the fuel from being contaminated with those elements which react with SiC.

Efficiency and cost advantages of an advanced-technology nuclear electrolytic hydrogen-energy production facility

NASA Technical Reports Server (NTRS)

Donakowski, T. D.; Escher, W. J. D.; Gregory, D. P.

1977-01-01

The concept of an advanced-technology (viz., 1985 technology) nuclear-electrolytic water electrolysis facility was assessed for hydrogen production cost and efficiency expectations. The facility integrates (1) a high-temperature gas-cooled nuclear reactor (HTGR) operating a binary work cycle, (2) direct-current (d-c) electricity generation via acyclic generators, and (3) high-current-density, high-pressure electrolyzers using a solid polymer electrolyte (SPE). All subsystems are close-coupled and optimally interfaced for hydrogen production alone (i.e., without separate production of electrical power). Pipeline-pressure hydrogen and oxygen are produced at 6900 kPa (1000 psi). We found that this advanced facility would produce hydrogen at costs that were approximately half those associated with contemporary-technology nuclear electrolysis: $5.36 versus $10.86/million Btu, respectively. The nuclear-heat-to-hydrogen-energy conversion efficiency for the advanced system was estimated as 43%, versus 25% for the contemporary system.

Assessment of Sensor Technologies for Advanced Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Korsah, Kofi; Kisner, R. A.; Britton Jr., C. L.

This paper provides an assessment of sensor technologies and a determination of measurement needs for advanced reactors (AdvRx). It is a summary of a study performed to provide the technical basis for identifying and prioritizing research targets within the instrumentation and control (I&C) Technology Area under the Department of Energy’s (DOE’s) Advanced Reactor Technology (ART) program. The study covered two broad reactor technology categories: High Temperature Reactors and Fast Reactors. The scope of “High temperature reactors” included Gen IV reactors whose coolant exit temperatures exceed ≈650 °C and are moderated (as opposed to fast reactors). To bound the scope formore » fast reactors, this report reviewed relevant operating experience from US-operated Sodium Fast Reactor (SFR) and relevant test experience from the Fast Flux Test Facility (FFTF). For high temperature reactors the study showed that in many cases instrumentation have performed reasonably well in research and demonstration reactors. However, even in cases where the technology is “mature” (such as thermocouples), HTGRs can benefit from improved technologies. Current HTGR instrumentation is generally based on decades-old technology and adapting newer technologies could provide significant advantages. For sodium fast reactors, the study found that several key research needs arise around (1) radiation-tolerant sensor design for in-vessel or in-core applications, where possible non-invasive sensing approaches for key parameters that minimize the need to deploy sensors in-vessel, (2) approaches to exfiltrating data from in-vessel sensors while minimizing penetrations, (3) calibration of sensors in-situ, and (4) optimizing sensor placements to maximize the information content while minimizing the number of sensors needed.« less

Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

PubMed Central

Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.

2011-01-01

Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048

Program closure and change among VA substance abuse treatment programs.

PubMed

Floyd, A S

1999-10-01

The population of Veterans Affairs (VA) substance abuse treatment programs in 1990 and 1994 was examined to determine which factors-program legitimacy or cost-accounted for program closure and change. Legitimacy is a concept in institutional theory that organizations tend to take on a form appropriate to the environment. The study had two competing hypotheses. The first was that if external pressures push programs to produce high-quality and efficient treatment, then those that are initially closer to the legitimate form should be less likely to close later, and among surviving programs they should be less likely to experience change. The second hypothesis was that cost is the primary factor in program closure and change. The study used data from administrative surveys of all VA programs (273 in 1990 and 389 in 1994). Program legitimacy variables measured whether programs offered the prevalent type of treatment, such as 12-step groups or behavioral treatment, and had the prevalent type of staff. Program costs did not explain closure or change. For inpatient programs, the risk of closure increased in facilities with more than one substance abuse treatment program. The risk of closure increased for outpatient programs offering the prevalent type of treatment, contrary to what was predicted by the legitimacy hypothesis. Inpatient programs that offered the prevalent treatment were less likely to change the type of treatment offered. Patterns of change differed over time for inpatient and outpatient programs. Legitimacy factors, rather than cost, seem to play a role in program closure and change, although the picture is clearer for inpatient programs than for outpatient programs.

Operation and postirradiation examination of ORR capsule OF-2: accelerated testing of HTGR fuel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tiegs, T.N.; Thoms, K.R.

1979-03-01

Irradiation capsule OF-2 was a test of High-Temperature Gas-Cooled Reactor fuel types under accelerated irradiation conditions in the Oak Ridge Research Reactor. The results showed good irradiation performance of Triso-coated weak-acid-resin fissile particles and Biso-coated fertile particles. These particles had been coated by a fritted gas distributor in the 0.13-m-diam furnace. Fast-neutron damage (E > 0.18 MeV) and matrix-particle interaction caused the outer pyrocarbon coating on the Triso-coated particles to fail. Such failure depended on the optical anisotropy, density, and open porosity of the outer pyrocarbon coating, as well as on the coke yield of the matrix. Irradiation of specimensmore » with values outside prescribed limits for these properties increased the failure rate of their outer pyrocarbon coating. Good irradiation performance was observed for weak-acid-resin particles with conversions in the range from 15 to 75% UC/sub 2/.« less

High temperature gas-cooled reactor (HTGR) graphite pebble fuel: Review of technologies for reprocessing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mcwilliams, A. J.

2015-09-08

This report reviews literature on reprocessing high temperature gas-cooled reactor graphite fuel components. A basic review of the various fuel components used in the pebble bed type reactors is provided along with a survey of synthesis methods for the fabrication of the fuel components. Several disposal options are considered for the graphite pebble fuel elements including the storage of intact pebbles, volume reduction by separating the graphite from fuel kernels, and complete processing of the pebbles for waste storage. Existing methods for graphite removal are presented and generally consist of mechanical separation techniques such as crushing and grinding chemical techniquesmore » through the use of acid digestion and oxidation. Potential methods for reprocessing the graphite pebbles include improvements to existing methods and novel technologies that have not previously been investigated for nuclear graphite waste applications. The best overall method will be dependent on the desired final waste form and needs to factor in the technical efficiency, political concerns, cost, and implementation.« less

Effectiveness of substance abuse treatment programming for women: a review.

PubMed

Ashley, Olivia Silber; Marsden, Mary Elen; Brady, Thomas M

2003-01-01

Recent research has shown that women and men differ in substance abuse etiology, disease progression, and access to treatment for substance abuse. Substance abuse treatment specifically designed for women has been proposed as one way to meet women's distinctive needs and reduce barriers to their receiving and remaining in treatment. However, relatively few substance abuse treatment programs offer specialized services for women, and effectiveness has not been fully evaluated. This article reviews the literature on the extent and effectiveness of substance abuse treatment programming for women and provides an overview of what is known about the components of successful treatment programs for women. Thirty-eight studies of the effect on treatment outcomes of substance abuse treatment programming for women were reviewed. Seven were randomized, controlled trials, and 31 were nonrandomized studies. In our review, six components of substance abuse treatment programming for women were examined: child care, prenatal care, women-only programs, supplemental services and workshops that address women-focused topics, mental health programming, and comprehensive programming. The studies found positive associations between these six components and treatment completion, length of stay, decreased use of substances, reduced mental health symptoms, improved birth outcomes, employment, self-reported health status, and HIV risk reduction. These findings suggest that to improve the future health and well-being of women and their children, there is a continued need for well-designed studies of substance abuse treatment programming for women.

Measurement of gender-sensitive treatment for women in mixed-gender substance abuse treatment programs.

PubMed

Tang, Zhiqun; Claus, Ronald E; Orwin, Robert G; Kissin, Wendy B; Arieira, Carlos

2012-06-01

Gender-sensitive (GS) substance abuse treatment services have emerged in response to the multidimensional profile of problems that women display upon admission to substance abuse treatment. The present study examines the extent to which treatment programs vary in GS programming for women in real-world mixed-gender treatment settings, where most women are treated. Data were collected through site visits using semi-structured interviews with program directors, clinical directors, and counselors in 13 mixed-gender treatment programs from Washington State. Rasch modeling techniques were used to analyze the data. Naturally occurring variation was revealed within and across the treatment programs, and demonstrated that reliable measures of three GS domains (Grella, 2008) can be constructed despite a small number of programs. This is the first study to quantify GS treatment for substance abusing women. The identified treatment services and practices and the way they clustered together to form scales have practical implications for researchers, service providers, clinicians, and policy makers. The scales can be used to study treatment outcomes and to evaluate the effectiveness, cost-effectiveness, and cost-benefit of GS programming for women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Treatment retention in a prison-based residential sex offender treatment program.

PubMed

Pelissier, Bernadette

2007-12-01

This study assessed the role of static factors, a dynamic factor (motivation to change sexually deviant behavior), and an administrative factor in predicting treatment retention within a prison-based sex offender treatment program. The analyses also included assessing differences in initial levels of motivation and differences in beginning-versus end-of-treatment motivation scores for various types of program discharges. The sample consisted of 251 individuals who were admitted to a residential prison-based sex offender treatment program where 46% completed the program. Paired comparison t-tests showed higher motivation scores at the end of treatment only among treatment completers. Multivariate analyses showed that treatment retention was associated with higher initial motivation scores, higher levels of education and admission to treatment within 3 months of initial commitment to prison. Implications for motivational enhancement programming as well as for changes in admission criteria are discussed.

Contrasting faith-based and traditional substance abuse treatment programs.

PubMed

Neff, James Alan; Shorkey, Clayton T; Windsor, Liliane Cambraia

2006-01-01

This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim's theory regarding religion with treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear "spiritual activities, beliefs, and rituals" dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated "structure and discipline" as more important and "work readiness" as less important. No differences were found for "group activities/cohesion" and "role modeling/mentoring," "safe, supportive environment," and "traditional treatment modalities." Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes.

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

Day treatment versus enhanced standard methadone services for opioid-dependent patients: a comparison of clinical efficacy and cost.

PubMed

Avants, S K; Margolin, A; Sindelar, J L; Rounsaville, B J; Schottenfeld, R; Stine, S; Cooney, N L; Rosenheck, R A; Li, S H; Kosten, T R

1999-01-01

This study examined the differential efficacy and relative costs of two intensities of adjunctive psychosocial services--a day treatment program and enhanced standard care--for the treatment of opioid-dependent patients maintained on methadone hydrochloride. A 12-week randomized clinical trial with 6-month follow-up was conducted in a community-based methadone maintenance program. Of the 308 patients who met inclusion criteria, 291 began treatment (day treatment program: N=145; enhanced standard care: N=146), and 237 completed treatment (82% of those assigned to the day treatment program and 81% of those receiving enhanced standard care). Two hundred twenty of the patients participated in the 6-month follow-up (75% of those in the day treatment program and 73% of those in enhanced standard care provided a follow-up urine sample for screening). Both interventions were 12 weeks in duration, manual-guided, and provided by master's-level clinicians. The day treatment was an intensive, 25-hour-per-week program. The enhanced standard care was standard methadone maintenance plus a weekly skills training group and referral to on- and off-site services. Outcome measures included twice weekly urine toxicology screens, severity of addiction-related problems, prevalence of HIV risk behaviors, and program costs. Although the cost of the day treatment program was significantly higher, there was no significant difference in the two groups' use of either opiates or cocaine. Over the course of treatment, drug use, drug-related problems, and HIV risk behaviors decreased significantly for patients assigned to both treatment intensities. Improvements were maintained at follow-up. Providing an intensive day treatment program to unemployed, inner-city methadone patients was not cost-effective relative to a program of enhanced methadone maintenance services, which produced comparable outcomes at less than half the cost.

42 CFR 54a.13 - Educational requirements for personnel in drug treatment programs.

Code of Federal Regulations, 2013 CFR

2013-10-01

....S.C. 290aa, et seq., FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES § 54a.13 Educational requirements for personnel in drug treatment programs. In determining whether personnel of a program... treatment programs. 54a.13 Section 54a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...

42 CFR 54a.13 - Educational requirements for personnel in drug treatment programs.

Code of Federal Regulations, 2012 CFR

2012-10-01

....S.C. 290aa, ET SEQ., FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES § 54a.13 Educational requirements for personnel in drug treatment programs. In determining whether personnel of a program... treatment programs. 54a.13 Section 54a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...

42 CFR 54a.13 - Educational requirements for personnel in drug treatment programs.

Code of Federal Regulations, 2011 CFR

2011-10-01

....S.C. 290aa, ET SEQ., FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES § 54a.13 Educational requirements for personnel in drug treatment programs. In determining whether personnel of a program... treatment programs. 54a.13 Section 54a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...

42 CFR 54a.13 - Educational requirements for personnel in drug treatment programs.

Code of Federal Regulations, 2014 CFR

2014-10-01

....S.C. 290aa, et seq., FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES § 54a.13 Educational requirements for personnel in drug treatment programs. In determining whether personnel of a program... treatment programs. 54a.13 Section 54a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...

42 CFR 54a.13 - Educational requirements for personnel in drug treatment programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

....S.C. 290aa, ET SEQ., FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES § 54a.13 Educational requirements for personnel in drug treatment programs. In determining whether personnel of a program... treatment programs. 54a.13 Section 54a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...

78 FR 70530 - Notice of Determination; New and Revised Treatments for the Imported Fire Ant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

...] Notice of Determination; New and Revised Treatments for the Imported Fire Ant Program AGENCY: Animal and... adding or revising certain treatment schedules for the Imported Fire Ant Program in the Plant Protection... imported fire ant program. Based on the treatment evaluation document, the environmental assessment, and...

Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform.

PubMed

Andrews, Christina; Abraham, Amanda; Grogan, Colleen M; Pollack, Harold A; Bersamira, Clifford; Humphreys, Keith; Friedmann, Peter

2015-05-01

The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment--the state governmental organizations charged with overseeing addiction treatment programs--are helping programs respond to new requirements under the ACA. We found that most Single State Agencies provide little assistance to addiction treatment programs. Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided assistance with enrollment outreach. In the absence of technical assistance, it is unlikely that addiction treatment programs will fully realize the ACA's promise to improve access to and quality of addiction treatment. Project HOPE—The People-to-People Health Foundation, Inc.

Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial.

PubMed

Bridgman, Kate; Onslow, Mark; O'Brian, Susan; Jones, Mark; Block, Susan

2016-10-01

Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early stuttering. The design was a parallel, open plan, noninferiority randomized controlled trial of the standard Lidcombe Program treatment and the experimental webcam Lidcombe Program treatment. Participants were 49 children aged 3 years 0 months to 5 years 11 months at the start of treatment. Primary outcomes were the percentage of syllables stuttered at 9 months postrandomization and the number of consultations to complete Stage 1 of the Lidcombe Program. There was insufficient evidence of a posttreatment difference of the percentage of syllables stuttered between the standard and webcam Lidcombe Program treatments. There was insufficient evidence of a difference between the groups for typical stuttering severity measured by parents or the reported clinical relationship with the treating speech-language pathologist. This trial confirmed the viability of the webcam Lidcombe Program intervention. It appears to be as efficacious and economically viable as the standard, clinic Lidcombe Program treatment.

Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

PubMed Central

Terry-McElrath, Yvonne M; Chriqui, Jamie F; McBride, Duane C

2011-01-01

Objective To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data. Study Design We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage. Data Extraction Methods State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available. Principal Findings Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income. Conclusions SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access. PMID:21105870

Participation in a novel treatment component during residential substance use treatment is associated with improved outcome: a pilot study.

PubMed

Decker, Kathleen P; Peglow, Stephanie L; Samples, Carl R

2014-05-16

A person-centered substance use treatment component, the Natural Recovery Program, was developed. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies. This was a pilot study of the program and was not randomized. A retrospective record review of 643 veterans in an inpatient mental health recovery and rehabilitation program was analyzed to determine if participants of Natural Recovery had a different rate of treatment completion than those who elected to participate in the core program alone. Univariate and multivariate analyses were conducted on: participation in the Natural Recovery Program; co-morbid psychiatric disorders; and legal, medical, and psychiatric issues. Participation in Natural Recovery was significantly associated with successful treatment completion when analyzed by univariate analysis (p = 0.01). Other significant variables associated with successful completion included: no co-morbid psychiatric diagnosis, fewer prior suicide attempts, and no homelessness prior to admission. Binary logistic regression demonstrated that participation in Natural Recovery was associated with improved treatment completion, even when other variables were considered (p = 0.01). Treatment retention was longer for patients who participated in Natural Recovery, even if they did not complete treatment. The Natural Recovery Program was associated with improved outcomes, as measured by treatment retention in the first 60 days and by treatment completion. Participants of Natural Recovery with co-morbid psychiatric disorders completed treatment at a higher rate than those with co-morbid psychiatric disorders who participated in the core program. Patients reported high satisfaction with the program. This program may be a valuable adjunct to residential treatment.

Participation in a novel treatment component during residential substance use treatment is associated with improved outcome: a pilot study

PubMed Central

2014-01-01

Background A person-centered substance use treatment component, the Natural Recovery Program, was developed. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies. Methods This was a pilot study of the program and was not randomized. A retrospective record review of 643 veterans in an inpatient mental health recovery and rehabilitation program was analyzed to determine if participants of Natural Recovery had a different rate of treatment completion than those who elected to participate in the core program alone. Univariate and multivariate analyses were conducted on: participation in the Natural Recovery Program; co-morbid psychiatric disorders; and legal, medical, and psychiatric issues. Results Participation in Natural Recovery was significantly associated with successful treatment completion when analyzed by univariate analysis (p = 0.01). Other significant variables associated with successful completion included: no co-morbid psychiatric diagnosis, fewer prior suicide attempts, and no homelessness prior to admission. Binary logistic regression demonstrated that participation in Natural Recovery was associated with improved treatment completion, even when other variables were considered (p = 0.01). Treatment retention was longer for patients who participated in Natural Recovery, even if they did not complete treatment. Conclusions The Natural Recovery Program was associated with improved outcomes, as measured by treatment retention in the first 60 days and by treatment completion. Participants of Natural Recovery with co-morbid psychiatric disorders completed treatment at a higher rate than those with co-morbid psychiatric disorders who participated in the core program. Patients reported high satisfaction with the program. This program may be a valuable adjunct to residential treatment. PMID:24886745

The Use of Adventure Programming in Traditional Substance Abuse Treatment Programs: An Exploratory Investigation.

ERIC Educational Resources Information Center

Moraes, Ricardo

As a valuable addition to substance abuse treatment, adventure programming can have positive impacts on clients' self-efficacy, social behavior, and problem solving. A study explored the extent to which traditional substance abuse treatment programs use adventure programming, the level of adventure training and experience among substance abuse…

Determinants of hospital-based substance abuse treatment programs.

PubMed

Bell, R

1994-01-01

Experts agree that treatment is the best solution to substance abuse problems. As the societywide problem of drug and alcohol dependence increases, so does the need for treatment programs. Research has shown that many hospitals have entered into the substance abuse treatment program business because a need for quality programs exists and because an alcohol and a substance abuse treatment product line has the potential for increasing sagging revenues. This article addresses the question of what types of hospitals are likely to engage in providing inpatient and/or outpatient treatment programs. The results indicate that organizational size (measured by the number of beds) is the best predictor of treatment service provision for both inpatient and outpatient settings, with larger hospitals being more likely to provide substance abuse programs. A need for additional chemical dependency treatment programs does not appear to be the primary motivating factor for hospitals developing this service. Rather, it seems hospitals provide these programs for other reasons--as part of providing a full array of services, as an average toward achieving organizational goals, as a means of sustaining a competitive advantage, or as a strategy for maintaining the same level of service as the competition.

42 CFR 8.11 - Opioid treatment program certification.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Opioid treatment program certification. 8.11... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.11 Opioid... Substances Act (21 U.S.C. 823(g)(1)) to dispense opioid drugs in the treatment of opioid addiction. An OTP...

42 CFR 8.11 - Opioid treatment program certification.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Opioid treatment program certification. 8.11... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.11 Opioid... Substances Act (21 U.S.C. 823(g)(1)) to dispense opioid drugs in the treatment of opioid addiction. An OTP...

42 CFR 8.11 - Opioid treatment program certification.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Opioid treatment program certification. 8.11... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.11 Opioid... Substances Act (21 U.S.C. 823(g)(1)) to dispense opioid drugs in the treatment of opioid addiction. An OTP...

42 CFR 8.11 - Opioid treatment program certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Opioid treatment program certification. 8.11... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.11 Opioid... Substances Act (21 U.S.C. 823(g)(1)) to dispense opioid drugs in the treatment of opioid addiction. An OTP...

42 CFR 8.11 - Opioid treatment program certification.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Opioid treatment program certification. 8.11... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.11 Opioid... Substances Act (21 U.S.C. 823(g)(1)) to dispense opioid drugs in the treatment of opioid addiction. An OTP...

Substance abuse intensive outpatient treatment: does program graduation matter?

PubMed

Wallace, Amy E; Weeks, William B

2004-07-01

Program graduation, even after controlling for length of stay, may predict for improved outcomes in some substance abuse treatment settings. We investigated the role of program graduation by comparing social outcomes and inpatient utilization the years before and after treatment among graduates and dropouts of a Veterans Administration substance abuse intensive outpatient program. At enrollment, graduates and dropouts were similar in all spheres measured. Patients who completed the treatment program used significantly fewer psychiatric inpatient bed days of care the year after they completed the program, both in comparison to their own prior use and in comparison to program dropouts. Graduates were more likely to be abstinent and less likely to fully relapse or be incarcerated at 6-month followup. Further research is needed to discern optimal treatment length-that which maximizes both length of stay and completion rates, while optimizing use of limited treatment resources.

AIDS Treatment In Brazil: Impacts And Challenges

PubMed Central

Nunn, Amy Stewart; Fonseca, Elize Massard da; Bastos, Francisco I.; Gruskin, Sofia

2009-01-01

Brazil has one of the developing world's largest, and arguably most successful, AIDS treatment programs. In this paper we review the treatment program, including controversial policies that Brazil has used to promote widespread local and global access to AIDS treatment. We also examine the lessons learned from this program and highlight the challenges Brazil faces, including the rising costs of AIDS treatment and changes in donors' funding priorities. Finally, we explore the relevance of Brazil's treatment program for other countries and its broad implications for global AIDS and health policy. PMID:19597210

Interest in marijuana treatment programs among teenage smokers and nonsmokers.

PubMed

Sheer, Amy J; Gorelick, David A; Collins, Charles C; Schroeder, Jennifer R; Heishman, Stephen J; Leff, Michelle K; Moolchan, Eric T

2009-12-01

Little is known about adolescents' interest in marijuana treatment programs. This question was evaluated by telephone interview in a convenience sample of 575 adolescents responding to advertisements for tobacco research studies. Eighty-one percent of respondents endorsed the need for marijuana treatment programs for adolescents. These adolescents were younger and less likely to smoke tobacco, smoke marijuana, or use alcohol than those not endorsing such a need. Among the 192 marijuana smokers, the 58.8% who endorsed the need for marijuana treatment programs took their first puff of marijuana at a younger age than those who did not endorse the need. Those who were willing to participate in a marijuana treatment program were more likely African American and took their first marijuana puff at a younger age than those not interested in treatment. These findings suggest that most adolescent marijuana smokers endorse the need for and are willing to attend marijuana treatment programs.

Continuing Day Treatment Programs Promote Recovery in Schizophrenia

PubMed Central

2009-01-01

Continuing day treatment programs focus on community stabilization through comprehensive individualized rehabilitation. They promote recovery through a variety of practical clinical therapeutic interventions. This empirically based report describes a continuing day treatment program’s rehabilitation of four clients with schizophrenia, chronic type in a western New York mental health clinic who were in each of the specialty services: a two-phase program, a program for seniors, and a program for co-occurring substance dependence. Some particularly difficult psychiatric symptoms of schizophrenia were successfully treated in this continuing day treatment program. Each of these clients showed improvements in their symptoms and overall community adjustment that may well have been unobtainable with less intensive outpatient treatment. PMID:19724730

Web-based treatment program using intensive therapeutic contact for patients with eating disorders: before-after study.

PubMed

ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; Drossaert, Constance H C; DeJong, Cor A J

2013-02-04

Although eating disorders are common in the Netherlands, only a few patients are treated by mental health care professionals. To reach and treat more patients with eating disorders, Tactus Addiction Treatment developed a web-based treatment program with asynchronous and intensive personalized communication between the patient and the therapist. This pilot study evaluated the web-based treatment program using intensive therapeutic contact in a population of 165 patients with an eating disorder. In a pre-post design with 6-week and 6-month follow-ups, eating disorder psychopathology, body dissatisfaction, Body Mass Index, physical and mental health, and quality of life were measured. The participant's satisfaction with the web-based treatment program was also studied. Attrition data were collected, and participants were classified as noncompleters if they did not complete all 10 assignments of the web-based treatment program. Differences in baseline characteristics between completers and noncompleters were studied, as well as reasons for noncompletion. Furthermore, differences in treatment effectiveness, treatment adherence, and baseline characteristics between participants of the three major eating disorder diagnostic groups EDNOS (n=115), BN purging (n=24), and BN nonpurging (n=24) were measured. Of the 165 participants who started the web-based treatment program, 89 participants (54%) completed all of the program assignments (completers) and 76 participants (46%) ended the program prematurely (noncompleters). Severe body dissatisfaction and physical and mental health problems seemed to have a negative impact on the completion of the web-based treatment program. Among the participants who completed the treatment program, significant improvements were found in eating disorder psychopathology (F=54.6, df = 68, P<.001, d=1.14). Body dissatisfaction, quality of life, and physical and mental health also significantly improved, and almost all of these positive effects were sustained up to 6 months after the participants had completed the web-based treatment program. Body Mass Index improved only within the group of participants suffering from obesity. The improvement in eating disorder psychopathology occurred in all three eating disorder diagnostic groups, and the percentage of completers did not differ significantly between these groups. Participants' satisfaction with the treatment program, as well as with their therapist, was high, and participants indicated that they would recommend the program to other patients with eating disorders. The results of this study suggest that the web-based treatment program has the potential to improve eating disorder psychopathology in patients with different types of eating disorders.

Characteristics and Outcomes of Female Infertility Treatment Programs Using Traditional Medicine in Korea: A Multisite Analysis.

PubMed

Kim, Kyeong Han; Jang, Soobin; Lee, Ju Ah; Go, Ho-Yeon; Jung, Jeeyoun; Park, Sunju; Lee, Myeong Soo; Ko, Seong-Gyu

2018-03-22

Infertility has long been recognized as a treatable disease, and complementary and alternative medicine treatments, such as acupuncture and moxibustion, have been used in Korea and China. This study describes female infertility treatment programs that used traditional Korean medicine (TKM) and were conducted by local governments in Korea and evaluates its effectiveness and safety. The authors officially requested related information from the report of the infertility treatment programs and related sources from 2006 to 2016 from the Health & Welfare Ministry of Korea and the Association of Korean Medicine (AKOM). Additional information was obtained from six Korean databases. Data including basic information about the programs, participant information, interventions, and outcomes were abstracted. A total of 9 reports, including multiple years of data from 6 programs (total 13 programs), were identified. In these 13 programs, a total of 1023 female subjects participated, and 205 of the 887 subjects who completed the program reported a successful pregnancy, indicating a 23.1% pregnancy rate. The programs lasted 3-9 months, and interventional elements, such as herbal medicine, acupuncture, fumigation, and massage, were identified. Significant adverse effects were not reported. This study suggests that infertility treatment programs with TKM interventions exhibited a positive effect on pregnancy in females with infertility. Thus, the infertility treatment programs with TKM interventions are expected to be useful and might serve as the primary treatment before assisted reproduction techniques.

HIV/AIDS Services in Private Substance Abuse Treatment Programs

PubMed Central

Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

2010-01-01

Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

Systematic Outcomes Research for Corrections-Based Treatment: Implications from the Criminal Justice Kentucky Treatment Outcome Study

ERIC Educational Resources Information Center

Staton-Tindall, Michele; McNees, Erin; Leukefeld, Carl G.; Walker, Robert; Thompson, LaDonna; Pangburn, Kevin; Oser, Carrie B.

2009-01-01

Over the last four years, the Kentucky correctional system has expanded corrections-based modified therapeutic community treatment from 6 programs to 24 programs. To examine the effectiveness of these programs, the state initiated a systematic treatment outcome study known as the Criminal Justice Kentucky Treatment Outcome Study (CJKTOS). The…

COL Application Content Guide for HTGRs: Revision to RG 1.206, Part 1 - Status Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wayne Moe

2012-08-01

A combined license (COL) application is required by the Nuclear Regulatory Commission (NRC) for all proposed nuclear plants. The information requirements for a COL application are set forth in 10 CFR 52.79, “Contents of Applications; Technical Information in Final Safety Analysis Report.” An applicant for a modular high temperature gas-cooled reactor (HTGR) must develop and submit for NRC review and approval a COL application which conforms to these requirements. The technical information necessary to allow NRC staff to evaluate a COL application and resolve all safety issues related to a proposed nuclear plant is detailed and comprehensive. To this, Regulatorymore » Guide (RG) 1.206, “Combined License Applications for Nuclear Power Plants” (LWR Edition), was developed to assist light water reactor (LWR) applicants in incorporating and effectively formatting required information for COL application review (Ref. 1). However, the guidance prescribed in RG 1.206 presumes a LWR design proposal consistent with the systems and functions associated with large LWR power plants currently operating under NRC license.« less

Effect of carbon ion irradiation on Ag diffusion in SiC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leng, Bin; Ko, Hyunseok; Gerczak, Tyler J.

Transport of Ag fission product through the silicon-carbide (SiC) diffusion barrier layer in TRISO fuel particles is of considerable interest given the application of this fuel type in high temperature gas-cooled reactor (HTGR) and other future reactor concepts. The reactor experiments indicate that radiation may play an important role in release of Ag; however so far the isolated effect of radiation on Ag diffusion has not been investigated in controlled laboratory experiments. In this study, we investigate the diffusion couples of Ag and polycrystalline 3C–SiC, as well as Ag and single crystalline 4H–SiC samples before and after irradiation with Cmore » 2+ ions. The diffusion couple samples were exposed to temperatures of 1500 °C, 1535 °C, and 1569 °C, and the ensuing diffusion profiles were analyzed by secondary ion mass spectrometry (SIMS). We found that diffusion coefficients calculated from these measurements indicate that Ag diffusion was greatly enhanced by carbon irradiation due to a combined effect of radiation damage on diffusion and the presence of grain boundaries in polycrystalline SiC samples.« less

Effect of carbon ion irradiation on Ag diffusion in SiC

DOE PAGES

Leng, Bin; Ko, Hyunseok; Gerczak, Tyler J.; ...

2015-11-14

Transport of Ag fission product through the silicon-carbide (SiC) diffusion barrier layer in TRISO fuel particles is of considerable interest given the application of this fuel type in high temperature gas-cooled reactor (HTGR) and other future reactor concepts. The reactor experiments indicate that radiation may play an important role in release of Ag; however so far the isolated effect of radiation on Ag diffusion has not been investigated in controlled laboratory experiments. In this study, we investigate the diffusion couples of Ag and polycrystalline 3C–SiC, as well as Ag and single crystalline 4H–SiC samples before and after irradiation with Cmore » 2+ ions. The diffusion couple samples were exposed to temperatures of 1500 °C, 1535 °C, and 1569 °C, and the ensuing diffusion profiles were analyzed by secondary ion mass spectrometry (SIMS). We found that diffusion coefficients calculated from these measurements indicate that Ag diffusion was greatly enhanced by carbon irradiation due to a combined effect of radiation damage on diffusion and the presence of grain boundaries in polycrystalline SiC samples.« less

[The total-quality-management-analysis of the continuation and discontinuation of alcohol family treatment: a grassroots approach].

PubMed

Nishikawa, K; Tatsuki, S

2001-06-01

A family support/treatment program was provided to thirty-three cases where a drinking family member (identified patient) had shown alcohol related problems but not yet admitted the problem. After a period of between thirteen and twenty-one months of family treatment, fourteen (42.4%) identified patients started their own treatment. The only statistically significant factor that was related to the patients' treatment program participation was the continuation of family members' involvement in a family treatment program. Among the thirty-three cases, a little less than one half (48.5%) continued the family program. In order to increase the patients' participation, it is crucial to encourage family members to continue their family support/treatment program. In order to identify factors that contribute treatment continuation as well as dropouts, workshops were held with those who dropped out and those who continued the family treatment program. The Total-Quality-Management (TQM) affinity and arrow diagram techniques were employed to classify the participants' statements and to find cause-effect relationships among the identified factors, respectively. Five family treatment discontinuation factors were identified: 1) a lack of information about family support program, 2) resistance against a "family change" orientation in family treatment program, 3) family member burnout, 4) a misfit between family needs for immediate problem solutions and what family program offers, and 5) a temporal improvement of patients' drinking problems. While widely varied factors were found to contribute discontinuation, only a very few factors were identified to facilitate the treatment continuation. It was concluded that treatment discontinuation, rather than continuation, was the norm among the families of problem drinkers. Based on the above findings, three kaizen plans were proposed. First, in order to make sure that family members obtain necessary information about the family support/treatment program, a pamphlet would be created and handed out to those who come to family treatment. Second, family support efforts would be emphasized more. Treatment staff is expected to become more cautious with regard to the family behavior change facilitation, especially at the early stage. Third, treatment staff is expected to become more aggressive about contacting family group members when they do not show up to a meeting.

Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network.

PubMed

Knudsen, Hannah K; Abraham, Amanda J; Roman, Paul M; Studts, Jamie L

2011-04-01

Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. During face-to-face interviews conducted in 2005-2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two thirds of these programs had at least one nurse on staff. In programs with nurses, the average rate of voluntary turnover was 15.0%. Turnover was significantly lower in hospital-based programs and programs offering adolescent treatment but higher in facilities offering residential treatment. Most of the administrators indicated that filling vacant nurse positions was difficult and took more than 2 months to complete. These findings suggest that nurse turnover is a significant issue facing many substance abuse treatment facilities. Efforts to improve retention of the addiction treatment workforce should be expanded to include nursing professionals. Copyright © 2011 Elsevier Inc. All rights reserved.

The Efficacy of Coerced Treatment for Offenders: An Evaluation of Two Residential Forensic Drug and Alcohol Treatment Programs.

ERIC Educational Resources Information Center

Baird, Francis X.; Frankel, Arthur J.

2001-01-01

Reviews the history of community-based treatment for offenders with drug and alcohol addiction. Describes the treatment regimen in two residential programs for offenders with drug and alcohol problems, including a description of the components of the residential treatment model utilized in these two programs. Findings support the efficacy of…

Retention of court-referred youths in residential treatment programs: client characteristics and treatment process effects.

PubMed

Orlando, Maria; Chan, Kitty S; Morral, Andrew R

2003-05-01

The juvenile justice system relies heavily on residential treatment services for adolescents. Because treatment dropout limits the likely effectiveness of these services, in this study we examine the client and program characteristics associated with program retention among a sample of adolescent probationers referred to residential rehabilitation by the Juvenile Court in Los Angeles. Participants in the present study (n = 291) are a subset of those in the Adolescent Outcomes Project, conducted within RAND's Drug Policy Research Center, to examine the outcomes of youths entering treatment at seven residential treatment programs. Three months after a preadmission interview, youths were asked about their perceptions of counselors at the program, other residents, and their feelings of safety in the program. In addition, they were asked whether they needed and had received various services (e.g., job training, legal advice, family counseling). Results of a multivariate survival analysis revealed that pretreatment characteristics including motivation and substance use severity, as well as treatment program factors including safety, and perceived over- and underprovision of services, contribute significantly to the prediction of retention. Pretreatment environmental risk factors and ratings of program counselor and resident support were marginally significant. These results imply that changes in adolescent residential program delivery may serve to increase retention rates, thus improving long-term outcomes.

Program Capacity to Eliminate Outcome Disparities in Addiction Health Services

PubMed Central

Guerrero, Erick G.; Aarons, Gregory; Grella, Christine; Garner, Bryan R.; Cook, Benjamin; Vega, William A.

2014-01-01

We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010–2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed. PMID:25450596

Program Capacity to Eliminate Outcome Disparities in Addiction Health Services.

PubMed

Guerrero, Erick G; Aarons, Gregory A; Grella, Christine E; Garner, Bryan R; Cook, Benjamin; Vega, William A

2016-01-01

We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed.

Profile of addicted patients who reenter treatment programs.

PubMed

López-Goñi, José J; Fernández-Montalvo, Javier; Cacho, Raúl; Arteaga, Alfonso

2014-01-01

Clinical experience shows that some patients who suffer from drug addiction are readmitted to treatment programs multiple times because of relapses that occur after they leave these programs. Patients who reenter treatment programs repeatedly may do so because they have problems or difficulties that were not addressed or that were not satisfactorily solved during previous treatment periods. This study explored the differential profile of addicted patients who reenter treatment programs. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Data regarding sociodemographic factors, drug consumption factors (assessed using the EuropASI), psychopathological factors (assessed using the Symptom Checklist-90-Revised [SCL-90-R]), and personality variables (assessed using the Millon Clinical Multiaxial Inventory II [MCMI-II]) were collected. A 65.9% (n = 166) of drug-addicted patients were readmitted into treatment programs. All of the variables for which data were collected were compared between these treatment repeaters and patients who were admitted for the first time. Significant differences between the 2 groups of patients were found for some of the variables that we examined. Treatment repeaters were generally older and had a poorer employment situation than first-time admits. Treatment repeaters were also more likely to report polyconsumption and to have sought treatment for alcohol abuse. Moreover, some of the scores for several EuropASI, SCL-90-R, and MCMI-II variables were statistically significantly different from those of the first-time admits. According to these results, patients who reenter treatment programs often present with more severe addiction problems. All of these data suggest that treatment programs should incorporate a detailed analysis regarding the existence and nature of prior treatments into the baseline protocols and they should offer follow-up services to patients who have completed their treatments. The implications of these results for further research and clinical practice are discussed.

Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

PubMed Central

McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

2008-01-01

Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

Selecting forest residue treatment alternatives using goal programming.

Treesearch

Bruce B. Bare; Brian F. Anholt

1976-01-01

The use of goal programing for selecting forest residue treatment alternatives within a multiple goal framework is described. The basic features of goal programing are reviewed and illustrated with a hypothetical problem involving the selection of residue treatments for 10 cutting units. Twelve residue-regeneration treatment combinations are evaluated by using physical...

Implementation of Motivational Interviewing in Substance Use Disorder Treatment: Research Network Participation and Organizational Compatibility.

PubMed

Rieckmann, Traci R; Abraham, Amanda J; Bride, Brian E

Despite considerable empirical evidence that psychosocial interventions improve addiction treatment outcomes across populations, implementation remains problematic. A small body of research points to the importance of research network participation as a facilitator of implementation; however, studies examined limited numbers of evidence-based practices. To address this gap, the present study examined factors impacting implementation of motivational interviewing (MI). This study used data from a national sample of privately funded treatment programs (n = 345) and programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) (n = 156). Data were collected via face-to-face interviews with program administrators and clinical directors (2007-2009). Analysis included bivariate t tests and chi-square tests to compare private and CTN programs, and multivariable logistic regression of MI implementation. A majority (68.0%) of treatment programs reported use of MI. Treatment programs participating in the CTN (88.9%) were significantly more likely to report use of MI compared with non-CTN programs (58.5%; P < 0.01). CTN programs (82.1%) also were more likely to use trainers from the Motivational Interviewing Network of Trainers as compared with private programs (56.1%; P < 0.05). Multivariable logistic regression models reveal that CTN-affiliated programs and programs with a psychiatrist on staff were more likely to use MI. Programs that used the Stages of Change Readiness and Treatment Eagerness Scale assessment tool were more likely to use MI, whereas programs placing greater emphasis on confrontational group therapy were less likely to use MI. Findings suggest the critical role of research network participation, access to psychiatrists, and organizational compatibility in adoption and sustained use of MI.

Barriers and facilitators to tobacco cessation in a nationwide sample of addiction treatment programs

PubMed Central

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-01-01

Introduction Smoking rates among addiction treatment clients are 3–4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. Methods The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semistructured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. Findings While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Conclusion Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. PMID:27296658

Results from a Multi-Modal Program Evaluation of a Four Year Statewide Juvenile Sex Offender Treatment and Reentry Program

ERIC Educational Resources Information Center

Underwood, Lee A.; Dailey, Frances L. L.; Merino, Carrie; Crump, Yolanda

2015-01-01

The results of the Program Evaluation show the OJJ Statewide Sex Offender Treatment program is exceptionally productive in meeting over 90% of its established performance markers. These markers included successful screening and assessment of risk and psychosocial needs, completion of initial and master treatment plans, establishment of sex…

The use of art and music therapy in substance abuse treatment programs.

PubMed

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

2014-01-01

Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

Employing continuous quality improvement in community-based substance abuse programs.

PubMed

Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

2012-01-01

This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

Obesity coverage gap: Consumers perceive low coverage for obesity treatments even when workplace wellness programs target BMI.

PubMed

Wilson, Elizabeth Ruth; Kyle, Theodore K; Nadglowski, Joseph F; Stanford, Fatima Cody

2017-02-01

Evidence-based obesity treatments, such as bariatric surgery, are not considered essential health benefits under the Affordable Care Act. Employer-sponsored wellness programs with incentives based on biometric outcomes are allowed and often used despite mixed evidence regarding their effectiveness. This study examines consumers' perceptions of their coverage for obesity treatments and exposure to workplace wellness programs. A total of 7,378 participants completed an online survey during 2015-2016. Respondents answered questions regarding their health coverage for seven medical services and exposure to employer wellness programs that target weight or body mass index (BMI). Using χ 2 tests, associations between perceptions of exposure to employer wellness programs and coverage for medical services were examined. Differences between survey years were also assessed. Most respondents reported they did not have health coverage for obesity treatments, but more of the respondents with employer wellness programs reported having coverage. Neither the perception of coverage for obesity treatments nor exposure to wellness programs increased between 2015 and 2016. Even when consumers have exposure to employer wellness programs that target BMI, their health insurance often excludes obesity treatments. Given the clinical and cost-effectiveness of such treatments, reducing that coverage gap may mitigate obesity's individual- and population-level effects. © 2017 The Obesity Society.

Native Nutrition--Northwest Indian Treatment Center Honors Culture to Heal the Mind

ERIC Educational Resources Information Center

Krohn, Elise

2011-01-01

The Northwest Indian Treatment Center runs a 45-day inpatient treatment program in Elma, Washington. The Squaxin Island Tribe created the program to address an unmet need for culturally based drug and alcohol treatment centers for Indian people who grew up on reservations. The program specializes in treating people with chronic relapse patterns…

A Controlled Evaluation of Behavioral Treatment with Children with ADHD Attending a Summer Treatment Program

ERIC Educational Resources Information Center

Coles, Erika K.; Pelham, William E.; Gnagy, Elizabeth M.; Burrows-MacLean, Lisa; Fabiano, Gregory A; Chacko, Anil; Wymbs, Brian T.; Tresco, Katy E.; Walker, Kathryn S.; Robb, Jessica A.

2005-01-01

Individual treatment response to behavior modification was examined in the context of a summer treatment program. Four children ages 11 to 12 and diagnosed with attention-deficit/hyperactivity disorder were examined in a BABAB design in which a comprehensive behavioral program was utilized and withdrawn across an 8-week period. Dependent measures…

The employment of nurses in publicly funded substance abuse treatment programs.

PubMed

Knudsen, Hannah K; Abraham, Amanda J

2012-10-01

Little is known about the organizational and environmental factors associated with the employment of nurses in substance abuse treatment programs. Using data collected from the administrators of 250 publicly funded substance abuse treatment programs, this study examined the organizational and environmental correlates of nurse employment in these settings. Negative binomial regression models indicated that the number of nurses employed by treatment programs was positively associated with government ownership, location within a healthcare setting, and the availability of detoxification services. Outpatient-only programs employed fewer nurses than programs with inpatient/residential services. Two environmental factors were associated with nurse employment. Programs that more strongly endorsed a scale of financial barriers employed significantly fewer nurses, whereas programs indicating that funding from state contracts could be used to pay for healthcare providers employed significantly more nurses. These findings suggest that organizational decisions about employing nurses may reflect both the characteristics of the program and the funding environment. Future research should continue to examine the employment of nurses in substance abuse treatment settings, particularly given the shifting environment due to the implementation of healthcare reform.

Sequential Multiple Assignment Randomized Trial (SMART) with Adaptive Randomization for Quality Improvement in Depression Treatment Program

PubMed Central

Chakraborty, Bibhas; Davidson, Karina W.

2015-01-01

Summary Implementation study is an important tool for deploying state-of-the-art treatments from clinical efficacy studies into a treatment program, with the dual goals of learning about effectiveness of the treatments and improving the quality of care for patients enrolled into the program. In this article, we deal with the design of a treatment program of dynamic treatment regimens (DTRs) for patients with depression post acute coronary syndrome. We introduce a novel adaptive randomization scheme for a sequential multiple assignment randomized trial of DTRs. Our approach adapts the randomization probabilities to favor treatment sequences having comparatively superior Q-functions used in Q-learning. The proposed approach addresses three main concerns of an implementation study: it allows incorporation of historical data or opinions, it includes randomization for learning purposes, and it aims to improve care via adaptation throughout the program. We demonstrate how to apply our method to design a depression treatment program using data from a previous study. By simulation, we illustrate that the inputs from historical data are important for the program performance measured by the expected outcomes of the enrollees, but also show that the adaptive randomization scheme is able to compensate poorly specified historical inputs by improving patient outcomes within a reasonable horizon. The simulation results also confirm that the proposed design allows efficient learning of the treatments by alleviating the curse of dimensionality. PMID:25354029

Treatment and postrelease rehabilitative programs for juvenile offenders.

PubMed

Underwood, Lee A; Knight, Pamela

2006-04-01

The juvenile justice system has become notably aware of the increasing use of postrelease rehabilitative treatment interventions for offenders. In many instances, juvenile justice systems are required to ensure that core treatment needs of youth are met. As a result of the heightened awareness of the need for postrelease rehabilitation treatment programs, many researchers and providers are calling for more systematic approaches to offender treatment. This article summarizes a body of literature on juvenile offenders who have specialized postrelease rehabilitative treatment needs. It reviews cognitive-behavioral theoretical models and core postrelease treatment strategies. It presents a review of youth who have specialized needs in light of postrelease practices, describes several model postrelease rehabilitation programs, and reviews outcomes of these programs.

Demographic Trends of Adults in New York City Opioid Treatment Programs--An Aging Population.

PubMed

Han, Benjamin; Polydorou, Soteri; Ferris, Rosie; Blaum, Caroline S; Ross, Stephen; McNeely, Jennifer

2015-01-01

The population of adults accessing opioid treatment is growing older, but exact estimates vary widely, and little is known about the characteristics of the aging treatment population. Further, there has been little research regarding the epidemiology, healt h status, and functional impairments in this population. To determine the utilization of opioid treatment services by older adults in New York City. This study used administrative data from New York State licensed drug treatment programs to examine overall age trends and characteristics of older adults in opioid treatment programs in New York City from 1996 to 2012. We found significant increases in utilization of opioid treatment programs by older adults in New York City. By 2012, those aged 50-59 made up the largest age group in opioid treatment programs. Among older adults there were notable shifts in demographic background including gender and ethnicity, and an increase in self-reported impairments. More research is needed to fully understand the specific characteristics and needs of older adults with opioid dependence.

Perceived benefits of the hepatitis C peer educators: a qualitative investigation.

PubMed

Batchelder, A W; Cockerham-Colas, L; Peyser, D; Reynoso, S P; Soloway, I; Litwin, A H

2017-09-29

Although opioid-dependent patients are disproportionately impacted by hepatitis C (HCV), many do not receive treatment. In addition to HCV treatment-access barriers, substance-using patients may be reluctant to pursue treatment because of wariness of the medical system, lack of knowledge, or stigma related to HCV treatment. Implementation of a formal peer education program is one model of reducing provider- and patient-level barriers to HCV treatment, by enhancing mutual trust and reducing stigma. We used thematic qualitative analysis to explore how 30 HCV patients and peer educators perceived a HCV peer program within an established methadone maintenance program in the USA. Participants unanimously described the program as beneficial. Participants described the peer educators' normalization and dispelling of myths and fears around HCV treatment, and their exemplification of HCV treatment success, and reductions in perceived stigma. Peer educators described personal benefits. These findings indicate that HCV peer educators can enhance HCV treatment initiation and engagement within opioid substitution programs.

Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study.

PubMed

Humphreys , K; Moos, R

2001-05-01

Twelve-step-oriented inpatient treatment programs emphasize 12-step treatment approaches and the importance of ongoing attendance at 12-step self-help groups more than do cognitive-behavioral (CB) inpatient treatment programs. This study evaluated whether this difference in therapeutic approach leads patients who are treated in 12-step programs to rely less on professionally provided services and more on self-help groups after discharge, thereby reducing long-term health care costs. A prospective, quasi-experimental comparison of 12-step-based (N = 5) and cognitive-behavioral (n = 5) inpatient treatment programs was conducted. These treatments were compared on the degree to which their patients participated in self-help groups, used outpatient and inpatient mental health services, and experienced positive outcomes (e.g., abstinence) in the year following discharge. Using a larger sample from an ongoing research project, 887 male substance-dependent patients from each type of treatment program were matched on pre-intake health care costs (N = 1774). At baseline and 1-year follow-up, patients' involvement in self-help groups (e.g., Alcoholics Anonymous), utilization and costs of mental health services, and clinical outcomes were assessed. Compared with patients treated in CB programs, patients treated in 12-step programs had significantly greater involvement in self-help groups at follow-up. In contrast, patients treated in CB programs averaged almost twice as many outpatient continuing care visits after discharge (22.5 visits) as patients treated in 12-step treatment programs (13.1 visits), and also received significantly more days of inpatient care (17.0 days in CB versus 10.5 in 12-step), resulting in 64% higher annual costs in CB programs ($4729/patient, p < 0.001). Psychiatric and substance abuse outcomes were comparable across treatments, except that 12-step patients had higher rates of abstinence at follow-up (45.7% versus 36.2% for patients from CB programs, p < 0.001). Professional treatment programs that emphasize self-help approaches increase their patients' reliance on cost-free self-help groups and thereby lower subsequent health care costs. Such programs therefore represent a cost-effective approach to promoting recovery from substance abuse.

Goal Attainment Scaling: A Primary Method of Treatment and Program Evaluation in Project SAIL - A Special Education Dropout Prevention Program.

ERIC Educational Resources Information Center

Harris, Linda Hall; Thompson, John L.

The manual discusses Project SAIL's (a special dropout prevention program) use of Goal Attainment Scaling as part of individualized education plans in the treatment of troubled adolescents and in overall program evaluation. The scaling is characterized as an explicit, respectful treatment contact through which the adolescent can learn to set…

42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

Code of Federal Regulations, 2010 CFR

2017-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

Code of Federal Regulations, 2010 CFR

2016-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2016-10-01 2016-10-01 false Treatment of incentive programs or add-on payments...

An investigation of language and phonological development and the responsiveness of preschool age children to the Lidcombe Program.

PubMed

Rousseau, Isabelle; Packman, Ann; Onslow, Mark; Harrison, Elisabeth; Jones, Mark

2007-01-01

Knowledge of variables that predict treatment time is of benefit in deciding when to start treatment for early stuttering. To date, the only variable clearly related to treatment time with the Lidcombe Program is pre-treatment stuttering frequency. Previous studies have shown that children whose stuttering is more severe take longer to complete Stage 1 of the program. However, studies to date have not investigated phonology and language as predictors of treatment time. In the context of a Phase II clinical trial, the present prospective study showed that phonological development does not predict treatment time but that, together, stuttering severity, MLU and CELF Receptive Score predict 35-45% of the variance for time taken to complete Stage 1. The reader should be able to (1) understand guidelines developed for the timing of intervention with the Lidcombe Program based on previous retrospective studies, (2) determine whether pre-treatment language and phonological development play a role in treatment-led recovery with the Lidcombe Program and (3) understand recent empirical evidence on time taken by preschool children to complete Stage 1 of the Lidcombe Program.

78 FR 44575 - Sickle Cell Disease Treatment Demonstration Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Sickle Cell... Extension: Sickle Cell Disease Treatment Demonstration Program (U1E) Awards to Three Currently Funded... the Sickle Cell Disease Treatment Demonstration Program. Three of these awards will end on August 31...

The Untreated Addiction: Going Tobacco-Free in a VA Substance Abuse Residential Rehabilitation Treatment Program (SARRTP).

PubMed

Conrad, Megan; Bolte, Teri; Gaines, Leigh; Avery, Zackery; Bodie, Linda

2018-05-02

Despite negative effects of tobacco on the human body and the high prevalence of smoking among those who enter treatment for substance use, few residential programs endorse a tobacco-free policy. Conventional wisdom suggests that it is overwhelming to quit more than one substance at a time, and as a result, many clinicians believe that a shift to a tobacco-free treatment environment is unfeasible. However, the most recent scientific literature suggests the opposite: targeting tobacco use during substance use treatment can increase abstinence rates from both smoking and substances of choice. Therefore, the purpose of the current project is to outline the process by which a residential substance use treatment program within a Veterans Affairs (VA) medical center implemented a tobacco-free policy. In addition, preliminary program evaluation data dispels the myth that eliminating tobacco use in a residential treatment program leads to a decline in patient interest and program utilization.

Effects of Program and Patient Characteristics on Retention of Drug Treatment Patients.

ERIC Educational Resources Information Center

Hser, Yih-Ing; Joshi, Vandana; Maglione, Margaret; Chou, Chih Ping; Anglin, M. Douglas

2001-01-01

Studied the effects of program and patient characteristics on patient retention in residential, out-patient, and methadone maintenance drug treatment programs. Data for 26,047 patients in 87 programs show that threshold retention rates were generally low for all 3 program types, although program practice and service provision played important…

Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs.

PubMed

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-08-01

Smoking rates among addiction treatment clients are 3-4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semi-structured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. Copyright © 2016 Elsevier Inc. All rights reserved.

Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth. Testimony before the Committee on Education and Labor, House of Representatives. GAO-08-146T

ERIC Educational Resources Information Center

Kutz, Gregory D.; O'Connell, Andy

2007-01-01

Residential treatment programs provide a range of services, including drug and alcohol treatment, confidence building, military-style discipline, and psychological counseling for troubled boys and girls with a variety of addiction, behavioral, and emotional problems. This testimony concerns programs across the country referring to themselves as…

42 CFR § 512.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

Code of Federal Regulations, 2010 CFR

2017-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.320 Treatment of incentive... under such models are independent of, and do not affect, any incentive programs or add-on payments under... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

28 CFR 550.50 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Drug Abuse Treatment Program § 550.50 Purpose and scope. The purpose of this subpart is to describe the Bureau's drug abuse treatment programs. All Bureau institutions have a drug abuse treatment specialist who, under the Drug Abuse Program Coordinator's supervision, provides drug abuse education and non...

28 CFR 550.50 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Drug Abuse Treatment Program § 550.50 Purpose and scope. The purpose of this subpart is to describe the Bureau's drug abuse treatment programs. All Bureau institutions have a drug abuse treatment specialist who, under the Drug Abuse Program Coordinator's supervision, provides drug abuse education and non...

28 CFR 550.50 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Drug Abuse Treatment Program § 550.50 Purpose and scope. The purpose of this subpart is to describe the Bureau's drug abuse treatment programs. All Bureau institutions have a drug abuse treatment specialist who, under the Drug Abuse Program Coordinator's supervision, provides drug abuse education and non...

28 CFR 550.50 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Drug Abuse Treatment Program § 550.50 Purpose and scope. The purpose of this subpart is to describe the Bureau's drug abuse treatment programs. All Bureau institutions have a drug abuse treatment specialist who, under the Drug Abuse Program Coordinator's supervision, provides drug abuse education and non...

28 CFR 550.50 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Drug Abuse Treatment Program § 550.50 Purpose and scope. The purpose of this subpart is to describe the Bureau's drug abuse treatment programs. All Bureau institutions have a drug abuse treatment specialist who, under the Drug Abuse Program Coordinator's supervision, provides drug abuse education and non...

Using distance technologies to facilitate a learning collaborative to implement stagewise treatment.

PubMed

Covell, Nancy H; Foster, Forrest P; Margolies, Paul J; Lopez, Luis O; Dixon, Lisa B

2015-06-01

This report describes experiences and outcomes of an online learning collaborative focused on implementation of stagewise treatment. Eleven participating programs convened online monthly for a year. Between meetings, program staff created an implementation plan and programs collected performance indicator data, including assessment of staff knowledge of integrated treatment for people with co-occurring disorders, whether a person's current stage of treatment was documented in his or her chart, and whether the treatments were appropriate for the stage of treatment. Descriptive statistics were used to characterize performance indicators and feedback. Wilcoxon matched-pairs signed-rank tests examined changes in performance indicators over time. Program staff generally demonstrated significant improvements in performance indicators over time and rated the distance learning collaborative favorably. Distance learning collaboratives can be structured to provide opportunities for program staff to interact and learn from one another and to implement and sustain changes.

Sentence level auditory comprehension treatment program for aphasic adults.

PubMed

Naeser, M A; Haas, G; Mazurski, P; Laughlin, S

1986-06-01

The purpose of this study was to investigate whether a newly developed sentence level auditory comprehension (SLAC) treatment program could be used to improve language comprehension test scores in adults with chronic aphasia. Results indicate that the SLAC treatment program can be used with chronic patients; performance on a standardized test (the Token Test) was improved after treatment; and improved performance could not be predicted from either anatomic CT scan lesion sites or pretreatment test scores. One advantage to the SLAC treatment program is that the patient can practice listening independently with a tape recorder device (Language Master) and earphones either in the hospital or at home.

USEPA'S SITE PROGRAM IMPACT ON THE DEVELOPMENT AND USE OF INNOVATIVE HAZARDOUS WASTE TREATMENT

EPA Science Inventory

The USEPA's SITE Program was created to meet the increased demand for innovative technologies for hazardous waste treatment. The primary mission of the SITe Program is to expedite the cleanup of sites on the NPL. The SITE Program has two components: The Demonstration Program and ...

45 CFR 304.50 - Treatment of program income.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Treatment of program income. 304.50 Section 304.50 Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT... FEDERAL FINANCIAL PARTICIPATION § 304.50 Treatment of program income. The IV-D agency must exclude from...

The Economic Cost of Substance Abuse Treatment in the State of Florida

ERIC Educational Resources Information Center

Alexandre, Pierre K.; Beulaygue, Isabelle C.; French, Michael T.; McCollister, Kathryn E.; Popovici, Ioana; Sayed, Bisma A.

2012-01-01

Objective: Public and private stakeholders of substance abuse treatment services require economic cost data to guide program evaluations and funding decisions. Background: Rigorous cost assessments have been conducted for several treatment programs across the United States, but a systematic and comprehensive evaluation of programs in a particular…

45 CFR 304.50 - Treatment of program income.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Treatment of program income. 304.50 Section 304.50 Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT... FEDERAL FINANCIAL PARTICIPATION § 304.50 Treatment of program income. The IV-D agency must exclude from...

Concerns about dose and underutilization of twelve-step programs: models, scales, and theory that inform treatment planning.

PubMed

Cloud, Richard N; Kingree, J B

2008-01-01

Researchers have observed that a majority of addicted persons who are encouraged and facilitated by treatment providers to attend twelve-step (TS) programs either drop out or sporadically use twelve-step programs following treatment. This is troubling given considerable evidence of TS program benefits associated with regular weekly attendance and ubiquitous reliance by treatment professionals on these programs to provide important support services. This chapter reviews and advances theory of TS utilization and dose that is supported by prior research, multivariate models, and scales that predict risk of TS meeting underutilization. Advancing theory should organize and clarify the process of initial utilization, guide intervention development, and improve adherence of TS program referrals, all of which should lead to improved treatment planning and better outcomes. Three theories are integrated to explain processes that may influence TS program dose: the health belief model, self-determination theory (motivational theory), and a person-in-organization cultural fit theory. Four multidimensional scales developed specifically to predict participation are described. Implications for practice and future research are considered in a final discussion. Information contained in this chapter raises awareness of the need for TS-focused treatments to focus on achieving weekly attendance during and after treatment.

Development and evaluation of addiction treatment programs in Latin America.

PubMed

Marín-Navarrete, Rodrigo; Medina-Mora, María Elena; Pérez-López, Alejandro; Horigian, Viviana E

2018-07-01

The aim of this article is to present a state-of-the-art review of the scientific studies that have evaluated healthcare systems, services and programs for addiction treatment in Latin America. As a secondary aim, this article presents a brief description and analysis of the addiction prevention and treatment resources and programs available in Latin America, based on information from the ATLAS on Substance Use (ATLAS-SU) project led by the WHO. Substance use disorders (SUDs) are among the main causes associated with global burden of disease. Around the world, many initiatives have been proposed to promote policies to reduce substance use and reduce the impact of SUD, including integrating treatments into healthcare systems, increasing access to treatment programs and impacting outcome measures. In Latin America, multiple efforts have been implemented to improve addiction services and programs, although little is known about the impact they have generated. International studies report the availability of strategies and public inicitatives on prevention and treatment of addiction in Latin America. These studies also report established networks of public and private services that include prevention and detoxification programs, outpatient and residential treatment, and also social reintegration initiatives. However, despite these advances, information on the evaluation of the progress, results and impact of these programs is limited.

Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.

PubMed

Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

2017-09-01

Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional expenditures for Whites absent cultural and language-sensitive treatment programs. The programs moderate, but do not overcome, entrenched expenditure disparities. These findings use investment in mental health services for Latino populations to indicate treatment access and utilization, but do not explicitly reflect penetration rates or intensity of services for consumers. New funding, along with an expectation that Latino children's well documented mental health treatment disparities will be addressed, holds potential for improved mental health access and reducing utilization inequities for this population, especially when specialized, culturally and linguistically sensitive mental health treatment programs are present to serve as recipients of funding. To further expand knowledge of how federal or state funding for community based mental health services for low income populations can drive down the longstanding and considerable Latino-White mental health treatment disparities, we must develop and test questions targeting policy drivers which can channel funding to programs and organizations aimed at delivering linguistically and culturally sensitive services to Latino children and their families.

Exploring the Relationship Between Treatment Satisfaction, Perceived Improvements in Functioning and Well-Being and Gambling Harm Reduction Among Clients of Pathological Gambling Treatment Programs

PubMed Central

Bernhard, Bo; Abarbanel, Brett L. L.; St. John, Sarah; Kalina, Ashlee

2014-01-01

The objective of this study was to evaluate the relationship between treatment service quality, perceived improvement in social, functional, and material well-being and reduction in gambling behaviors among clients of Nevada state-funded pathological gambling treatment programs. Utilizing survey data from 361 clients from 2009 to 2010, analyses revealed that client satisfaction with treatment services is positively associated with perceived improvements in social, functional, and material well-being, abstinence from gambling, reduction in gambling thoughts and reduction in problems associated with gambling, even after controlling for various respondent characteristics. These findings can be useful to treatment program staff in managing program development and allocating resources. PMID:23756725

Impulsive lifestyle counseling to prevent dropout from treatment for substance use disorders in people with antisocial personality disorder: A randomized study.

PubMed

Thylstrup, Birgitte; Hesse, Morten

2016-06-01

Patients with antisocial personality disorder in outpatient treatment for substance use disorders are at high risk of drop-out. Using a randomized design, this study tested the impact of adding a brief psycho-educational program, the Impulsive Lifestyle Counseling program, to outpatient substance abuse treatment in order to prevent treatment dropout. Patients (N=175) were recruited from 13 municipal treatment centers in Denmark, and assigned to treatment as usual or to the experimental condition. In all, 172 patients could be included in the analyses. In the intent-to-treat analysis, the risk of treatment dropout was reduced among patients randomized to the experimental program (hazard ratio=0.63, p=.031), after controlling for age, gender, and substitution treatment status. The study supported the efficacy of the Impulsive Lifestyle Counseling program as a method for preventing treatment dropout for patients with comorbid antisocial personality disorder in substance abuse treatment. Trial registration #ISRCTN67266318. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adoption of Injectable Naltrexone in U.S. Substance Use Disorder Treatment Programs

PubMed Central

Aletraris, Lydia; Edmond, Mary Bond; Roman, Paul M

2015-01-01

Objective: Medication-assisted treatment for substance use disorders (SUDs) is not widely used in treatment programs. The aims of the current study were to document the prevalence of adoption and implementation of extended-release injectable naltrexone, the newest U.S. Food and Drug Administration–approved medication for alcohol use disorder (AUD), in U.S. treatment programs and to examine associations between organizational and patient characteristics and adoption. Method: The study used interview data from a nationally representative sample of 307 U.S. SUD treatment programs to examine adoption and implementation of injectable naltrexone. Results: Thirteen percent of programs used injectable naltrexone for AUD, and 3% of programs used it for opioid use disorder. Every treatment program that offered injectable naltrexone to its patients used it in conjunction with psychosocial treatment, particularly cognitive behavioral therapy. Multivariate logistic regression results indicated that adoption was positively associated with the provision of wraparound services, the percentage of privately insured patients, and the presence of inpatient detoxification services. For-profit status and offering inpatient services were negatively associated with adoption. Within adopting programs, an average of 4.1% of AUD patients and 7.1% of patients with opioid use disorder were currently receiving the medication, despite clinical directors’ reports of positive patient outcomes, particularly for relapsers and for those who had been noncompliant with other medications. Cost was a significant issue for the majority of adopting organizations. Conclusions: The rate of adoption of injectable naltrexone in U.S. treatment programs remains limited. Researchers should continue to examine patient, organizational, and external characteristics associated with the adoption and implementation of injectable naltrexone over time. PMID:25486403

The comparative effectiveness of clinic, work-site, phone, and Web-based tobacco treatment programs.

PubMed

An, Lawrence C; Betzner, Anne; Schillo, Barbara; Luxenberg, Michael G; Christenson, Matthew; Wendling, Ann; Saul, Jessie E; Kavanaugh, Annette

2010-10-01

Tobacco treatment programs may be offered in clinical settings, at work-sites, via telephone helplines, or over the Internet. Little comparative data exist regarding the real-world effectiveness of these programs. This paper compares the reach, effectiveness, and costs of these different modes of cessation assistance. This is an observational study of cohorts of participants in Minnesota's QUITPLAN programs in 2004. Cessation assistance was provided in person at 9 treatment centers, using group counseling at 68 work-sites, via a telephone helpline, or via the Internet. The main outcomes of the study are enrollment by current smokers, self-reported 30-day abstinence, and cost per quit. Reach was calculated statewide for the helpline and Web site, regionally for the treatment centers, and for the employee population for work-site programs. Enrollment was greatest for the Web site (n = 4,698), followed by the helpline (n = 2,351), treatment centers (n = 616), and work-sites (n = 479). The Web site attracted younger smokers. Smokers at treatment centers had higher levels of nicotine dependence. The helpline reached more socially disadvantaged smokers. Responder 30-day abstinence rates were higher for the helpline (29.3%), treatment centers (25.8%), and work-sites (19.6%) compared with the online program (12.5%). These differences persisted after controlling for baseline differences in participant characteristics and use of pharmacological therapy. The cost per quit was lowest for the Web site program ($291 per quit, 95% CI = $229-$372). Treatment center, work-site, helpline, and Web site programs differ in their reach, effectiveness, and estimated cost per quit. Each program plays a part in assisting populations of tobacco users in quitting.

Methadone maintenance in prison: evaluation of a pilot program in Puerto Rico.

PubMed

Heimer, Robert; Catania, Holly; Newman, Robert G; Zambrano, John; Brunet, Arlyn; Ortiz, Arturo Marti

2006-06-28

To describe and evaluate a pilot methadone maintenance program for heroin-dependent inmates of Las Malvinas men's prison in San Juan, Puerto Rico. Data from self-report of inmates' drug use before and during incarceration, attitudes about drug treatment in general and methadone maintenance in particular, and expectations about behaviors upon release from prison and from testing inmates' urine were analyzed comparing program patients (n=20) and inmates selected at random from the prison population (n=40). Qualitative data obtained by interviewing program staff, the correctional officers and superintendent, and commonwealth officials responsible for establishing and operating the program were analyzed to identify attitudes about methadone and program effectiveness. Heroin use among prisoners not in treatment was common; 58% reported any use while incarcerated and 38% reported use in past 30 days. All patients in the treatment program had used heroin in prison in the 30 days prior to enrolling in treatment. While in treatment, the percentage of patients not using heroin was reduced, according to both self-report and urine testing, to one in 18 (94% reduction) and one in 20 (95% reduction), respectively. Participation in treatment was associated with an increased acceptance of methadone maintenance. Prison personnel and commonwealth officials were supportive of the program. The program appears to be a success, and prison officials have begun an expansion from the current ceiling of 24 inmates to treat 300 or more inmates.

Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

PubMed

Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

2015-01-01

To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

Counting the cost: estimating the economic benefit of pedophile treatment programs.

PubMed

Shanahan, M; Donato, R

2001-04-01

The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.

A Framework for Conducting a National Study of Substance Abuse Treatment Programs Serving American Indian and Alaska Native Communities

PubMed Central

Novins, Douglas K.; Moore, Laurie A.; Beals, Janette; Aarons, Gregory A.; Rieckmann, Traci; Kaufman, Carol E.

2013-01-01

Background Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research. Objectives and Methods We developed a framework for studying these substance abuse treatment programs (n = 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve. Results Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research. Conclusion and Scientific Significance This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies. PMID:22931088

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

Effectiveness of an intensive multidisciplinary headache treatment program.

PubMed

Gunreben-Stempfle, Birgit; Griessinger, Norbert; Lang, Eberhard; Muehlhans, Barbara; Sittl, Reinhard; Ulrich, Kathrin

2009-07-01

To investigate if the effectiveness of a 96-hour multidisciplinary headache treatment program exceeds the effectiveness of a 20-hour program and primary care. When dealing with chronic back pain, low-intensity multidisciplinary treatment yields no significantly better results than standard care and monodisciplinary therapy; however, high-intensity treatment does. For multidisciplinary headache treatment, such comparisons are not yet available. In a previous study undertaken by our Pain Center, the outcome of a minimal multidisciplinary intervention model (20-hour) did not exceed primary care. Forty-two patients suffering from frequent headaches (20 +/- 9 headache days/month; range: 8-30) were treated and evaluated in a 96-hour group program. The results were compared with the outcomes of the previous study. Subjects who had undergone either the 20-hour multidisciplinary program or the primary care were used as historical control groups. A significant reduction in migraine days (P < .001), tension-type headache days (P < .001), frequency of migraine attacks (P = .004), and depression score (P < .001) was seen at the follow-up after 22 (+/-2) weeks. Comparing the intensive multidisciplinary program with primary care, repeated measures ANOVAs revealed significant time x group interactions for migraine days (P = .020), tension-type headache days (P = .016), and frequency of migraine attacks (P = .016). In comparison with the 20-hour multidisciplinary program, the 96-hour program showed significantly better effects only in the reduction of migraine days (P = .037) and depression score (P = .003). The responder-rates (> or =50% improvement) in the 96-hour program were significantly higher than in the 20-hour program (migraine days, P = .008; tension-type headache days, P = .044) and primary care (migraine days, P = .007; tension-type headache days, P = .003; tension-type headache intensity, P = .037). The effect sizes were small to medium in the 96-hour program. Particularly with the reduction of migraine symptomatology, the 96-hour program performed better than the 20-hour program, which produced only negligible or small effects. Intensive multidisciplinary headache treatment is highly effective for patients with chronic headaches. Furthermore, migraine symptomatology responds especially well to this intensive treatment program, whereas effects on tension-type headaches were realized by both multidisciplinary programs. Randomized controlled trials and subgroup analysis are needed to find out if these results can be replicated and which patient characteristics allow for sufficient improvements for headache sufferers even with less complex treatment.

Examining variation in treatment costs: a cost function for outpatient methadone treatment programs.

PubMed

Dunlap, Laura J; Zarkin, Gary A; Cowell, Alexander J

2008-06-01

To estimate a hybrid cost function of the relationship between total annual cost for outpatient methadone treatment and output (annual patient days and selected services), input prices (wages and building space costs), and selected program and patient case-mix characteristics. Data are from a multistate study of 159 methadone treatment programs that participated in the Center for Substance Abuse Treatment's Evaluation of the Methadone/LAAM Treatment Program Accreditation Project between 1998 and 2000. Using least squares regression for weighted data, we estimate the relationship between total annual costs and selected output measures, wages, building space costs, and selected program and patient case-mix characteristics. Findings indicate that total annual cost is positively associated with program's annual patient days, with a 10 percent increase in patient days associated with an 8.2 percent increase in total cost. Total annual cost also increases with counselor wages (p<.01), but no significant association is found for nurse wages or monthly building costs. Surprisingly, program characteristics and patient case mix variables do not appear to explain variations in methadone treatment costs. Similar results are found for a model with services as outputs. This study provides important new insights into the determinants of methadone treatment costs. Our findings concur with economic theory in that total annual cost is positively related to counselor wages. However, among our factor inputs, counselor wages are the only significant driver of these costs. Furthermore, our findings suggest that methadone programs may realize economies of scale; however, other important factors, such as patient access, should be considered.

Nature and Resolution of a Model Application: The Collaborative Intensive Community Treatment Program

ERIC Educational Resources Information Center

Amendola, A. Mark; Oliver, Robert W.

2003-01-01

The success of any program for youth relies on program integrity. This requires that the program is delivered as planned on a daily basis. Many factors converge on this equation. This article outlines initial development and components of a comprehensive treatment program grounded in the principles of Aggression Replacement Training.

Evaluation of a four- versus six-week length of stay in the Navy's alcohol treatment program.

PubMed

Trent, L K

1998-05-01

Attempts to balance escalating health care costs with resource downsizing have prompted alcohol treatment directors in the U.S. Navy to consider reducing the standard length of stay in treatment. The objectives of this study were to (1) determine whether a 4-week inpatient treatment program is as effective as a 6-week program, and (2) explore the potential for matching patients to a 4- or 6-week program according to the severity of their condition at intake. A total of 2,823 active-duty alcohol-dependent inpatients (2,685 men, 138 women) at 12 Navy treatment facilities participated in the evaluation. All facilities conducted a 6-week program until data had been collected for 1,380 participants; they then switched to a 4-week program (n = 1,443). Background information and clinical profile were obtained when patients entered treatment; 1-year outcome data (e.g., alcohol use, behavior problems, job performance, quality of life) were obtained from participants, work supervisors and aftercare advisors. Hierarchical multiple regression analyses were used to assess the effect of length of stay on outcome and to examine patient-program interactions. The single best predictor of success at 1 year was months of aftercare attendance. Program membership failed to explain any of the observed differences in the criterion measures, once the effects of other predictors had been taken into account. Severity of condition and patient-program interactions were likewise nonsignificant. It was concluded that a reduction in length of stay from 6 weeks to 4 weeks in the Navy's inpatient alcohol treatment program would not have an adverse effect on outcome.

Primary Prevention Programs at the Elementary Level: Issues of Treatment Integrity, Systematic Screening, and Reinforcement

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Kalberg, Jemma Robertson; Bruhn, Allison Leigh; Mahoney, Michelle E.; Driscoll, Steven A.

2008-01-01

This study examined issues of treatment integrity, systematic screenings, and access to reinforcement relative to school-wide positive behavior support programs (SW-PBS) implemented in two rural elementary schools during the first year of program implementation. Results suggested that treatment fidelity, as measured by self-report and direct…

Belongingness--The Critical Variable in the Residential Treatment of Alcoholism.

ERIC Educational Resources Information Center

Machell, David F.

Many alcohol treatment programs have stressed a sense of belongingness as a means for successful treatment of alcoholics in a residential setting. An examination of the effectiveness of this strategy in highly structured and less structured programs involved 200 chronic, recidivistic male adult alcoholics in a residential program. Subjects were…

76 FR 49500 - Privacy Act of 1974; Department of Homeland Security United States Coast Guard-020 Substance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... system of records titled, ``DHS/USCG-020 Substance Abuse Prevention and Treatment Program System of.../United States Coast Guard--020 Substance Abuse Prevention and Treatment Program System of Records. In... Substance Abuse Prevention and Treatment program, including to identify alcohol and drug abusers within the...

Caries Risk Assessment/Treatment Programs in U.S. Dental Schools.

ERIC Educational Resources Information Center

Yorty, Jack S.; Brown, K. Birgitta

1999-01-01

A survey of 42 U.S. dental schools was conducted to identify the number and characteristics of caries risk- assessment/treatment programs. Findings address lectures about caries risk, use of variable recall programs, categorization of risk level, early detection and treatment of lesions, and restoration of radiographically visible lesions. (DB)

'Sputnik': a programmatic approach to improve tuberculosis treatment adherence and outcome among defaulters.

PubMed

Gelmanova, I Y; Taran, D V; Mishustin, S P; Golubkov, A A; Solovyova, A V; Keshavjee, S

2011-10-01

A novel patient-centered tuberculosis (TB) treatment delivery program, 'Sputnik', was introduced for patients at high risk of treatment default in Tomsk City, Russian Federation. To assess the effects of the Sputnik intervention on patient default rates. We analyzed the characteristics of patients referred to the program, treatment adherence of Sputnik program enrollees before and during the intervention, and final outcomes for all patients referred to the Sputnik program. For patients continuing their existing regimens after referral to the program (n = 46), mean adherence to treatment increased by 56% (from 52% of prescribed doses prior to enrolment to 81%). For patients initiating new regimens after referral ( n = 5), mean adherence was 83%. Mean adherence for patients with multidrug-resistant TB (MDR-TB; n = 38) was 79% and for all others (n = 13) it was 89%. The cure rate was 71.1% for patients with MDR-TB, 60% for all others and 68% in the program overall. The Sputnik intervention was successful in reducing rates of treatment default among patients at high risk for non-adherence.

Long-term Outcomes among Drug Dependent Mothers Treated in Women-only versus Mixed-gender Programs

PubMed Central

Hser, Yih-Ing; Evans, Elizabeth; Huang, David; Messina, Nena

2011-01-01

This study examined the long-term outcomes of women who were pregnant or parenting at admission to women-only (WO; n=500) versus mixed-gender (MG; a matched sample of 500) substance abuse treatment programs. Administrative records on arrests, incarcerations, mental health services utilization, and drug treatment participation were collected, covering 3 years pre-admission and 8 years post-admission. Women treated in WO programs had lower levels of arrest, mental health services utilization rates, and drug treatment participation during the first year after drug treatment. No differences were found between the two groups in the long-term trajectories except that WO program participants had lower incarceration rates during the third year after treatment. The study findings suggest a positive short-term impact of WO versus MG programs with regard to arrest and mental health service utilization. Limited long-term gain is shown in the reductions in post-treatment incarceration. The study findings suggest the added value of specialized WO programs and begin to address the gap in knowledge regarding long-term outcomes for substance-abusing women. PMID:21466942

Availability of tobacco cessation services in substance use disorder treatment programs: Impact of state tobacco control policy.

PubMed

Abraham, Amanda J; Bagwell-Adams, Grace; Jayawardhana, Jayani

2017-08-01

Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States. State tobacco control and state demographic data (n=51) were merged with treatment program data from the 2012 National Survey of Substance Abuse Treatment Services (n=10.413) to examine availability of TC screening, counseling and pharmacotherapy services in SUD treatment programs using multivariate logistic regression models clustered at the state-level. Approximately 60% of SUD treatment programs offered TC screening services, 41% offered TC counseling services and 26% offered TC pharmacotherapy services. Results of multivariate logistic regression showed the odds of offering TC services were greater for SUD treatment programs located in states with higher cigarette excise taxes and greater spending on tobacco prevention and control. Findings indicate cigarette excise taxes and recommended funding levels may be effective policy tools for increasing access to TC services in SUD treatment programs. Coupled with changes to insurance coverage for TC under the Affordable Care Act, state tobacco control policy tools may further reduce tobacco use in the United States. Published by Elsevier Ltd.

Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

ERIC Educational Resources Information Center

Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

2005-01-01

TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

Management practices in substance abuse treatment programs.

PubMed

McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

2009-07-01

Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

The Use of Art and Music Therapy in Substance Abuse Treatment Programs

PubMed Central

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

2014-01-01

While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

Health economics evaluation of a gastric cancer early detection and treatment program in China.

PubMed

Li, Dan; Yuan, Yuan; Sun, Li-Ping; Fang, Xue; Zhou, Bao-Sen

2014-01-01

To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. RESULTS from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. RESULTS from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.

Treatment Readiness as a Determinant of Treatment Participation in a Prison-Based Rehabilitation Program: An Exploratory Study.

PubMed

Bosma, Anouk Q; Kunst, Maarten J J; Dirkzwager, Anja J E; Nieuwbeerta, Paul

2017-06-01

The current study had three aims. First, it measured treatment readiness among offenders who entered the Prevention of Recidivism program. This is a prison-based rehabilitation program in the Netherlands that aims to lower re-offending rates among offenders with a prison sentence of at least for months and that is carried out during the final months of incarceration. Second, the study evaluated whether treatment readiness was associated with treatment participation. Third, the study examined whether treatment readiness measured with a validated instrument predicted treatment participation above and beyond a clinical assessment of treatment readiness, currently used as a criterion to include offenders in rehabilitation programs. To address these aims, data were used from the fourth wave of a research project studying the effects of imprisonment on the life of detainees in the Netherlands. Results indicated that treatment readiness as measured with a validated instrument was a significant predictor of treatment participation. Also, the current study showed that treatment readiness measured with a validated instrument improved the prediction of treatment participation above and beyond a clinical assessment of treatment readiness. Outcomes were discussed in light of study limitations and implications.

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis.

PubMed

Aletraris, Lydia; Roman, Paul M

2015-10-01

The provision of HIV education and testing in substance use disorder (SUD) treatment programs is an important public health strategy for reducing HIV incidence. For many at-risk individuals, SUD treatment represents the primary point of access for testing and receiving HIV-related services. This study uses two waves of nationally representative data of 265 privately-funded SUD treatment programs in the U.S. to examine organizational and patient characteristics associated with offering a dedicated HIV/AIDS treatment track, onsite HIV/AIDS support groups, and onsite HIV testing. Our longitudinal analysis indicated that the majority of treatment programs reported providing education and prevention services, but there was a small, yet significant, decline in the number of programs providing these services. Programs placed more of an emphasis on providing information on the transmission of HIV rather than on acquiring risk-reduction skills. There was a notable and significant increase (from 26.0% to 31.7%) in programs that offered onsite HIV testing, including rapid HIV testing, and an increase in the percentage of patients who received testing in the programs. Larger programs were more likely to offer a dedicated HIV/AIDS treatment track and to offer onsite HIV/AIDS support groups, while accredited programs and programs with a medical infrastructure were more likely to provide HIV testing. The percentage of injection drug users was positively linked to the availability of specialized HIV/AIDS tracks and HIV/AIDS support groups, and the percentage of female clients was associated with the availability of onsite support groups. The odds of offering HIV/AIDS support groups were also greater in programs that had a dedicated LGBT track. The findings suggest that access to hospitals and medical care services is an effective way to facilitate adoption of HIV services and that programs are providing a needed service among a group of patients who have a heightened risk of HIV transmission. Nonetheless, the fact that fewer than one third of programs offered onsite testing, and, of the ones that did, fewer than one third of their patients received testing, raises concern in light of federal guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Provision of Hepatitis C Education in a Nationwide Sample of Drug Treatment Programs.

ERIC Educational Resources Information Center

Astone, Janetta; Strauss, Shiela M.; Vassilev, Zdravko P.; Des Jarlais, Don C.

2003-01-01

Using a nationwide sample of drug treatment programs, reports the results of an analysis that differentiates programs providing Hepatitis C virus (HCV) education to all of their patients versus programs that do not. Fifty-four percent of the programs provide HCV education to all of their patients. Findings indicate a need to increase HCV…

Posttreatment attrition and its predictors, attrition bias, and treatment efficacy of the anxiety online programs.

PubMed

Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

2014-10-14

Although relatively new, the field of e-mental health is becoming more popular with more attention given to researching its various aspects. However, there are many areas that still need further research, especially identifying attrition predictors at various phases of assessment and treatment delivery. The present study identified the predictors of posttreatment assessment completers based on 24 pre- and posttreatment demographic and personal variables and 1 treatment variable, their impact on attrition bias, and the efficacy of the 5 fully automated self-help anxiety treatment programs for generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). A complex algorithm was used to diagnose participants' mental disorders based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR). Those who received a primary or secondary diagnosis of 1 of 5 anxiety disorders were offered an online 12-week disorder-specific treatment program. A total of 3199 individuals did not formally drop out of the 12-week treatment cycle, whereas 142 individuals formally dropped out. However, only 347 participants who completed their treatment cycle also completed the posttreatment assessment measures. Based on these measures, predictors of attrition were identified and attrition bias was examined. The efficacy of the 5 treatment programs was assessed based on anxiety-specific severity scores and 5 additional treatment outcome measures. On average, completers of posttreatment assessment measures were more likely to be seeking self-help online programs; have heard about the program from traditional media or from family and friends; were receiving mental health assistance; were more likely to learn best by reading, hearing and doing; had a lower pretreatment Kessler-6 total score; and were older in age. Predicted probabilities resulting from these attrition variables displayed no significant attrition bias using Heckman's method and thus allowing for the use of completer analysis. Six treatment outcome measures (Kessler-6 total score, number of diagnosed disorders, self-confidence in managing mental health issues, quality of life, and the corresponding pre- and posttreatment severity for each program-specific anxiety disorder and for major depressive episode) were used to assess the efficacy of the 5 anxiety treatment programs. Repeated measures MANOVA revealed a significant multivariate time effect for all treatment outcome measures for each treatment program. Follow-up repeated measures ANOVAs revealed significant improvements on all 6 treatment outcome measures for GAD and PTSD, 5 treatment outcome measures were significant for SAD and PD/A, and 4 treatment outcome measures were significant for OCD. Results identified predictors of posttreatment assessment completers and provided further support for the efficacy of self-help online treatment programs for the 5 anxiety disorders. Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).

Workforce Professionalism in Drug Treatment Services: Impact of California’s Proposition 36

PubMed Central

Wu, Fei; Hser, Yih-Ing

2011-01-01

This article investigates whether California’s Proposition 36 has promoted the workforce professionalism of drug treatment services during its first five years of implementation. Program surveys inquiring about organizational information, Proposition 36 implementation, and staffing were conducted in 2003 and 2005 among all treatment providers serving Proposition 36 clients in five selected California counties (San Diego, Riverside, Kern, Sacramento, and San Francisco). A one-hour self-administered questionnaire was completed by 118 treatment providers representing 102 programs. This article examines five topics that are relevant to drug treatment workforce professionalism: resources and capability, standardized intake assessment and outcome evaluation, staff qualification, program accreditation, and information technology. Results suggest that Proposition 36 had a positive influence on the drug treatment workforce’s professionalism. Improvements have been observed in program resources, client intake assessment and outcome evaluation databases, staff professionalization, program accreditation, and information technology system. However, some areas remain problematic, including, for example, the consistent lack of adequate resources serving women with children. PMID:21036513

A Comparative Evaluation of Minimal Therapist Contact and 15-Session Treatment for Female Orgasmic Dysfunction.

ERIC Educational Resources Information Center

Morokoff, Patricia J.; LoPiccolo, Joseph

1986-01-01

Compared a four-session minimal therapist contact (MTC) program for treatment of lifelong global orgasmic dysfunction in women to a 15-session full therapist contact (FTC) program. Both programs were effective in producing female orgasm and in improving satisfaction with the sexual relationship and, for women in MTC treatment, happiness in…

Considering a Private Residential Treatment Program for a Troubled Teen? Questions for Parents and Guardians to Ask

ERIC Educational Resources Information Center

Federal Trade Commission, 2008

2008-01-01

Private residential treatment programs for young people offer a range of services, including drug and alcohol treatment, confidence building, military-style discipline, and psychological counseling for a variety of addiction, behavioral, and emotional problems. Many of these programs are intended to provide a less-restrictive alternative to…

A Randomized Controlled Trial of an Online Relapse Prevention Program for Adolescents in Substance Abuse Treatment

ERIC Educational Resources Information Center

Trudeau, Kimberlee J.; Black, Ryan A.; Kamon, Jody L.; Sussman, Steve

2017-01-01

Background: An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base is lacking. Objective: To assess the efficacy of the online Navigating my Journey (NmJ) program. Methods: 129 adolescent-aged…

The Application of Traditional Martial Arts Practice and Theory to the Treatment of Violent Adolescents.

ERIC Educational Resources Information Center

Twemlow, Stuart W.; Sacco, Frank C.

1998-01-01

Reviews treatment programs, the complex problems posed by youth gangs, and the use of martial arts in the treatment of violence and proposes a program for violent adolescents. The program philosophy is committed to respect and self-control; emphasis is on leadership and community service. Provides clinical examples. (Author/EMK)

Mental health court and assisted outpatient treatment: perceived coercion, procedural justice, and program impact.

PubMed

Munetz, Mark R; Ritter, Christian; Teller, Jennifer L S; Bonfine, Natalie

2014-03-01

Mandated community treatment has been proposed as a mechanism to engage people with severe and persistent mental disorders in treatment. Recently, two approaches to mandate treatment through the courts have been highlighted: assisted outpatient treatment (AOT) and mental health court programs. This study examined levels of perceived coercion, procedural justice, and the impact of the program (mental health court or AOT) among participants in a community treatment system. Data were analyzed from interviews with former AOT participants who were no longer under court supervision (N=17) and with graduates of a mental health court program (N=35). The MacArthur Admission Experience Survey, created to measure perceived coercion, procedural justice, and program impact on hospital admission, was modified to include judges and case managers. Mental health court graduates perceived significantly less coercion and more procedural justice in their interactions with the judge than did AOT participants. No significant difference was found between mental health court and AOT participants in perceptions of procedural justice in interactions with their case managers. Mental health court participants felt more respected and had more positive feelings about the program than did AOT participants. Both mental health courts and AOT programs have potentially coercive aspects. Findings suggest that judges and case managers can affect participants' perceptions of these programs by the degree to which they demonstrate procedural justice, a process that may affect the long-term effects of the programs on individuals.

Sensation-Focused Intensive Treatment for Panic Disorder with Moderate to Severe Agoraphobia

ERIC Educational Resources Information Center

Morissette, Sandra Baker; Spiegel, David A.; Heinrichs, Nina

2005-01-01

The current article presents a detailed description of an intensive treatment program for panic disorder with moderate to severe levels of agoraphobia (PDA), called Sensation-Focused Intensive Treatment (SFIT). Although the efficacy of traditional CBT treatment programs has been well established for the treatment of PDA, patients with moderate to…

Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

PubMed

Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

2015-05-01

The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Gender differences among prisoners in drug treatment.

PubMed

Langan, N P; Pelissier, B M

2001-01-01

Nearly all prison-based substance abuse treatment programs have been designed with male prisoners in mind. Administering these male-oriented programs to women prisoners has been the standard correctional practice. Recently, this practice has received considerable criticism. Critics argue that female prisoners have special needs that are not met by programs originally designed for male prisoners. However, most of the empirical support for the existence of such special needs rely on two inappropriate samples: prisoners who are not in treatment and treatment participants who are not incarcerated. Findings from these two different groups may not be generalizable to the population of prisoners in treatment. This paper directly addresses this generalizability problem with an examination of gender differences among 1,326 male and 318 female federal prisoners who were enrolled in a substance abuse treatment program. Women used drugs more frequently, used harder drugs, and used them for different reasons than men. Women also confronted more difficulties than men in areas linked to substance abuse such as educational background, childhood family environment, adult social environment, mental health, and physical health. We find support for the argument that substance abuse treatment programs which were originally designed for men may be inappropriate for the treatment of women.

Uncertainty and Sensitivity Analyses of a Pebble Bed HTGR Loss of Cooling Event

DOE PAGES

Strydom, Gerhard

2013-01-01

The Very High Temperature Reactor Methods Development group at the Idaho National Laboratory identified the need for a defensible and systematic uncertainty and sensitivity approach in 2009. This paper summarizes the results of an uncertainty and sensitivity quantification investigation performed with the SUSA code, utilizing the International Atomic Energy Agency CRP 5 Pebble Bed Modular Reactor benchmark and the INL code suite PEBBED-THERMIX. Eight model input parameters were selected for inclusion in this study, and after the input parameters variations and probability density functions were specified, a total of 800 steady state and depressurized loss of forced cooling (DLOFC) transientmore » PEBBED-THERMIX calculations were performed. The six data sets were statistically analyzed to determine the 5% and 95% DLOFC peak fuel temperature tolerance intervals with 95% confidence levels. It was found that the uncertainties in the decay heat and graphite thermal conductivities were the most significant contributors to the propagated DLOFC peak fuel temperature uncertainty. No significant differences were observed between the results of Simple Random Sampling (SRS) or Latin Hypercube Sampling (LHS) data sets, and use of uniform or normal input parameter distributions also did not lead to any significant differences between these data sets.« less

Summary of Planned Implementation for the HTGR Lessons Learned Applicable to the NGNP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ian Mckirdy

2011-09-01

This document presents a reconciliation of the lessons learned during a 2010 comprehensive evaluation of pertinent lessons learned from past and present high temperature gas-cooled reactors that apply to the Next Generation Nuclear Plant Project along with current and planned activities. The data used are from the latest Idaho National Laboratory research and development plans, the conceptual design report from General Atomics, and the pebble bed reactor technology readiness study from AREVA. Only those lessons related to the structures, systems, and components of the Next Generation Nuclear Plant (NGNP), as documented in the recently updated lessons learned report are addressed.more » These reconciliations are ordered according to plant area, followed by the affected system, subsystem, or component; lesson learned; and finally an NGNP implementation statement. This report (1) provides cross references to the original lessons learned document, (2) describes the lesson learned, (3) provides the current NGNP implementation status with design data needs associated with the lesson learned, (4) identifies the research and development being performed related to the lesson learned, and (5) summarizes with a status of how the lesson learned has been addressed by the NGNP Project.« less

Power Peaking Effect of OTTO Fuel Scheme Pebble Bed Reactor

NASA Astrophysics Data System (ADS)

Setiadipura, T.; Suwoto; Zuhair; Bakhri, S.; Sunaryo, G. R.

2018-02-01

Pebble Bed Reactor (PBR) type of Hight Temperature Gas-cooled Reactor (HTGR) is a very interesting nuclear reactor design to fulfill the growing electricity and heat demand with a superior passive safety features. Effort to introduce the PBR design to the market can be strengthen by simplifying its system with the Once-through-then-out (OTTO) cycle PBR in which the pebble fuel only pass the core once. Important challenge in the OTTO fuel scheme is the power peaking effect which limit the maximum nominal power or burnup of the design. Parametric survey is perform in this study to investigate the contribution of different design parameters to power peaking effect of OTTO cycle PBR. PEBBED code is utilized in this study to perform the equilibrium PBR core analysis for different design parameter and fuel scheme. The parameters include its core diameter, height-per-diameter (H/D), power density, and core nominal power. Results of this study show that diameter and H/D effectsare stronger compare to the power density and nominal core power. Results of this study might become an importance guidance for design optimization of OTTO fuel scheme PBR.

Characteristics of potential repository wastes. Volume 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-07-01

The LWR spent fuels discussed in Volume 1 of this report comprise about 99% of all domestic non-reprocessed spent fuel. In this report we discuss other types of spent fuels which, although small in relative quantity, consist of a number of diverse types, sizes, and compositions. Many of these fuels are candidates for repository disposal. Some non-LWR spent fuels are currently reprocessed or are scheduled for reprocessing in DOE facilities at the Savannah River Site, Hanford Site, and the Idaho National Engineering Laboratory. It appears likely that the reprocessing of fuels that have been reprocessed in the past will continuemore » and that the resulting high-level wastes will become part of defense HLW. However, it is not entirely clear in some cases whether a given fuel will be reprocessed, especially in cases where pretreatment may be needed before reprocessing, or where the enrichment is not high enough to make reprocessing attractive. Some fuels may be canistered, while others may require special means of disposal. The major categories covered in this chapter include HTGR spent fuel from the Fort St. Vrain and Peach Bottom-1 reactors, research and test reactor fuels, and miscellaneous fuels, and wastes generated from the decommissioning of facilities.« less

Leadership, Burnout, and Job Satisfaction in Outpatient Drug-Free Treatment Programs

PubMed Central

Broome, Kirk M.; Knight, Danica K.; Edwards, Jennifer R.; Flynn, Patrick M.

2009-01-01

Counselors are a critical component of substance abuse treatment programming, but their working experiences are not yet well understood. As treatment-improvement efforts focus increasingly on these individuals, their perceptions of program leadership, emotional burnout, and job satisfaction and related attitudes take on greater significance. This study explores counselor views and the impact of organizational context using data from a nationwide set of 94 outpatient drug-free (ODF) treatment programs in a hierarchical linear model (HLM) analysis. Results show counselors hold generally positive opinions of program director leadership and job satisfaction, and have low levels of burnout, but they also have important variations in their ratings. Higher counselor caseloads were related to poorer ratings, and leadership behaviors predicted both satisfaction and burnout. These findings add further evidence that treatment providers should also address the workplace environment for staff as part of quality-improvement efforts. PMID:19339143

Leadership, burnout, and job satisfaction in outpatient drug-free treatment programs.

PubMed

Broome, Kirk M; Knight, Danica K; Edwards, Jennifer R; Flynn, Patrick M

2009-09-01

Counselors are a critical component of substance abuse treatment programming, but their working experiences are not yet well understood. As treatment improvement efforts focus increasingly on these individuals, their perceptions of program leadership, emotional burnout, and job satisfaction and related attitudes take on greater significance. This study explores counselor views and the impact of organizational context using data from a nationwide set of 94 outpatient drug-free treatment programs in a hierarchical linear model analysis. Results show counselors hold generally positive opinions of program director leadership and job satisfaction and have low levels of burnout, but they also have important variations in their ratings. Higher counselor caseloads were related to poorer ratings, and leadership behaviors predicted both satisfaction and burnout. These findings add further evidence that treatment providers should also address the workplace environment for staff as part of quality improvement efforts.

Predictors of treatment use among foster mothers in an attachment-based intervention program.

PubMed

Bick, Johanna; Dozier, Mary; Moore, Shannon

2012-01-01

The current study examined predictors of treatment use among 56 foster mothers who participated in an attachment-based intervention program for foster infants. Foster mothers' levels of treatment use were coded at early, middle, and late phases of the intervention program. Foster mothers' states of mind with regard to attachment predicted their understanding of the intervention session concepts. Specifically, autonomous foster mothers showed higher levels of understanding at the start of the intervention program, when compared with non-autonomous foster mothers. State of mind with regard to attachment also predicted foster mothers' levels of reflective functioning during the intervention sessions. Autonomous foster mothers showed higher levels of reflective functioning at early, middle, and late stages of the intervention program, when compared with non-autonomous foster mothers. The relevance of these findings for both treatment effectiveness and treatment delivery is discussed.

Concurrent Group Treatment for Hepatitis C: Implementation and Outcomes in a Methadone Maintenance Treatment Program

PubMed Central

Stein, Melissa R.; Soloway, Irene J.; Jefferson, Karen S.; Roose, Robert J.; Arnsten, Julia H.; Litwin, Alain H.

2012-01-01

Chronic hepatitis C virus (HCV) infection is highly prevalent among current and former drug users. However, the minority of patients enrolled in drug treatment programs have initiated HCV treatment. New models are needed to overcome barriers to care. In this retrospective study, we describe the implementation and outcomes of 42 patients treated in a Concurrent Group Treatment (CGT) program. Patients participated in weekly provider-led group treatment sessions which included review of side effects; discussion of adherence and side effect management; administration of interferon injections; brief physical exam; and ended with brief meditation. Of the first 27 patients who initiated CGT, 42% achieved a sustained viral response. Additionally, 87% (13/15) of genotype-1 infected patients treated with direct acting antiviral agent achieved an undetectable viral load at 24 weeks. The CGT model may be effective in overcoming barriers to treatment and improving adherence and outcomes among patients enrolled in drug treatment programs. PMID:23036920

Influence of Organizational Functioning on Client Engagement in Treatment

PubMed Central

Greener, Jack M.; Joe, George W.; Simpson, D. Dwayne; Rowan-Szal, Grace A.; Lehman, Wayne E. K.

2007-01-01

The present study focused on the relationship between organizational functioning factors measured in a staff survey using the TCU Organizational Readiness for Change (ORC) assessment and client-level engagement measured by the TCU Client Evaluation of Self and Treatment (CEST) in drug treatment programs. The sample consisted of 531 clinical and counseling staff and 3475 clients from 163 substance abuse treatment programs located in 9 states from three regional Addiction Technology Transfer Centers (ATTC). Measures of client engagement in treatment (rapport, satisfaction, and participation) were shown to be higher in programs with more positive staff ratings of organizational functioning. In particular, these programs had fewer agency needs and more favorable ratings for their resources, staff attributes, and climate. These findings help establish the importance of addressing organizational factors as part of an overall strategy for improving treatment effectiveness. PMID:17433863

Enhancing access and retention in substance abuse treatment: the role of Medicaid payment acceptance and cultural competence.

PubMed

Guerrero, Erick G

2013-10-01

Health insurance coverage and quality of care are common factors believed to improve access for and retention of racial and ethnic minority groups in health care. However, there is little evidence that acceptance of public insurance and provision of culturally responsive care decrease wait time and retention of minority populations in community-based substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, CA. An analytical sample of 13,328 primarily African American and Latino clients nested within 104 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on count measures of days to initiate and days spent in treatment. Programs that accepted public insurance (p<.001) and in which staff reported personal involvement (p<.01) and linkages and resources with minority communities (p<.001) were negatively associated with client wait time. Similarly, programs with culturally responsive policies and assessment and treatment practices (p<.05) were positively associated with retention in treatment, after controlling for individual and program characteristics. These preliminary findings provide an evidentiary base for the role of community-based financial and cultural practices in improving accessibility and treatment adherence in a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to expand public insurance and enhance culturally competent care, are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Evaluation of 6 remote First Nations community-based buprenorphine programs in northwestern Ontario: Retrospective study.

PubMed

Mamakwa, Solomon; Kahan, Meldon; Kanate, Dinah; Kirlew, Mike; Folk, David; Cirone, Sharon; Rea, Sara; Parsons, Pierre; Edwards, Craig; Gordon, Janet; Main, Fiona; Kelly, Len

2017-02-01

To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. Retrospective cohort study. Six First Nations communities in northwestern Ontario. A total of 526 First Nations participants in opioid-dependence treatment programs. Buprenorphine-naloxone substitution therapy and First Nations healing programming. Retention rates and urine drug screening (UDS) results. Treatment retention rates at 6, 12, and 18 months were 84%, 78%, and 72%, respectively. We estimate that the rate at 24 months will also be more than 70%. The UDS programming varied and was implemented in only 1 community. Initially urine testing was voluntary and it then became mandatory. Screening with either method found the proportion of urine samples with negative results for illicit opioids ranged between 84% and 95%. The program's treatment retention rates and negative UDS results were higher than those reported for most methadone and buprenorphine-naloxone programs, despite a patient population where severe posttraumatic stress disorder is endemic, and despite the programs' lack of resources and addiction expertise. Community-based programs like these overcome the initial challenge of cultural competence. First Nations communities in other provinces should establish their own buprenorphinenaloxone programs, using local primary care physicians as prescribers. Sustainable core funding is needed for programming, long-term aftercare, and trauma recovery for such initiatives. Copyright© the College of Family Physicians of Canada.

The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program.

PubMed

Oser, Carrie; Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

2009-08-01

Women's substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative's National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n=217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings.

Identifying and reducing disparities in successful addiction treatment completion: testing the role of Medicaid payment acceptance.

PubMed

Guerrero, Erick G; Garner, Bryan R; Cook, Benjamin; Kong, Yinfei; Vega, William A; Gelberg, Lillian

2017-05-25

Medicaid has become the largest payer of substance use disorder treatment and may enhance access to quality care and reduce disparities. We tested whether treatment programs' acceptance of Medicaid payments was associated with reduced disparities between Mexican Americans and non-Latino Whites. We analyzed client and program data from 122 publicly funded treatment programs in 2010 and 112 programs in 2013. These data were merged with information regarding 15,412 adult clients from both periods, of whom we selected only Mexican Americans (n = 7130, 46.3%) and non-Latino Whites (n = 8282, 53.7%). We used multilevel logistic regression and variance decomposition to examine associations and underlying factors associated with Mexican American and White differences in treatment completion. Variables of interest included client demographics; drug use severity and mental health issues; and program license, accreditation, and acceptance of Medicaid payments. Mexican Americans had lower odds of treatment completion (OR = 0.677; 95% CI = 0.534, 0.859) compared to non-Latino Whites. This disparity was explained in part by primary drug used, greater drug use severity, history of mental health disorders, and program acceptance of Medicaid payments. The interaction between Mexican Americans and acceptance of Medicaid was statistically significant (OR = 1.284; 95% CI = 1.008, 1.637). Findings highlighted key program and client drivers of this disparity and the promising role of program acceptance of Medicaid payment to eliminate disparities in treatment completion among Mexican Americans. Implications for health policy during the Trump Administration are discussed.

The response of an assertive community treatment program following a natural disaster.

PubMed

Lachance, K R; Santos, A B; Burns, B J

1994-10-01

A newly forming model treatment program for seriously mentally ill adults was dramatically affected by a natural disaster in September 1989. Hurricane Hugo rendered the offices of the Assertive Community Treatment Program uninhabitable, its vehicles marginally driveable, and its resources virtually nonexistent. In the three months following the storm, however, not a single psychiatric rehospitalization took place. Although the authors cannot claim that the program model was solely responsible for this outcome, this paper illustrates the service system elements that contributed to the program's effectiveness in the wake of one of the nation's most severe natural disasters.

The MICA Case Conference Program at Tewksbury Hospital, Mass.: an integrated treatment model.

PubMed

Clodfelter, Reynolds C; Albanese, Mark J; Baker, Gregg; Domoto, Katherine; Gui, Amy L; Khantzian, Edward J

2003-01-01

This report describes the MICA (Mentally Ill Chemically Abusing) Program at the Tewksbury Hospital campus in Tewksbury, Massachusetts. Several campus facilities collaborate in the MICA Program. Through Expert Case Conferences, principles of integrated psychosocial treatment with dual diagnosis patients are demonstrated. An expert clinician focuses on the interplay between psychological pain, characterological traits, defenses, and the patient's drug of choice. Patients who have participated in the program have reported positive experiences. The staff reported that the program has resulted in facility improvement in assessment and treatment of complex dual diagnosis patients.

Cognitive-Behavioral Treatment for Adolescents Who Sexually Offend and Their Families: Individual and Family Applications in a Collaborative Outpatient Program

ERIC Educational Resources Information Center

Kolko, David J.; Noel, Colleen; Thomas, Gretchen; Torres, Eunice

2004-01-01

This article describes an outpatient treatment program for adolescent sexual abusers that was established by a mental health agency in collaboration with a specialized probation program in the juvenile court. Individualized treatment is based on a comprehensive clinical assessment with the youth and guardian, for which examples are provided. Given…

The Treatment of Assets and Income From Assets in Income-Conditioned Government Benefit Programs; Technical Papers.

ERIC Educational Resources Information Center

Wisconsin Univ., Madison. Inst. for Research on Poverty.

These technical papers were presented at the Conference on Treatment of Assets and Income from Assets in Income Conditioned Programs. Six papers dealing with current and alternative treatments of assets and income from assets in programs that offer both cash and noncash benefits were presented. The first three authors reviewed the network of rules…

Motivational Enhancement and Schema-Focused Cognitive Behaviour Therapy in the Treatment of Chronic Eating Disorders

ERIC Educational Resources Information Center

George, Louise; Thornton, Chris; Touyz, Stephen W.; Waller, Glenn; Beumont, Pierre J. V.

2004-01-01

A day hospital program for the treatment of patients with long-term anorexia nervosa (AN) is described. This program forms part of a comprehensive system of day programs that reflect and incorporate patients' varying degrees of readiness for change and attempt to match patients' readiness for change to the interventions offered in treatment.…

Motivation and Readiness for Drug Treatment: Differences by Modality and Special Populations

PubMed Central

Melnick, Gerald; Hawke, Josephine; De Leon, George

2014-01-01

The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of over 6000 admissions to 38 programs. Results from multilevel analyses show (1) an ordered increase in motivation by settings from referral to out patient, to methadone maintenance, to highest levels in residential programs; (2) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment. PMID:24735224

Motivation and readiness for drug treatment: differences by modality and special populations.

PubMed

Melnick, Gerald; Hawke, Josephine; De Leon, George

2014-01-01

The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of more than 6,000 admissions to 38 programs. Results from multilevel analyses show (a) an ordered increase in motivation by settings from referral to outpatient, to methadone maintenance, and to the highest levels in residential programs and (b) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment.

Feasibility Study of an Interactive Multimedia Electronic Problem Solving Treatment Program for Depression: A Preliminary Uncontrolled Trial

PubMed Central

Berman, Margit I.; Jr., Jay C. Buckey; Hull, Jay G.; Linardatos, Eftihia; Song, Sueyoung L.; McLellan, Robert K.; Hegel, Mark T.

2014-01-01

Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9 weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a mini mally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4 weeks), and study endpoint (10 weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated. PMID:24680231

A descriptive study of past experiences with weight-loss treatment.

PubMed

Burke, Lora E; Steenkiste, Ann; Music, Edvin; Styn, Mindi A

2008-04-01

Overweight and obesity affect more than 60% of the adult population in the United States. Most adults who are overweight have a history of previous weight-loss treatment. Exploring individuals' past experiences with weight-loss treatment may allow improvements to the current approach to treatment. To examine individuals' prior experiences with weight-loss treatment, their treatment preferences, and what they found to be most and least satisfying. Cross-sectional descriptive study. Individuals (N=155) who had registered for a weight-loss study wait list and met standard criteria for a weight-loss program (aged 18 to 55 years and body mass index between 25 and 42). Questionnaire packets were mailed to participants. Descriptive analyses of the participants' past history with weight-loss treatment, treatment preference, self-efficacy, therapeutic efficacy, barriers to adherence to weight-loss treatment, barriers to healthy eating, and experiences associated with following a low-fat diet. One hundred ten participants (71%) returned completed questionnaire packets. The sample (82% white, 84% female, aged 42.6+/-8.5 years, and body mass index 33.5+/-5.3) was representative of those who seek weight-loss treatment in research settings. Participants were, on average, aged 21.1+/-8.9 years when they first tried a weight-loss program; 96.3% had tried to lose weight since that first time. The two most frequently tried programs were doing it on their own (93.5%) and commercial programs (70.8%). Barriers included having trouble controlling what I eat when hungry (71.3%), difficulty motivating myself to eat appropriately (66.2%), and using food as a reward (59.3%). Preferred weight-loss regimens were doing it on their own (30.6%) and a research program (22.4%). Participants were not seeking their preferred treatment. These data can be used to improve weight-loss programs by tailoring programs to meet the needs and preferences of participants.

OTP Directory

Science.gov Websites

Skip Navigation medication-assisted treatment for substance use disorders Back to MAT home  • Opioid Treatment Program Directory Select to view the opioid treatment programs in a State - Select - All Substance Abuse Treatment Division of Pharmacologic Therapies 5600 Fishers Lane * Rockville, MD 20857 * 240

Treatment Outcomes in an Adolescent Chemical Dependency Program.

ERIC Educational Resources Information Center

Ralph, Norbert; McMenamy, Carol

1996-01-01

Investigates treatment outcomes for all admissions to an adolescent chemical dependency program over a 10-month period. Interviews with parents of patients were conducted. The effect of various pretreatment and treatment factors on outcomes were investigated. Better treatment outcome was associated with older adolescents, greater participation in…

Dimensions of Publicness and Performance in Substance Abuse Treatment Organizations

ERIC Educational Resources Information Center

Heinrich, Carolyn J.; Fournier, Elizabeth

2004-01-01

Changes in funding, clientele, and treatment practices of public and privately owned substance abuse treatment programs, compelled in part by increased cost containment pressures, have prompted researchers' investigations of the implications of organizational form for treatment programs. These studies primarily probe associations between ownership…

Overview and example application of the Landscape Treatment Designer

Treesearch

Alan A. Ager; Nicole M. Vaillant; David E. Owens; Stuart Brittain; Jeff Hamann

2012-01-01

The Landscape Treatment Designer (LTD) is a multicriteria spatial prioritization and optimization system to help design and explore landscape fuel treatment scenarios. The program fills a gap between fire model programs such as FlamMap, and planning systems such as ArcFuels, in the fuel treatment planning process. The LTD uses inputs on spatial treatment objectives,...

A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

PubMed

Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

2016-01-01

Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

Motivational enhancement therapy to improve treatment utilization and outcome in pregnant substance users

PubMed Central

Winhusen, Theresa; Kropp, Frankie; Babcock, Dean; Hague, Diane; Erickson, Sarah J.; Renz, Connie; Rau, Leela; Lewis, Daniel; Leimberger, Jeff; Somoza, Eugene

2008-01-01

Pregnant substance users can benefit significantly from substance abuse treatment but treatment retention can be challenging. Two hundred pregnant substance users entering outpatient substance abuse treatment at 1 of 4 treatment programs were randomized to receive either 3 individual sessions of Motivational Enhancement Therapy for pregnant substance users (MET-PS) or the first 3 individual sessions normally provided by the program. All participants were encouraged to participate in all other treatment offered by the program. Outcome measures included treatment utilization according to clinic records, qualitative urine toxicology measures, and self-report of substance use. One hundred and sixty two participants (i.e., 81%) completed the 1 month active phase. Participants attended 62% of scheduled treatment on average and reported decreased substance use during the first month of treatment, with no differences between MET-PS and treatment as usual participants. There was some evidence that the efficacy of MET-PS varied between sites and that MET-PS might be more beneficial than TAU in decreasing substance use in minority participants. These results suggest that MET-PS is not more effective than treatment as usual for pregnant substance users in general but that there might be particular subgroups or treatment programs for which MET-PS might be more or less effective than treatment as usual. PMID:18083322

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

PubMed

Kirigin, K A; Braukmann, C J; Atwater, J D; Wolf, M M

1982-01-01

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.

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

PubMed Central

Kirigin, K A; Braukmann, C J; Atwater, J D; Wolf, M M

1982-01-01

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. PMID:7096223

Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey.

PubMed

Kruse, Gina R; Rigotti, Nancy A; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2017-12-01

There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world. To measure the prevalence of tobacco cessation treatment content, skills training and teaching methods reported by tobacco treatment training programs across the world. Web-based survey in May-September 2013 among tobacco cessation training experts across six geographic regions and four World Bank income levels. Response rate was 73% (84 of 115 countries contacted). Of 104 individual programs from 84 countries, most reported teaching brief advice (78%) and one-to-one counseling (74%); telephone counseling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programs in lower income countries less often reported teaching about medications, behavioral treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programs reported a median 15 hours of training. Face-to-face training was common (85%); online programs were rare (19%). Almost half (47%) included no learner assessment. Only 35% offered continuing education. Nearly all programs reported teaching evidence-based treatment modalities in a face-to-face format. Few programs delivered training online or offered continuing education. Skills-based training was less common among low- and middle-income countries (LMICs). There is a large unmet need for tobacco treatment training protocols which emphasize practical skills, and which are more rapidly scalable than face-to-face training in LMICs.

Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

PubMed

Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

2016-01-01

The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa.

Material Control and Accounting Design Considerations for High-Temperature Gas Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Trond Bjornard; John Hockert

The subject of this report is domestic safeguards and security by design (2SBD) for high-temperature gas reactors, focusing on material control and accountability (MC&A). The motivation for the report is to provide 2SBD support to the Next Generation Nuclear Plant (NGNP) project, which was launched by Congress in 2005. This introductory section will provide some background on the NGNP project and an overview of the 2SBD concept. The remaining chapters focus specifically on design aspects of the candidate high-temperature gas reactors (HTGRs) relevant to MC&A, Nuclear Regulatory Commission (NRC) requirements, and proposed MC&A approaches for the two major HTGR reactormore » types: pebble bed and prismatic. Of the prismatic type, two candidates are under consideration: (1) GA's GT-MHR (Gas Turbine-Modular Helium Reactor), and (2) the Modular High-Temperature Reactor (M-HTR), a derivative of Areva's Antares reactor. The future of the pebble-bed modular reactor (PBMR) for NGNP is uncertain, as the PBMR consortium partners (Westinghouse, PBMR [Pty] and The Shaw Group) were unable to agree on the path forward for NGNP during 2010. However, during the technology assessment of the conceptual design phase (Phase 1) of the NGNP project, AREVA provided design information and technology assessment of their pebble bed fueled plant design called the HTR-Module concept. AREVA does not intend to pursue this design for NGNP, preferring instead a modular reactor based on the prismatic Antares concept. Since MC&A relevant design information is available for both pebble concepts, the pebble-bed HTGRs considered in this report are: (1) Westinghouse PBMR; and (2) AREVA HTR-Module. The DOE Office of Nuclear Energy (DOE-NE) sponsors the Fuel Cycle Research and Development program (FCR&D), which contains an element specifically focused on the domestic (or state) aspects of SBD. This Material Protection, Control and Accountancy Technology (MPACT) program supports the present work summarized in this report, namely the development of guidance to support the consideration of MC&A in the design of both pebble-bed and prismatic-fueled HTGRs. The objective is to identify and incorporate design features into the facility design that will cost effectively aid in making MC&A more effective and efficient, with minimum impact on operations. The theft of nuclear material is addressed through both MC&A and physical protection, while the threat of sabotage is addressed principally through physical protection.« less

76 FR 49491 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

...] Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration... code under the Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The deadline for... interested parties of an opportunity to participate in the Treatment of Certain Complex Diagnostic Laboratory...

Use of MMPI Subtypes in Predicting Completion of a Residential Alcoholism Treatment Program.

ERIC Educational Resources Information Center

Sheppard, Debra; And Others

1988-01-01

Examined patient characteristics relevant to treatment outcome by administering Minnesota Multiphasic Personality Inventory to 86 men following admission to a residential alcoholism treatment program. Cluster analyses yielded three subtypes which differed significantly in their rates of treatment completion. Comparison of data to that obtained in…

Healing the community to heal the individual: literature review of aboriginal community-based alcohol and substance abuse programs.

PubMed

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-07-01

To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for longterm program sustainability. Programs require increased documentation of their inroads in this developing field.

Eating Disorders: An Experiment in the Development of a Preventative Program.

ERIC Educational Resources Information Center

Bruce, Vivian M.

1986-01-01

This article describes how health professionals at the University of Manitoba developed an educational and treatment program for eating disorders. Discusses the group's two objectives: to plan a preventative program for all eating disorders (including obesity) that would be oriented to health maintenance and to organize a treatment program. (CT)

The Dual Participants: A High Risk Drinking Driver Target Group.

ERIC Educational Resources Information Center

Kline, Michael V.; And Others

1988-01-01

Studied dual participants (N=2,525), multiple offender drinking driver program participants who also attend non-drinking driver alcohol treatment programs. Findings support need for drinking driver programs to be aware of high risk dual participants and for alcohol-related treatment programs to provide drinking and driving education to all dual…

Outcomes of Adventure Program Participation by Adolescents Involved in Psychiatric Treatment.

ERIC Educational Resources Information Center

Witman, Jeffrey P.

The purpose of this study was to determine the impact of adventure program participation upon adolescents in psychiatric treatment. All adventure programs included goal setting, awareness, cooperative and trust activities, and group and individual problem-solving. Participants' total hours of program participation ranged from 8-22 hours. A random…

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

PubMed

Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

Hispanic Parenting Women in Women-Only versus Mixed-Gender Drug Treatment: A 10-Year Prospective Study

PubMed Central

Hser, Yih-Ing; Hunt, Samantha A.; Evans, Elizabeth; Chang, Yen-Jung; Messina, Nena P.

2012-01-01

The present study examined Hispanic substance-using parenting women treated in women-only (WO; n=126) versus mixed-gender (MG; n=853) programs and associated outcomes assessed 10 years after admission. Relative to other races/ethnicities of women admitted to the set of 40 California treatment programs in 2000–2002, Hispanic women were underrepresented in WO programs. Compared to those in MG programs, Hispanic women in WO programs demonstrated more severe treatment needs, indicated by their greater severity in drug and alcohol use, health and mental health problems, and criminal justice involvement at admission. They also had fewer economic resources (15% WO vs. 23% MG were employed, p<.05; 48% vs. 37% on public assistance, p<.05). Data based on administrative records covering 3 years pre-admission and 8 years post-admission showed that Hispanic women treated in WO programs had higher mental health service utilization over 8 years post-treatment admission, though no differences were found in trajectories of arrests and incarceration. In sum, long-term outcomes (in terms of criminal justice involvement) among Hispanic women in WO treatment were comparable to those in the MG treatment, despite greater service needs at admission. WO programs were able to engage more Hispanic women in use of mental health services. Future research should focus on factors limiting Hispanic women’s participation in WO programs, which could suggest ways for improvement so as to benefit all Hispanic women in need of these special services. PMID:22398357

Evaluation of a community-based sex offender treatment program using a good lives model approach.

PubMed

Harkins, Leigh; Flak, Vanja E; Beech, Anthony R; Woodhams, Jessica

2012-12-01

In this study the authors assessed a Good Lives model (GLM) approach to sex offender treatment and compare it to a standard Relapse Prevention program. The comparisons examined (a) attrition rates, (b) treatment change in areas targeted in treatment and achievement of a posttreatment treated profile, and (c) views of offenders and facilitators. There were no differences in the attrition rates or the rates of treatment change between the two programs, indicating that they were equally effective at retaining participants and achieving change on areas targeted within treatment. Both facilitators and program participants reported the Good Lives approach module's impact in a positive, future-focused manner. In contrast, those who attended the Relapse Prevention module did not report their perceptions and motivations in a manner that was focused on the positives in their future as frequently as those who attended the module with the Good Lives model approach.

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM TECHNOLOGY PROFILES: SIXTH EDITION

EPA Science Inventory

The Superfund Innovative Technology Evaluation (SITE) Program evaluates new and promising treatment and monitoring and measurement technologies for cleanup of hazardous waste sites. The program was created to encourage the development and routine use of innovative treatment techn...

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM - TECHNOLOGY PROFILES - SEVENTH EDITION

EPA Science Inventory

The Superfund Innovative Technology Evaluation (SITE) Program evaluates new and promising treatment and monitoring and measurement technologies for cleanup of hazardous waste sites. The program was created to encourage the development and routine use of innovative treatment techn...

Promoting weight control at the worksite: a pilot program of self-motivation using payroll-based incentives.

PubMed

Jeffery, R W; Forster, J L; Snell, M K

1985-03-01

Thirty-six individuals participated in a worksite weight-loss program in which the central component was a self-motivation program of biweekly payroll deductions refunded contingent on meeting self-selected weight-loss goals. Half were assigned to early treatment and the remainder to a delayed treatment control group. Nine additional individuals also enrolled at the time of delayed treatment and were included in descriptive analyses of factors associated with weight loss. Results showed low program attrition over 6 months (6%) and mean weight losses (12.3 lb) that are competitive with those obtained in clinical settings. Although not different at baseline, participants in the delayed treatment group lost more than twice as much weight as those in the early treatment condition. This difference was interpreted as either a strong seasonal effect or a critical mass effect related to the proportion of employees at the worksite participating in the program. We conclude that self-motivation programs for health behavior change using the payroll system as an organization framework offer a promising new methodology for promoting healthful behaviors in work settings.

Predictors of treatment attrition as indicators for program improvement not offender shortcomings: a study of sex offender treatment attrition.

PubMed

Beyko, Michelle J; Wong, Stephen C P

2005-10-01

This study classified potential attrition predictors under the domains of risk, need and responsivity (D. Andrews & J. Bonta, 2003). Non-sexual criminogenic needs (e.g. aggression, rule violating behaviors) and responsivity factors (e.g. lack of motivation and denial) were the two main clusters of predictors that correctly classified 95.3% of program completers and non-completers using discriminant function analysis in a sample of high-risk male sexual offenders treated in an accredited inpatient sex offender treatment program. Rapists were more aggressive than other types of sex offenders and were more likely to drop out of treatment. Some studies of predictors of treatment attrition have used offender problem behaviors or psychopathologies to predict attrition and then use the information to exclude offenders from treatment. Others have argued, and we concur, that results of attrition research should not be used to develop an "attrition profile" to exclude offenders from treatment. Predictors of attrition should be seen as markers for program improvement, rather than shortcomings of the offender. Suggestions for program improvements to reduce the rate of attrition, based on results of research, are presented.

Change in interpersonal problems after cognitive agoraphobia and schema-focused therapy versus psychodynamic treatment as usual of inpatients with agoraphobia and Cluster C personality disorders.

PubMed

Gude, Tore; Hoffart, Asle

2008-04-01

The aim was to study whether patients with panic disorder with agoraphobia and co-occurring Cluster C traits would respond differently regarding change in interpersonal problems as part of their personality functioning when receiving two different treatment modalities. Two cohorts of patients were followed through three months' in-patient treatment programs and assessed at follow-up one year after end of treatment. The one cohort comprised 18 patients treated with "treatment as usual" according to psychodynamic principles, the second comprised 24 patients treated in a cognitive agoraphobia and schema-focused therapy program. Patients in the cognitive condition showed greater improvement in interpersonal problems than patients in the treatment as usual condition. Although this quasi-experimental study has serious limitations, the results may indicate that agoraphobic patients with Cluster C traits should be treated in cognitive agoraphobia and schema-focused programs rather than in psychodynamic treatment as usual programs in order to reduce their level of interpersonal problems.

Long-term impact of integration of household water treatment and hygiene promotion with antenatal services on maternal water treatment and hygiene practices in Malawi.

PubMed

Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D; Ayers, Tracy; Hoekstra, Robert M; Quick, Robert

2013-02-01

A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants.

Evaluation of Drug Abuse Treatment Effectiveness: Summary of the DARP Followup Research. Treatment Research Report.

ERIC Educational Resources Information Center

Simpson, D. Dwayne; Sells, S. B.

The Drug Abuse Reporting Program (DARP) was initiated in 1969 as a federally supported client reporting system for community-based drug abuse treatment programs. Posttreatment follow-up interviews were conducted with over 4,000 persons from 34 treatment agencies to describe major findings from the drug abuse treatment research of the DARP relating…

Competing values among criminal justice administrators: The importance of substance abuse treatment.

PubMed

Henderson, Craig E; Taxman, Faye S

2009-08-01

This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators' attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators' attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models.

Competing Values Among Criminal Justice Administrators: The Importance of Substance Abuse Treatment*

PubMed Central

Henderson, Craig E.; Taxman, Faye S.

2009-01-01

This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators’ attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators’ attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models. PMID:19054632

Spanish language proficiency among providers and Latino clients' engagement in substance abuse treatment.

PubMed

Guerrero, Erick G; Khachikian, Tenie; Kim, Tina; Kong, Yinfei; Vega, William A

2013-12-01

Quality of care, such as provision of services in Spanish, is a common factor believed to improve treatment engagement among Spanish-speaking Latinos in health care. However, there is little evidence that Spanish language proficiency among providers increases treatment access and retention in publicly funded substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, California. An analytic sample of 1903 Latino clients nested within 40 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on days to initiate and spent in treatment. As hypothesized, Spanish language proficiency was negatively associated with client wait time and positively associated with retention in treatment, after controlling for individual and program characteristics. The path analysis models showed that Spanish language proficiency played a mediating role between professional accreditation and client wait time and retention. These preliminary findings provide an evidentiary base for the role of providers' Spanish language proficiency and Latino engagement in treatment for a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to enhance linguistically competent care, are discussed. © 2013.

Impact of early treatment programs on HIV epidemics: An immunity-based mathematical model.

PubMed

Rahman, S M Ashrafur; Vaidya, Naveen K; Zou, Xingfu

2016-10-01

While studies on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have demonstrated substantial advantages in controlling HIV transmission, the overall benefits of the programs with early initiation of antiretroviral therapy (ART) have not been fully understood and are still on debate. Here, we develop an immunity-based (CD4+ T cell count based) mathematical model to study the impacts of early treatment programs on HIV epidemics and the overall community-level immunity. The model is parametrized using the HIV prevalence data from South Africa and fully analyzed for stability of equilibria and infection persistence criteria. Using our model, we evaluate the effects of early treatment on the new infection transmission, disease death, basic reproduction number, HIV prevalence, and the community-level immunity. Our model predicts that the programs with early treatments significantly reduce the new infection transmission and increase the community-level immunity, but the treatments alone may not be enough to eliminate HIV epidemics. These findings, including the community-level immunity, might provide helpful information for proper implementation of HIV treatment programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

PubMed

Snowden, Lonnie R; McClellan, Sean R

2013-09-01

We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

PubMed Central

McClellan, Sean R.

2013-01-01

Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

The treatment of medial tibial stress syndrome in athletes; a randomized clinical trial

PubMed Central

2012-01-01

Background The only three randomized trials on the treatment of MTSS were all performed in military populations. The treatment options investigated in this study were not previously examined in athletes. This study investigated if functional outcome of three common treatment options for medial tibial stress syndrome (MTSS) in athletes in a non-military setting was the same. Methods The study design was randomized and multi-centered. Physical therapists and sports physicians referred athletes with MTSS to the hospital for inclusion. 81 athletes were assessed for eligibility of which 74 athletes were included and randomized to three treatment groups. Group one performed a graded running program, group two performed a graded running program with additional stretching and strengthening exercises for the calves, while group three performed a graded running program with an additional sports compression stocking. The primary outcome measure was: time to complete a running program (able to run 18 minutes with high intensity) and secondary outcome was: general satisfaction with treatment. Results 74 Athletes were randomized and included of which 14 did not complete the study due a lack of progress (18.9%). The data was analyzed on an intention-to-treat basis. Time to complete a running program and general satisfaction with the treatment were not significantly different between the three treatment groups. Conclusion This was the first randomized trial on the treatment of MTSS in athletes in a non-military setting. No differences were found between the groups for the time to complete a running program. Trial registration CCMO; NL23471.098.08 PMID:22464032

The Adoption of Wraparound Services among Substance Abuse Treatment Organizations Serving Criminal Offenders: The Role of a Women-Specific Program

PubMed Central

Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

2009-01-01

Women’s substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative’s National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n = 217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings. PMID:19181457

40 CFR 264.271 - Treatment program.

Code of Federal Regulations, 2013 CFR

2013-07-01

....271 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land... land treatment program that is designed to ensure that hazardous constituents placed in or on the...

40 CFR 264.271 - Treatment program.

Code of Federal Regulations, 2010 CFR

2010-07-01

....271 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land... land treatment program that is designed to ensure that hazardous constituents placed in or on the...

40 CFR 264.271 - Treatment program.

Code of Federal Regulations, 2014 CFR

2014-07-01

....271 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land... land treatment program that is designed to ensure that hazardous constituents placed in or on the...

40 CFR 264.271 - Treatment program.

Code of Federal Regulations, 2011 CFR

2011-07-01

....271 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land... land treatment program that is designed to ensure that hazardous constituents placed in or on the...

40 CFR 264.271 - Treatment program.

Code of Federal Regulations, 2012 CFR

2012-07-01

....271 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land... land treatment program that is designed to ensure that hazardous constituents placed in or on the...

The SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION program - Technology Profiles

EPA Science Inventory

The Superfund Innovative Technology Evaluation (SITE) program was created to evaluate new and promising treatment technologies for cleanup at hazardous waste sites. The mission of the SITE program is to encourage the development and routine use of innovative treatment technologie...

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM - TECHNOLOGY PROFILES 4th Edition

EPA Science Inventory

The Superfund Innovative Technology Evaluation (SITE) Program evaluates new and promising treatment technologies for cleanup of hazardous waste sites. The program was created to encourage the development and routine use of innovative treatment technologies. As a result, the SI...

The transition to medication adoption in publicly funded substance use disorder treatment programs: organizational structure, culture, and resources.

PubMed

Knudsen, Hannah K; Roman, Paul M

2014-05-01

Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform's impact on this sector of the treatment system.

Evidence-based treatment practices for drug-involved adults in the criminal justice system.

PubMed

Friedmann, Peter D; Taxman, Faye S; Henderson, Craig E

2007-04-01

The aim of this study was to estimate the extent and organizational correlates of evidence-based practices (EBPs) in correctional facilities and community-based substance abuse treatment programs that manage drug-involved adult offenders. Correctional administrators and treatment program directors affiliated with a national sample of 384 criminal justice and community-based programs providing substance abuse treatment to adult offenders in the United States were surveyed in 2004. Correctional administrators reported the availability of up to 13 specified EBPs, and treatment directors up to 15. The sum total of EBPs indicates their extent. Linear models regress the extent of EBPs on variables measuring structure and leadership, culture and climate, administrator attitudes, and network connectedness of the organization. Most programs offer fewer than 60% of the specified EBPs to drug-involved offenders. In multiple regression models, offender treatment programs that provided more EBPs were community based, accredited, and network connected, with a performance-oriented, nonpunitive culture, more training resources, and leadership with a background in human services, a high regard for the value of substance abuse treatment, and an understanding of EBPs. The use of EBPs among facility- and community-based programs that serve drug-involved adult offenders has room for improvement. Initiatives to disseminate EBPs might target these institutional and environmental domains, but further research is needed to determine whether such organization interventions can promote the uptake of EBPs.

EVIDENCE-BASED TREATMENT PRACTICES FOR DRUG-INVOLVED ADULTS IN THE CRIMINAL JUSTICE SYSTEM

PubMed Central

Friedmann, Peter D.; Taxman, Faye S.; Henderson, Craig E.

2007-01-01

OBJECTIVE To estimate the extent and organizational correlates of evidence-based practices (EBPs) in correctional facilities and community-based substance abuse treatment programs that manage drug-involved adult offenders. METHODS Correctional administrators and treatment program directors affiliated with a national sample of 384 criminal justice and community-based programs providing substance abuse treatment to adult offenders in the United States were surveyed in 2004. Correctional administrators reported the availability of up to 13 specified EBPs and treatment directors up to 15. The sum total of EBPs indicates their extent. Linear models regress the extent of EBPs on variables measuring structure and leadership, culture and climate, administrator attitudes and network connectedness of the organization. RESULTS Most programs offer fewer than 60% of the specified EBPs to drug-involved offenders. In multiple regression models, offender treatment programs that provided more EBPs were community-based, accredited, and network-connected; with a performance-oriented, non-punitive culture, more training resources; and leadership with a background in human services, a high regard for the value of substance abuse treatment and an understanding of EBPs. CONCLUSIONS The use of EBPs among facility- and community-based programs that serve drug-involved adult offenders has room for improvement. Initiatives to disseminate EBPs might target these institutional and environmental domains, but further research is needed to determine whether such organization interventions can promote the uptake of EBPs. PMID:17383551

Evolving a model for integrated treatment in a residential setting for people with psychiatric and substance use disorders.

PubMed

Mayes, John; Handley, Samantha

2005-01-01

This paper discusses the implementation of a residential, integrated treatment program serving dually diagnosed people with histories of homelessness. Attention is focused on the program structure and how the program developed over time. Program modifications tended to relax program rules and embrace a motivational, stage-wise model using harm-reduction principles. Despite initial skepticism regarding these modifications, outcomes such as program retention, abstinence from substances, employment, and hospitalization improved.

The effectiveness of alternative planned durations of residential drug abuse treatment.

PubMed Central

McCusker, J; Vickers-Lahti, M; Stoddard, A; Hindin, R; Bigelow, C; Zorn, M; Garfield, F; Frost, R; Love, C; Lewis, B

1995-01-01

Randomized controlled trials were conducted at two residential drug abuse treatment facilities to compare programs that differed in planned duration. One trial compared a 6-month and a 12-month therapeutic community program (n = 184), and the second compared a 3-month and a 6-month relapse prevention program (n = 444). Retention rates over comparable time periods differed minimally by planned treatment duration, and the longer programs had lower completion rates. There was no effect in either trial of planned treatment duration on changes in psychosocial variables between admission and exit or on rates or patterns of drug use at follow-up between 2 and 6 months after exit. PMID:7573630

Dual diagnosis capability in mental health and addiction treatment services: An assessment of programs across multiple state systems

PubMed Central

McGovern, Mark P.; Lambert-Harris, Chantal; Gotham, Heather J.; Claus, Ronald E.; Xie, Haiyi

2012-01-01

Despite increased awareness of the benefits of integrated services for persons with co-occurring substance use and psychiatric disorders, estimates of the availability of integrated services vary widely. The present study utilized standardized measures of program capacity to address co-occurring disorders, the Dual Diagnosis Capability in Addiction Treatment (DDCAT) and Dual Diagnosis Capability in Mental Health Treatment (DDCMHT) indexes, and sampled 256 programs across the United States. Approximately 18% of addiction treatment and 9% of mental health programs met criteria for dual diagnosis capable services. This is the first report on public access to integrated services using objective measures. PMID:23183873

Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

PubMed

Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

2016-04-01

Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Determining Appropriate Criteria in the Evaluation of Correctional Mental Health Treatment for Inmates.

ERIC Educational Resources Information Center

Alexander, Rudolph, Jr.

1992-01-01

Notes that, despite changed goals of mental health treatment for inmates, some prison treatment programs still evaluate effects in terms of adjustment indicators. Discusses and critiques proposals in Ohio to use adjustment indicators as outcome measures for new treatment program for mentally ill inmates. Discusses proper outcome measures for…

Drug Abuse Treatment in Prisons. Treatment Research Report.

ERIC Educational Resources Information Center

National Inst. for Advanced Studies, Washington, DC.

This report, based on a 1979 national survey of drug abuse treatment programs in the prisons of the 50 states and the District of Columbia, presents data on 160 operational programs. Descriptive information on the identification of drug-dependent inmates and the provision of drug abuse treatment by state adult correctional institutions is…

A gender-specific approach to improving substance abuse treatment for women: The Healthy Steps to Freedom program.

PubMed

Lindsay, Anne R; Warren, Cortney S; Velasquez, Sara C; Lu, Minggen

2012-07-01

Given that women increasingly report using drugs to lose weight, substance abuse treatment programs must include body image, weight, eating pathology, and health knowledge as core intervention targets. This study tested the efficacy of a supplemental health and body image curriculum designed for women in substance abuse treatment who report weight concerns called Healthy Steps to Freedom (HSF). Data from 124 adult women recruited from substance abuse treatment facilities in southern Nevada completed measures of drug use, body dissatisfaction, eating pathology, thin-ideal internalization, and health knowledge/behaviors before and after participation in the 12-week HSF program. Results revealed that thin-ideal internalization, body dissatisfaction, and eating disorder symptoms significantly decreased after HSF program participation, whereas health-related behaviors (e.g., increased healthy food consumption) and knowledge (e.g., understanding of basic nutrition, exercise) increased. These results suggest that the inclusion of the HSF program in substance abuse treatment improves weight-related issues in substance-abusing women. Copyright © 2012 Elsevier Inc. All rights reserved.

An Internet-based self-help treatment for fear of public speaking: a controlled trial.

PubMed

Botella, C; Gallego, M J; Garcia-Palacios, A; Guillen, V; Baños, R M; Quero, S; Alcañiz, M

2010-08-01

This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.

An investigation of the role of parental request for self-correction of stuttering in the Lidcombe Program.

PubMed

Donaghy, Michelle; Harrison, Elisabeth; O'Brian, Sue; Menzies, Ross; Onslow, Mark; Packman, Ann; Jones, Mark

2015-01-01

The Lidcombe Program is a behavioural treatment for stuttering in children younger than 6 years that is supported by evidence of efficacy and effectiveness. The treatment incorporates parent verbal contingencies for stutter-free speech and for stuttering. However, the contribution of those contingencies to reductions in stuttering in the program is unclear. Thirty-four parent-child dyads were randomized to two treatment groups. The control group received standard Lidcombe Program and the experimental group received Lidcombe Program without instruction to parents to use the verbal contingency request for self-correction. Treatment responsiveness was measured as time to 50% stuttering severity reduction. No differences were found between groups on primary outcome measures of the number of weeks and clinic visits to 50% reduction in stuttering severity. This clinical experiment challenges the assumption that the verbal contingency request for self-correction contributes to treatment efficacy. Results suggest the need for further research to explore this issue.

Cultural issues in an Outpatient Program for stimulant abusers.

PubMed

Pérez-Arce, P; Carr, K D; Sorensen, J L

1993-01-01

Cocaine abuse has created widespread problems, especially in poor urban ethnic minority communities. This article discusses the cultural issues in delivering a cocaine treatment program to a predominantly minority patient population. The Stimulant Treatment Outpatient Program (STOP) of San Francisco General Hospital's Substance Abuse Services was established in 1990 as a public service clinic. Many program elements apply equally well to various cultural groups, including individual and group counseling, limited time in treatment, and crisis intervention. Culturally linked clinical issues include provision of a supportive infrastructure, role models in leadership positions, understanding the cultural influences in patients' lives, and establishing communication links with Cultural themes are discussed as they apply to treating African-Americans, Latinos, Asian-Americans, Native Americans, and clients of different genders. Programmatic outcome indicators, including program attrition, suggest that different cultural groups benefit differentially from the treatment.

Fidelity and outcomes in six integrated dual disorders treatment programs.

PubMed

Chandler, Daniel W

2011-02-01

Fidelity scores and outcomes were measured in six outpatient programs in California which implemented Integrated Dual Disorders Treatment (IDDT). Outcomes were measured for 1 year in four sites and 2 years in two sites; fidelity was assessed at 6 month intervals. Three of the six sites achieved high fidelity (at least a 4 on a 5 point fidelity scale) and three moderate fidelity (at least a 3). Retention in treatment, mental health functioning, stage of substance abuse treatment, abstinence, and psychiatric hospitalization were measured. Outcomes for individual programs were generally positive but not consistent within programs or across programs. Using pooled data in a longitudinal regression model with random effects at person level and adjustment of standard errors for clustering by site, change over time was not statistically significant for the primary outcomes. Fidelity scores had limited association with positive outcomes.

Results from the DOE Advanced Gas Reactor Fuel Development and Qualification Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

David Petti

2014-06-01

Modular HTGR designs were developed to provide natural safety, which prevents core damage under all design basis accidents and presently envisioned severe accidents. The principle that guides their design concepts is to passively maintain core temperatures below fission product release thresholds under all accident scenarios. This level of fuel performance and fission product retention reduces the radioactive source term by many orders of magnitude and allows potential elimination of the need for evacuation and sheltering beyond a small exclusion area. This level, however, is predicated on exceptionally high fuel fabrication quality and performance under normal operation and accident conditions. Germanymore » produced and demonstrated high quality fuel for their pebble bed HTGRs in the 1980s, but no U.S. manufactured fuel had exhibited equivalent performance prior to the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program. The design goal of the modular HTGRs is to allow elimination of an exclusion zone and an emergency planning zone outside the plant boundary fence, typically interpreted as being about 400 meters from the reactor. To achieve this, the reactor design concepts require a level of fuel integrity that is better than that claimed for all prior US manufactured TRISO fuel, by a few orders of magnitude. The improved performance level is about a factor of three better than qualified for German TRISO fuel in the 1980’s. At the start of the AGR program, without a reactor design concept selected, the AGR fuel program selected to qualify fuel to an operating envelope that would bound both pebble bed and prismatic options. This resulted in needing a fuel form that could survive at peak fuel temperatures of 1250°C on a time-averaged basis and high burnups in the range of 150 to 200 GWd/MTHM (metric tons of heavy metal) or 16.4 to 21.8% fissions per initial metal atom (FIMA). Although Germany has demonstrated excellent performance of TRISO-coated UO2 particle fuel up to about 10% FIMA and 1150°C, UO2 fuel is known to have limitations because of CO formation and kernel migration at the high burnups, power densities, temperatures, and temperature gradients that may be encountered in the prismatic modular HTGRs. With uranium oxycarbide (UCO) fuel, the kernel composition is engineered to prevent CO formation and kernel migration, which are key threats to fuel integrity at higher burnups, temperatures, and temperature gradients. Furthermore, the recent poor fuel performance of UO2 TRISO fuel pebbles measured in Chinese irradiation testing in Russia and in German pebbles irradiated at 1250°C, and historic data on poorer fuel performance in safety testing of German pebbles that experienced burnups in excess of 10% FIMA [1] have each raised concern about the use of UO2 TRISO above 10% FIMA and 1150°C and the degree of margin available in the fuel system. This continues to be an active area of study internationally.« less

Benefit-cost analysis of addiction treatment: methodological guidelines and empirical application using the DATCAP and ASI.

PubMed

French, Michael T; Salomé, Helena J; Sindelar, Jody L; McLellan, A Thomas

2002-04-01

To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment. A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines. Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit-cost analysis and a sensitivity analysis of the estimates. The DATCAP was administered at three outpatient drug-free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7-months postadmission. The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit-cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se. This study used previously validated, research-proven instruments and methods to perform a practical benefit-cost analysis of real-world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.

Treatment outcomes for human African Trypanosomiasis in the Democratic Republic of the Congo: analysis of routine program data from the world's largest sleeping sickness control program.

PubMed

Hasker, E; Mpanya, A; Makabuza, J; Mbo, F; Lumbala, C; Kumpel, J; Claeys, Y; Kande, V; Ravinetto, R; Menten, J; Lutumba, P; Boelaert, M

2012-09-01

To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database. Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%). High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes. © 2012 Blackwell Publishing Ltd.

28 CFR 550.57 - Inmate appeals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.57 Inmate appeals. Inmates may seek formal review of complaints regarding the operation of the drug abuse treatment program by using administrative remedy procedures in 28...

28 CFR 550.57 - Inmate appeals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.57 Inmate appeals. Inmates may seek formal review of complaints regarding the operation of the drug abuse treatment program by using administrative remedy procedures in 28...

28 CFR 550.57 - Inmate appeals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.57 Inmate appeals. Inmates may seek formal review of complaints regarding the operation of the drug abuse treatment program by using administrative remedy procedures in 28...

28 CFR 550.57 - Inmate appeals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.57 Inmate appeals. Inmates may seek formal review of complaints regarding the operation of the drug abuse treatment program by using administrative remedy procedures in 28...

28 CFR 550.57 - Inmate appeals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.57 Inmate appeals. Inmates may seek formal review of complaints regarding the operation of the drug abuse treatment program by using administrative remedy procedures in 28...

Examining Treatment Climate Across Prison-Based Substance Abuse Treatment Groups.

PubMed

Kelly, Christopher E; Welsh, Wayne N

2016-06-06

With notable exceptions, few studies have looked critically at the role and effects of factors other than individual or programmatic differences that contribute to the climate within substance abuse treatment programs. De Leon's work on the therapeutic community, however, indicates that factors beyond the individual and program can contribute to the overall functioning of similarly situated communities. In this study, we introduce and examine the concept of the "treatment group," the level of aggregation between the individual who participates in treatment and the organization that provides it. The treatment group refers to the social context and dynamics that operate among treatment participants, and we sought to study differences in treatment climate across 12 prison-based treatment groups within a single prison. Using data from 604 participants who were assigned at random to one of the 12 groups, we analyzed differences on seven treatment climate indicators from one month and six months into the program across the treatment groups. No differences were found among the treatment groups at after one month; however, after 6 months, significant differences emerged across the groups on three treatment climate variables: program structure, counselor rapport, and counselor competence. This study is among the first of its kind to conceptualize and examine treatment climate across otherwise similar groups and find that differences emerge on several indicators of climate. As such, we argue that the treatment group may be important to consider in both the delivery and evaluation of substance abuse treatment.

Problem severity and motivation for treatment in incarcerated substance abusers.

PubMed

Hiller, Matthew L; Narevic, Egle; Webster, J Matthew; Rosen, Paul; Staton, Michele; Leukefeld, Carl; Garrity, Thomas F; Kayo, Rebecca

2009-01-01

Studies of community-based treatment programs for substance users document that motivation for treatment is a consistent predictor of clients remaining under treatment for a longer period of time. Recent research has replicated this in prison-based treatment programs, implying that motivation is clinically important regardless of setting. The current study examines predictors of treatment motivation using data collected from 661 male drug-involved inmates during in-depth interviews that include components of the Addiction Severity Index, TCU Motivation Scale, and the Heath Services Research Instrument. Findings showed treatment motivation can be measured effectively in prison-based settings. Motivation scores were not significantly different between individuals in a prison-based treatment program and those in the general prison population. Furthermore, higher motivation for treatment scores were associated with greater levels of problem severity, suggesting that individuals with more drug-use related life problems may recognize this need and desire help for beginning long-term recovery.

Availability and capacity of substance abuse programs in correctional settings: A classification and regression tree analysis.

PubMed

Taxman, Faye S; Kitsantas, Panagiota

2009-08-01

OBJECTIVE TO BE ADDRESSED: The purpose of this study was to investigate the structural and organizational factors that contribute to the availability and increased capacity for substance abuse treatment programs in correctional settings. We used classification and regression tree statistical procedures to identify how multi-level data can explain the variability in availability and capacity of substance abuse treatment programs in jails and probation/parole offices. The data for this study combined the National Criminal Justice Treatment Practices (NCJTP) Survey and the 2000 Census. The NCJTP survey was a nationally representative sample of correctional administrators for jails and probation/parole agencies. The sample size included 295 substance abuse treatment programs that were classified according to the intensity of their services: high, medium, and low. The independent variables included jurisdictional-level structural variables, attributes of the correctional administrators, and program and service delivery characteristics of the correctional agency. The two most important variables in predicting the availability of all three types of services were stronger working relationships with other organizations and the adoption of a standardized substance abuse screening tool by correctional agencies. For high and medium intensive programs, the capacity increased when an organizational learning strategy was used by administrators and the organization used a substance abuse screening tool. Implications on advancing treatment practices in correctional settings are discussed, including further work to test theories on how to better understand access to intensive treatment services. This study presents the first phase of understanding capacity-related issues regarding treatment programs offered in correctional settings.

Translating Addictions Research into Evidence-based Practice: the Polaris CD Outcomes Management System

PubMed Central

Toche-Manley, L.; Grissom, G.; Dietzen, L.; Sangsland, S.

2011-01-01

Converting the findings from addictions studies into information actionable by (non-research) treatment programs is important to improving program outcomes. This paper describes the translation of the findings of studies on Patient-Services matching, prediction of patient response to treatment (Expected Treatment Response) and prediction of dropout to provide evidence-based decision support in routine treatment. The findings of the studies and their application to the development of an outcomes management system are described. Implementation issues in a network of addictions treatment programs are discussed. The work illustrates how outcomes management systems can play an important role in translating research into practice. PMID:21324606

A model of nonparticipation in alcohol treatment programs.

PubMed

Burton, T L; Williamson, D L

1997-01-01

Why do the vast majority of those who suffer harm from drinking fail to obtain treatment? Based on a review of research literature and educational and treatment program materials, a model of nonparticipation in treatment is proposed whereby particular population groups are separated out according to whether or not they exhibit specified characteristics related to both harm from drinking and attitudes towards treatment. Eleven groups have been identified in the model, each of which has different reasons for failing to seek and/or obtain treatment. It is suggested that differing educational program messages should be sent to each group. While the model does not purport to be wholly inclusive of all nonparticipation, it offers a basis for addressing the variety of disparate groups that suffer harm from drinking but do not obtain treatment.

Healing the community to heal the individual

PubMed Central

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-01-01

ABSTRACT OBJECTIVE To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for long-term program sustainability. Programs require increased documentation of their inroads in this developing field. PMID:18625824

Didactic Migraine Education in US Doctor of Pharmacy Programs

PubMed Central

Padiyara, Rosalyn S.; Schommer, Jon C.

2010-01-01

Objective To compare didactic migraine education in doctor of pharmacy (PharmD) programs in the United States with the Headache Consortium's evidence-based migraine treatment recommendations. Methods A self-administered survey instrument was mailed to all 90 Accreditation Council for Pharmacy Education (ACPE) approved PharmD programs in the United States. Results Seventy-seven programs responded (86%) and 69 useable survey instruments were analyzed. Fifty-five percent of programs discussed the Consortium's guidelines, 49% discussed the selection of nonprescription versus prescription agents, 45% recommended a butalbital-containing product as migraine treatment, and 20% educated students about tools for assessing migraine-related debilitation. At least 50% of programs taught information consistent with the remaining Consortium recommendations. Conclusion Approximately half of the PharmD programs teach concepts about migraine headache treatment consistent with the US Headache Consortium's recommendations. PMID:20221355

Evaluation of 6 remote First Nations community-based buprenorphine programs in northwestern Ontario

PubMed Central

Mamakwa, Solomon; Kahan, Meldon; Kanate, Dinah; Kirlew, Mike; Folk, David; Cirone, Sharon; Rea, Sara; Parsons, Pierre; Edwards, Craig; Gordon, Janet; Main, Fiona; Kelly, Len

2017-01-01

Abstract Objective To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. Design Retrospective cohort study. Setting Six First Nations communities in northwestern Ontario. Participants A total of 526 First Nations participants in opioid-dependence treatment programs. Intervention Buprenorphine-naloxone substitution therapy and First Nations healing programming. Main outcome measures Retention rates and urine drug screening (UDS) results. Results Treatment retention rates at 6, 12, and 18 months were 84%, 78%, and 72%, respectively. We estimate that the rate at 24 months will also be more than 70%. The UDS programming varied and was implemented in only 1 community. Initially urine testing was voluntary and it then became mandatory. Screening with either method found the proportion of urine samples with negative results for illicit opioids ranged between 84% and 95%. Conclusion The program’s treatment retention rates and negative UDS results were higher than those reported for most methadone and buprenorphine-naloxone programs, despite a patient population where severe posttraumatic stress disorder is endemic, and despite the programs’ lack of resources and addiction expertise. Community-based programs like these overcome the initial challenge of cultural competence. First Nations communities in other provinces should establish their own buprenorphinenaloxone programs, using local primary care physicians as prescribers. Sustainable core funding is needed for programming, long-term aftercare, and trauma recovery for such initiatives. PMID:28209683

Case Manager Perspectives on the Role of Treatment in Supportive Housing for People with Severe Mental Illness

PubMed Central

Stanhope, Victoria; Choy-Brown, Mimi; Tiderington, Emmy; Henwood, Benjamin F.; Padgett, Deborah K.

2016-01-01

Objective Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an in-depth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. PMID:28163830

The From Survivor to Thriver Program: RCT of an online therapist-facilitated program for rape-related PTSD

PubMed Central

Littleton, Heather; Grills, Amie E.; Kline, Katherine D.; Schoemann, Alexander M.; Dodd, Julia C.

2016-01-01

This study evaluated the efficacy of the From Survivor to Thriver program, an interactive, online therapist-facilitated cognitive-behavioral program for rape-related PTSD. Eighty-seven college women with rape-related PTSD were randomized to complete the interactive program (n = 46) or a psycho-educational self-help website (n = 41). Both programs led to large reductions in interview-assessed PTSD at post-treatment (interactive d = 2.22, psycho-educational d = 1.10), which were maintained at three month follow-up. Both also led to medium- to large-sized reductions in self-reported depressive and general anxiety symptoms. Follow-up analyses supported that the therapist-facilitated interactive program led to superior outcomes among those with higher pre-treatment PTSD whereas the psycho-educational self-help website led to superior outcomes for individuals with lower pre-treatment PTSD. Future research should examine the efficacy and effectiveness of online interventions for rape-related PTSD including whether treatment intensity matching could be utilized to maximize outcomes and therapist resource efficiency. PMID:27513363

The From Survivor to Thriver program: RCT of an online therapist-facilitated program for rape-related PTSD.

PubMed

Littleton, Heather; Grills, Amie E; Kline, Katherine D; Schoemann, Alexander M; Dodd, Julia C

2016-10-01

This study evaluated the efficacy of the From Survivor to Thriver program, an interactive, online therapist-facilitated cognitive-behavioral program for rape-related PTSD. Eighty-seven college women with rape-related PTSD were randomized to complete the interactive program (n=46) or a psycho-educational self-help website (n=41). Both programs led to large reductions in interview-assessed PTSD at post-treatment (interactive d=2.22, psycho-educational d=1.10), which were maintained at three month follow-up. Both also led to medium- to large-sized reductions in self-reported depressive and general anxiety symptoms. Follow-up analyses supported that the therapist-facilitated interactive program led to superior outcomes among those with higher pre-treatment PTSD whereas the psycho-educational self-help website led to superior outcomes for individuals with lower pre-treatment PTSD. Future research should examine the efficacy and effectiveness of online interventions for rape-related PTSD including whether treatment intensity matching could be utilized to maximize outcomes and therapist resource efficiency. Copyright © 2016 Elsevier Ltd. All rights reserved.

Addiction Recovery: 12-Step Programs and Cognitive-Behavioral Psychology.

ERIC Educational Resources Information Center

Bristow-Braitman, Ann

1995-01-01

Provides helping professionals with an overview of treatment issues referred to as spiritual by those recovering from alcohol and drug addictions through 12-step programs. Reviews conflicts between academically trained helping professionals and researchers, and those advocating spiritually oriented treatment programs. Discusses spiritual…

Sex Offender Rehabilitation Programs in State Prisons: A Nationwide Survey.

ERIC Educational Resources Information Center

Sapp, Allen D.; Vaughn, Michael S.

1991-01-01

Examined programs and strategies for rehabilitation used in adult sex offender treatment programs in state-operated adult correctional institutions. Questionnaires were completed by 73 adult sex offender treatment providers. The results revealed that incarcerated adult sex offenders were receiving comprehensive psychotherapy and behavior…

Drugs and Gender: A Women's Recovery Program.

ERIC Educational Resources Information Center

Levers, Lisa Lopez; Hawes, Anderson R.

1990-01-01

Describes a drug treatment program designed and implemented for women which takes into account gender differences. Claims by paying attention to the actual life worlds and needs of women, the program effectively modified the service delivery system to accommodate these women and facilitate their treatment. (ABL)

MODELING THE AMBIENT CONDITION EFFECTS OF AN AIR-COOLED NATURAL CIRCULATION SYSTEM

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Rui; Lisowski, Darius D.; Bucknor, Matthew

The Reactor Cavity Cooling System (RCCS) is a passive safety concept under consideration for the overall safety strategy of advanced reactors such as the High Temperature Gas-Cooled Reactor (HTGR). One such variant, air-cooled RCCS, uses natural convection to drive the flow of air from outside the reactor building to remove decay heat during normal operation and accident scenarios. The Natural convection Shutdown heat removal Test Facility (NSTF) at Argonne National Laboratory (“Argonne”) is a half-scale model of the primary features of one conceptual air-cooled RCCS design. The facility was constructed to carry out highly instrumented experiments to study the performancemore » of the RCCS concept for reactor decay heat removal that relies on natural convection cooling. Parallel modeling and simulation efforts were performed to support the design, operation, and analysis of the natural convection system. Throughout the testing program, strong influences of ambient conditions were observed in the experimental data when baseline tests were repeated under the same test procedures. Thus, significant analysis efforts were devoted to gaining a better understanding of these influences and the subsequent response of the NSTF to ambient conditions. It was determined that air humidity had negligible impacts on NSTF system performance and therefore did not warrant consideration in the models. However, temperature differences between the building exterior and interior air, along with the outside wind speed, were shown to be dominant factors. Combining the stack and wind effects together, an empirical model was developed based on theoretical considerations and using experimental data to correlate zero-power system flow rates with ambient meteorological conditions. Some coefficients in the model were obtained based on best fitting the experimental data. The predictive capability of the empirical model was demonstrated by applying it to the new set of experimental data. The empirical model was also implemented in the computational models of the NSTF using both RELAP5-3D and STARCCM+ codes. Accounting for the effects of ambient conditions, simulations from both codes predicted the natural circulation flow rates very well.« less

Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

PubMed

McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

2004-09-01

Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

Adults with Pedophilic Interests in the United States: Current Practices and Suggestions for Future Policy and Research.

PubMed

Lasher, Michael P; Stinson, Jill D

2017-04-01

Adults with pedophilic interests are often viewed by the public as a homogenous subgroup based on what we know from those who sexually offend against children. The stigma associated with child sexual abuse may serve to deter such behaviors but may also interfere with the person's stability and willingness to seek assistance in managing pedophilic interests. This article contrasts the sex offender response and prevention efforts typically employed in the U.S. (i.e., containment, registration, and notification policies and public education programs) with treatment programs aimed at preventing child sexual abuse in Germany, Belgium, and Canada. Five major areas are identified that should be further examined with regard to implementing preventative outreach and treatment programs in the U.S.: barriers to outreach and treatment programs, how to expand or reframe current preventative educational programs, implementation of such programs in light of current mandating reporting policies, promising treatment approaches for pedophilic interests among non-offenders, and ethical concerns relevant to preventative psychological interventions.

Residential family treatment for parents with substance use disorders who are involved with child welfare: two perspectives on program design, collaboration, and sustainability.

PubMed

Hammond, Gretchen Clark; McGlone, Amanda

2013-01-01

This article discusses the service design, implementation, and evaluation findings of two residential family treatment programs: Wayside House (MN) and OnTrack (OR). Both programs specialize in family-centered services for adults with substance use disorders (SUD) who are involved with child welfare. Information on program design, services offered, and key collaborations are detailed. Implications for program sustainability are provided.

Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Bridgman, Kate; Onslow, Mark; O'Brian, Susan; Jones, Mark; Block, Susan

2016-01-01

Purpose: Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early…

A Guide to Dental Care for the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) Under Medicaid.

ERIC Educational Resources Information Center

Lindahl, Roy L.; Young, Wesley O.

This guide has been developed to assist administrators, providers of dental care, and others involved in carrying out the dental care provisions of the EPSDT program (Early and Periodic Screening, Diagnosis, and Treatment Program). It is intended to assist in the development of programs concerned with the unique characteristics of dental diseases…

Health Insurance Enrollment and Availability of Medications for Substance Use Disorders.

PubMed

Abraham, Amanda J; Rieckmann, Traci; Andrews, Christina M; Jayawardhana, Jayani

2017-01-01

Medications for treatment of substance use disorders are underutilized in treatment programs in the United States. Little is known about how insurance enrollment within states affects treatment program decisions about whether to offer medications. The primary objective of the study was to examine the impact of health insurance enrollment on availability of substance use disorder medications among treatment programs. Data from the 2012 National Survey of Substance Abuse Treatment Services, National Survey on Drug Use and Health, American Community Survey, Area Health Resource File, and the Substance Abuse and Mental Health Services Administration were combined to examine the impact of state insurance enrollment on availability of substance use disorder medications in treatment programs (N=9,888). A two-level, random-intercept logistic regression model was estimated to account for potential unobserved heterogeneity among treatment programs nested in states. The percentage of state residents with employer-based insurance and Medicaid was associated with greater odds of offering at least one medication among treatment programs. A 5% increase in the rate of private insurance enrollment was associated with a 7.7% increase in the probability of offering at least one medication, and a 5% increase in the rate of state Medicaid enrollment was associated with a 9.3% increase in the probability of offering at least one medication. Results point to the potential significance of health insurance enrollment in shaping the availability of substance use disorder medications. Significant expansions in health insurance enrollment spurred by the Affordable Care Act have the potential to increase access to medications for many Americans.

Quitting Smoking During Substance Use Disorders Treatment: Patient and Treatment-related Variables

PubMed Central

Campbell, Barbara K.; Le, Thao; Tajima, Barbara; Guydish, Joseph

2016-01-01

Although individuals in substance use disorders (SUD) treatment continue to smoke at high rates, regulatory, policy and programming changes promoting tobacco cessation are being implemented and some patients quit successfully. We examined associations of smoking patterns, tobacco advertising receptivity, anti-tobacco message awareness, health risk perception, attitudes towards addressing smoking and availability of smoking cessation services with quitting smoking during SUD treatment. Surveys were completed by 1127 patients in 24 programs chosen randomly, stratified by program type (residential, methadone maintenance, outpatient), from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Among respondents who had been in SUD treatment for at least one month, there were 631 current smokers and 52 former smokers who reported quitting smoking during treatment for at least one month prior to survey completion; these respondents comprised our sample (N=683). Results showed that participants who reported health concerns as a reason for quitting were 1.27 times more likely to have quit during treatment (p=.015) than those reporting health concerns affected quitting a little or not at all. Additionally, participants who reported that smoking cessation was part of their personal treatment plan during SUD treatment were 1.08 times more likely to have quit during treatment (p<.001). Participants in methadone treatment were 49% less likely to report successfully quitting during treatment than those in outpatient treatment (95%CI: 0. 35-0.75, p<.001). Leveraging health concerns about smoking and including smoking cessation in an individualized treatment plan may help increase smoking cessation during SUD treatment. PMID:28017183

The Development of a Substance Abuse Treatment Program for Forensic Patients with Cognitive Impairment

ERIC Educational Resources Information Center

Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.

2007-01-01

The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.

Assessing Conformity to Standards for Treatment Foster Care.

ERIC Educational Resources Information Center

Farmer, Elizabeth M. Z.; Burns, Barbara J.; Dubs, Melanie S.; Thompson, Shealy

2002-01-01

This study examined conformity to the Program Standards for Treatment Foster Care among 42 statewide programs. Findings suggest fair to good overall conformity, with considerable variation among programs. A discussion of methodological and substantive considerations for future research and evaluation using this approach is included. (Contains…

Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

ERIC Educational Resources Information Center

Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

2011-01-01

Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

Neuro-Linguistic Programming Treatment for Anxiety: Magic or Myth?

ERIC Educational Resources Information Center

Krugman, Martin; And Others

1985-01-01

Compared neuro-linguistic programing treatment for anxiety with self-control desensitization of equal duration and a waiting-list control group in treating public speaking anxiety. Results indicated that neither treatment was more effective in reducing anxiety than merely waiting for one hour. (Author/MCF)

Characteristics of substance abuse treatment programs providing services for HIV/AIDS, hepatitis C virus infection, and sexually transmitted infections: the National Drug Abuse Treatment Clinical Trials Network.

PubMed

Brown, Lawrence S; Kritz, Steven Allan; Goldsmith, R Jeffrey; Bini, Edmund J; Rotrosen, John; Baker, Sherryl; Robinson, Jim; McAuliffe, Patrick

2006-06-01

Illicit drug users sustain the epidemics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hepatitis C (HCV), and sexually transmitted infections (STIs). Substance abuse treatment programs present a major intervention point in stemming these epidemics. As a part of the "Infections and Substance Abuse" study, established by the National Drug Abuse Treatment Clinical Trials Network, sponsored by National Institute on Drug Abuse, three surveys were developed; for treatment program administrators, for clinicians, and for state and District of Columbia health and substance abuse department administrators, capturing service availability, government mandates, funding, and other key elements related to the three infection groups. Treatment programs varied in corporate structure, source of revenue, patient census, and medical and non-medical staffing; medical services, counseling services, and staff education targeted HIV/AIDS more often than HCV or STIs. The results from this study have the potential to generate hypotheses for further health services research to inform public policy.

Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

PubMed

Knudsen, Hannah K; Abraham, Amanda J

2012-01-01

Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

Perceptions of the State Policy Environment and Adoption of Medications in the Treatment of Substance Use Disorders

PubMed Central

Knudsen, Hannah K.; Abraham, Amanda J.

2012-01-01

Objective Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Methods Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. Results A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state’s Medicaid formulary and that state-contract funding permitted the purchase of medications. Conclusions States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment. PMID:22227755

DESALINATION AND WATER TREATMENT RESEARCH AT SANDIA NATIONAL LABORATORIES.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rigali, Mark J.; Miller, James E.; Altman, Susan J.

Water is the backbone of our economy - safe and adequate supplies of water are vital for agriculture, industry, recreation, and human consumption. While our supply of water today is largely safe and adequate, we as a nation face increasing water supply challenges in the form of extended droughts, demand growth due to population increase, more stringent health-based regulation, and competing demands from a variety of users. To meet these challenges in the coming decades, water treatment technologies, including desalination, will contribute substantially to ensuring a safe, sustainable, affordable, and adequate water supply for the United States. This overview documentsmore » Sandia National Laboratories' (SNL, or Sandia) Water Treatment Program which focused on the development and demonstration of advanced water purification technologies as part of the larger Sandia Water Initiative. Projects under the Water Treatment Program include: (1) the development of desalination research roadmaps (2) our efforts to accelerate the commercialization of new desalination and water treatment technologies (known as the 'Jump-Start Program),' (3) long range (high risk, early stage) desalination research (known as the 'Long Range Research Program'), (4) treatment research projects under the Joint Water Reuse & Desalination Task Force, (5) the Arsenic Water Technology Partnership Program, (6) water treatment projects funded under the New Mexico Small Business Administration, (7) water treatment projects for the National Energy Technology Laboratory (NETL) and the National Renewable Energy Laboratory (NREL), (8) Sandia- developed contaminant-selective treatment technologies, and finally (9) current Laboratory Directed Research and Development (LDRD) funded desalination projects.« less

PROMOTING SUPPORTIVE PARENTING IN NEW MOTHERS WITH SUBSTANCE-USE PROBLEMS: A PILOT RANDOMIZED TRIAL OF RESIDENTIAL TREATMENT PLUS AN ATTACHMENT-BASED PARENTING PROGRAM

PubMed Central

BERLIN, LISA J.; SHANAHAN, MEGHAN; CARMODY, KAREN APPLEYARD

2015-01-01

This pilot randomized trial tested the feasibility and efficacy of supplementing residential substance-abuse treatment for new mothers with a brief, yet rigorous, attachment-based parenting program. Twenty-one predominantly (86%) White mothers and their infants living together in residential substance-abuse treatment were randomly assigned to the program (n = 11) or control (n = 10) group. Program mothers received 10 home-based sessions of Dozier’s Attachment and Biobehavioral Catch-up (ABC) intervention. Postintervention observations revealed more supportive parenting behaviors among the randomly assigned ABC mothers. PMID:25424409

What sex abusers say about their treatment: results from a qualitative study on pedophiles in treatment at a Canadian penitentiary clinic.

PubMed

Drapeau, Martin; Korner, Annett C; Granger, Luc; Brunet, Louis

2005-01-01

This exploratory study used qualitative methodology to examine what pedophiles think about treatment, as well as their daily experience of a treatment program. To this end, twenty-three offenders receiving treatment from the La Macaza federal penitentiary clinic were interviewed using non-directive semi-structured interviews. Comparative analysis was used to analyze the resulting material. The following themes are discussed based on the results of this analysis: (a) the participants' past experience of therapy; (b) motivations for choosing the La Macaza clinic for treatment; (c) the structure of the program; (d) the group dynamics; (e) the therapists; and (f) the hardships and difficulties of treatment. Results suggest that the therapists and the program may have a function of containment or holding. Although part of the therapeutic process involves a focus on identifying and reducing cognitive distortions, results also warn therapists against misusing this concept by applying it to legitimately different opinions. Findings are discussed in terms of possible program improvements. The authors conclude that greater attention must be given to process research.

Successful treatment of chronic hepatitis C with pegylated interferon in combination with ribavirin in a methadone maintenance treatment program

PubMed Central

Litwin, Alain H.; Harris, Kenneth A.; Nahvi, Shadi; Zamor, Philippe J.; Soloway, Irene J.; Tenore, Peter L.; Kaswan, Daniel; Gourevitch, Marc. N.; Arnsten, Julia H.

2009-01-01

Injection drug users constitute 60% of the more than 4 million people in the United States with hepatitis C virus (HCV), including many methadone maintenance patients. Few data exist describing clinical outcomes for patients receiving HCV treatment on-site in a methadone maintenance settings. In this retrospective study, we describe clinical outcomes for 73 patients receiving HCV treatment on-site in a methadone maintenance treatment program. Fifty-five percent of patients achieved end-of-treatment response, and 45% achieved sustained viral response. These treatment response rates are nearly equivalent to previously published HCV treatment response rates, despite high prevalences of ongoing drug use (49%), psychiatric comorbidity (67%), and HIV coinfection (32%). These data show that on-site HCV treatment with pegylated interferon and ribavirin is effective in methadone-maintained patients, many of whom are active drug users, psychiatrically ill, or HIV coinfected, and that methadone maintenance treatment programs represent an opportunity to safely treat chronic hepatitis C. PMID:19038524

Motivation for Treatment Among Women Offenders in Prison-Based Treatment and Longitudinal Outcomes Among Those Who Participate in Community Aftercare

PubMed Central

Grella, Christine E.; Rodriguez, Luz

2011-01-01

Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their risk of recidivism. Surveys were conducted with women (N = 1,158) in prison-based substance abuse treatment programs. Return-to-prison was examined among participants in community-based aftercare (N = 1,182) over 12 months following treatment discharge. Higher treatment motivation was associated with child welfare involvement, prior treatment, and use of “harder” drugs; ethnic minority women had lower treatment motivation compared with White women. Participants who completed the aftercare program, or who had longer treatment duration, and those who had participated in an in-prison program prior to parole had reduced risk of recidivism. Study findings suggest the value of community aftercare for women offenders, particularly when combined with prior in-prison treatment. PMID:22185040

The Lidcombe Program and child language development: Long-term assessment.

PubMed

Imeson, Juliet; Lowe, Robyn; Onslow, Mark; Munro, Natalie; Heard, Rob; O'Brian, Sue; Arnott, Simone

2018-03-15

This study was driven by the need to understand the mechanisms underlying Lidcombe Program treatment efficacy. The aim of the present study was to extend existing data exploring whether stuttering reductions observed when children successfully treated with the Lidcombe Program are associated with restricted language development. Audio recordings of 10-min parent-child conversations at home were transcribed verbatim for 11 pre-school-age children with various stuttering severities. Language samples from three assessments-pre-treatment, 9 and 18 months after beginning treatment-were analysed using SALT software for lexical diversity, utterance length and sentence complexity. At 18 months posttreatment commencement, the children had attained and maintained statistically significant stuttering reductions. During that period, there was no evidence that Lidcombe Program treatment was associated with restricted language development. The continued search for the mechanisms underlying this successful treatment needs to focus on other domains.

Organizational Implementation of Evidence-Based Substance Abuse Treatment in Racial and Ethnic Minority Communities

PubMed Central

He, Amy; Kim, Ahraemi; Aarons, Gregory A.

2013-01-01

We evaluated organizational factors associated with the implementation of contingency management treatment (CMT) and medication-assisted treatment (MAT) in substance abuse treatment (SAT) programs serving racial and ethnic minority communities. Analysis of cross-sectional data collected in 2010–2011 from a random sample of 148 publicly funded SAT programs showed that accepting private insurance was positively associated with CMT and MAT implementation, whereas larger programs were associated with greater implementation of MAT. Supervisorial openness to and expectations about implementing evidence-based practices (EBPs) and attributes for change were strongly associated with CMT, whereas the interactions between openness to EBPs and programs that accept private insurance and that are governed by parent organizations were positively associated with MAT. These external expectations and managerial attitudes supported the implementation of psychosocial and pharmacotherapy treatments in SAT. Implications for improving standards of care in minority communities are discussed. PMID:24046236

Perceptions of Attrition and Family Participation: A Qualitative Study of Pediatric Obesity Clinicians

PubMed Central

Skelton, Joseph A.; Irby, Megan B.; Beech, Bettina M.; Rhodes, Scott D.

2012-01-01

Objective The majority of participants drop out of pediatric obesity treatment programs; however, clinicians have little knowledge of how to address this problem. The objective of this study was to explore obesity treatment clinicians’ perceptions of contributors to attrition, as well as methods to maintain family participation. Methods Semi-structured interviews were conducted with 29 pediatric obesity clinicians representing primary care (PC), community-based (CB), and tertiary-care (TC) treatment programs in North Carolina. Interviews were recorded, transcribed verbatim, and coded using a multistage inductive approach. Grounded theory was used to analyze responses. Results Eleven themes emerged from analysis, including: the influence of program elements, family characteristics, and the variety of approaches employed to address retention. Only TC programs reported attempts to address attrition. Patients’ past experiences with obesity treatment, desire for immediate outcomes, and relationships with clinicians were perceived as important factors related to attrition. Other important themes were: families’ understanding of obesity treatment; importance of realistic expectations; and families’ value of treatment. Important differences and similarities among programs were identified. All clinicians reported families came to treatment through physician-, not self-referral. Conclusions Clinicians perceive attrition to be a significant problem in pediatric obesity treatment. As a result of clinical interviews, several potential avenues to address attrition were identified, including: the need for clinicians to develop relationships with families, assist in building appropriate expectations, and address families’ value of treatment. Findings of this study can inform larger investigations of attrition, and guide exploration of family impressions of and experiences in treatment. PMID:22795203

The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives.

PubMed

Leibowitz, Scott F; Spack, Norman P

2011-10-01

Few interdisciplinary treatment programs that tend to the needs of youth with gender nonconforming behaviors, expressions, and identities exist in academic medical centers with formal residency training programs. Despite this, the literature provides evidence that these youth have higher rates of poor psychosocial adjustment and suicide attempts. This article explores the logistical considerations involved in developing a specialized interdisciplinary service to these gender minority youth in accordance with the existing treatment guidelines.Demographic data will be presented and treatment issues will be explored. The impact that a specialized interdisciplinary treatment program has on clinical expansion, research development, education and training, and community outreach initiatives is discussed.

An external evaluation of the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program in Gujarat and Uttar Pradesh, India.

PubMed

Lamberti, Laura M; Taneja, Sunita; Mazumder, Sarmila; LeFevre, Amnesty; Black, Robert E; Walker, Christa L Fischer

2015-12-01

To address inadequate coverage of oral rehydration salts (ORS) and zinc supplements for the treatment of diarrhea among children under-five, the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program was carried out from 2011-2013 in Gujarat and from 2011-2014 in Uttar Pradesh (UP), India. The program focused on improving the diarrhea treatment practices of public and private sector providers. We conducted cross-sectional household surveys in program districts at baseline and endline and constructed state-specific logistic regression models with generalized estimating equations to assess changes in ORS and zinc treatment during the program period. Between baseline and endline, zinc coverage increased from 2.5% to 22.4% in Gujarat and from 3.1% to 7.0% in UP; ORS coverage increased from 15.3% to 39.6% in Gujarat but did not change in UP. In comparison to baseline, children with diarrhea in the two-weeks preceding the endline survey had higher odds of receiving zinc treatment in both Gujarat (odds ratio, OR = 11.2; 95% confidence interval (CI) 6.4-19.3) and UP (OR = 2.4; 95% CI 1.4-3.9), but the odds of receiving ORS only increased in Gujarat (OR = 3.6; 95% CI 2.7-4.8; UP OR = 0.9; 95% CI 0.7-1.2). Seeking care outside the home, especially from a public sector source, was associated with higher odds of receiving ORS and zinc. During the duration of the DAZT program, there were modest improvements in the treatment of diarrhea among young children. Future programs should build upon and accelerate this trend with continued investment in public and private sector provider training and supply chain sustainability, in addition to targeted caregiver demand generation activities.

Impact of Community-Based HIV/AIDS Treatment on Household Incomes in Uganda

PubMed Central

Feulefack, Joseph F.; Luckert, Martin K.; Mohapatra, Sandeep; Cash, Sean B.; Alibhai, Arif; Kipp, Walter

2013-01-01

Though health benefits to households in developing countries from antiretroviral treatment (ART) programs are widely reported in the literature, specific estimates regarding impacts of treatments on household incomes are rare. This type of information is important to governments and donors, as it is an indication of returns to their ART investments, and to better understand the role of HIV/AIDS in development. The objective of this study is to estimate the impact of a community-based ART program on household incomes in a previously underserved rural region of Uganda. A community-based ART program, based largely on labor contributions from community volunteers, was implemented and evaluated. All households with HIV/AIDS patients enrolled in the treatment programme (n = 134 households) were surveyed five times; once at the beginning of the treatment and every three months thereafter for a period of one year. Data were collected on household income from cash earnings and value of own production. The analysis, using ordinary least squares and quantile regressions, identifies the impact of the ART program on household incomes over the first year of the treatment, while controlling for heterogeneity in household characteristics and temporal changes. As a result of the treatment, health conditions of virtually all patients improved, and household incomes increased by approximately 30% to 40%, regardless of household income quantile. These increases in income, however, varied significantly depending on socio-demographic and socio-economic control variables. Overall, results show large and significant impacts of the ART program on household incomes, suggesting large returns to public investments in ART, and that treating HIV/AIDS is an important precondition for development. Moreover, development programs that invest in human capital and build wealth are important complements that can increase the returns to ART programs. PMID:23840347

Sudden Gains in the Treatment of Depression in a Partial Hospitalization Program

ERIC Educational Resources Information Center

Drymalski, Walter M.; Washburn, Jason J.

2011-01-01

Objective: This study examines sudden gains (SGs), or rapid improvements in symptoms, among adults in treatment for depression in a partial hospitalization program (PHP). This study identifies the proportion of people who experience SGs in a PHP, when SGs occur in treatment, and the association of SGs with outcomes at the end of treatment. Method:…

49 CFR 40.291 - What is the role of the SAP in the evaluation, referral, and treatment process of an employee who...

Code of Federal Regulations, 2010 CFR

2010-10-01

... employee to an appropriate education and/or treatment program; (3) Conducting a face-to-face follow-up evaluation to determine if the employee has actively participated in the education and/or treatment program..., referral, and treatment process of an employee who has violated DOT agency drug and alcohol testing...

Measuring Parental Treatment Adherence in a Multimodal Treatment Program for Children with ADHD: A Preliminary Investigation

ERIC Educational Resources Information Center

Springer, Craig; Reddy, Linda A.

2010-01-01

This study evaluated the clinical significance of measuring between session parental adherence on child and parent outcomes for 51 children (age 4 to 8.5 years) with attention deficit/hyperactivity disorder (ADHD) in a multimodal group training program. Three group treatment conditions: (a) child-only treatment (C1), (c) child and parent training…

An Investigation of Language and Phonological Development and the Responsiveness of Preschool Age Children to the Lidcombe Program

ERIC Educational Resources Information Center

Rousseau, Isabelle; Packman, Ann; Onslow, Mark; Harrison, Elisabeth; Jones, Mark

2007-01-01

Knowledge of variables that predict treatment time is of benefit in deciding when to start treatment for early stuttering. To date, the only variable clearly related to treatment time with the Lidcombe Program is pre-treatment stuttering frequency. Previous studies have shown that children whose stuttering is more severe take longer to complete…

New York area and worldwide: call-in radio program on HIV.

PubMed

1999-07-16

Treatment activist Jules Levin, founder of the National AIDS Treatment Advocacy Group, has begun a weekly radio program called "Living Well with HIV". Listeners can call in with questions for experts featured on the show. Programs on hepatitis and AIDS have already been scheduled. Contact information is provided.

Summer Sports: A Recreationally Based Program for Building Peer Relations.

ERIC Educational Resources Information Center

Pelham, Jr., William E.; Gnagy, Elizabeth M.

1998-01-01

Describes the Summer Treatment Program (STP), a comprehensive sports training and treatment program for students with Attention Deficit/Hyperactivity Disorder. STP incorporates social-skills training, academic instruction, parent training, and medication evaluation. STP has been shown to be highly successful and its principles can be transferred…

Substance Abuse, Relapse, and Treatment Program Evaluation in Malaysia: Perspective of Rehab Patients and Staff Using the Mixed Method Approach

PubMed Central

Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Dang, Hoang Minh; Khairuddin, Rozainee

2016-01-01

This study examined reasons for substance abuse and evaluated the effectiveness of substance treatment programs in Malaysia through interviews with rehab patients and staff. Substance rehab patients (aged 18–69 years; n = 30) and staff (ages 30–72 years; n = 10) participated in semi-structured interviews covering a range of topics, including family and peer relationships, substance use and treatment history, factors for substance use and relapse, motivation for entering treatment, work experience, job satisfaction, treatment evaluation, and patient satisfaction. Most patients did not demonstrate the substance progression trend and had normal family relationships. Most patients reported having peers from normal family backgrounds as well. Various environmental and personal factors was cited as contributing to substance abuse and relapse. There was no significant difference between patient and staff program evaluation scores although the mean score for patients was lower. A holistic treatment approach with a combination of cognitive–behavioral, medical, social, and spiritual components was favored by patients. Suggestions for improving existing programs include better tailoring treatment to individual needs, and providing more post-treatment group support. PMID:27303313

Communication and quality of life outcomes from an interprofessional intensive, comprehensive, aphasia program (ICAP).

PubMed

Hoover, Elizabeth L; Caplan, David N; Waters, Gloria S; Carney, Anne

2017-03-01

Intensive Comprehensive Aphasia Programs (ICAPs) have developed in response to a growing need for treatments which produce changes in language function in people with aphasia, especially in the chronic phase of recovery. ICAPs are growing in number and several papers have presented preliminary results of their use, but little data exist about their efficacy or effectiveness. This paper explores the communication effects of an ICAP program that incorporated evidenced-based individual and group treatment in an interprofessional program. Twenty-seven individuals with chronic aphasia were provided with 30 h of interprofessional treatment a week for a four-week period in both individual and group formats. A delayed treatment, within-participant research protocol was used. Language measures were taken at two intervals pre- and two intervals post treatment. Functional, narrative, and quality of life measures were taken once pre and once post treatment. Significant change was observed on targeted language functions post treatment. Significant treatment effects were also observed on functional and quality of life measures as well as on all impairment-based language measures for the group. The results provide evidence of linguistic and quality of life change in individuals with chronic aphasia who were treated in an interprofessional ICAP.

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

Needs assessment and treatment compliance at state opioid substitution treatment programes in Georgia.

PubMed

Piralishvili, G; Gamkrelidze, I; Nikolaishvili, N; Chavchanidze, M

2013-01-01

conduct needs assessments and treatment compliance evaluations in MMT and Suboxone Substitution State Programs in Georgia (Republic of). 506 patients (2 females) were surveyed (92% on Methadone, 8% on Suboxone) from 6 Tbilisi and 4 regional State Programs in 2011 November. Mean age - 40±8,56 (22-65) year; 254 (51.4%) were in treatment for 1-3 year. Evaluation was carried out on the base of structured self-questionnaire that covers demographics, drug use history, general drug use trends, psychotherapeutic sessions' acceptance and open label question regarding treatment challenges and satisfaction. 305 (60.3%) attended individual and 57 (11.3%) group psychotherapy sessions with 50.79% attending once/month or rare. The main reason given for therapy non-attendance - no needs for it (29.48%); the main drugs before admission - heroin (80.04%), buprenorphine (53.49%); Main drugs used in Georgia nowadays - desomorphine ("crocodile"), alcohol and marihuana. Commonly used drugs by program patients (136 positive answers) - alcohol-13.62%, marihuana-10.39%, pregabalin - 8.17%, opioids- 6.62% (mostly-"crocodile"), home-made stimulants-6.23%, sedatives -5.45%. 55.4% are extremely satisfied with treatment, 82.4% - with program staff. Patients' main wishes- free of charge programs (46.4%) and provide take-home doses (22.07%). Methadone and Suboxone ST are being well accepted in Georgia and appear to be reducing illegal opioid use. However, the psychotherapeutic sessions' attendance is very low.

The promise of prison-based treatment for dually diagnosed inmates.

PubMed

Wexler, Harry K

2003-10-01

The Stay'n Out therapeutic community was created 25 years ago, the first rigorously evaluated prison program that demonstrated recidivism reduction. Since then, there has been a growing appreciation for the recidivism-reducing benefit of substance abuse treatment and the general understanding has been reached that prison treatment for substance abuse is good for the public interest. A number of replicated outcome studies have led to increases in treatment capacity in most state correctional systems, primarily utilizing the therapeutic community model. In contrast, efforts to introduce treatment for offenders with co-occurring mental illness and substance abuse disorders (COD) are only beginning. This article describes developments in prison substance abuse treatment and reentry programs and offers some guiding observations from prison substance abuse treatment history that could facilitate the development of COD treatment. Lessons learned include that: public safety (i.e., recidivism reduction) is a primary goal; personal accountability as a basic treatment value facilitates cooperation between treatment and correctional staff; self-help approaches foster more ambitious treatment goals than just symptom reduction; and well-run treatment programs often ease the burden of correctional administration.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Istanbul Water and Sewerage Administration (ISKI) was formed in 1982, and since that time a phased program of sewage collection and treatment has been implemented. Fifteen waste treatment plants, ranging from full scale biological treatment to pre-treatment, are in the design or planning stage, and over 2,000 km of collection lines have been installed. Concurrent with the program is an increasing emphasis on industrial waste treatment, which results in the production of both non-hazardous and hazardous sludges.

Constructive conflict and staff consensus in substance abuse treatment.

PubMed

Melnick, Gerald; Wexler, Harry K; Chaple, Michael; Cleland, Charles M

2009-03-01

Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.

"Transcend": initial outcomes from a posttraumatic stress disorder/substance abuse treatment program.

PubMed

Donovan, B; Padin-Rivera, E; Kowaliw, S

2001-10-01

This paper describes the development of a comprehensive treatment program for combat veterans diagnosed with posttraumatic stress disorder (PTSD) and substance abuse (SA). Outcome data are presented on 46 male patients who completed treatment between 1996 and 1998. The treatment approach, defined by a detailed manual, integrates elements of cognitive-behavioral skills training, constructivist theory approaches, SA relapse prevention strategies, and peer social support into a group-focused program. The Clinician-Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were used to assess treatment effectiveness at discharge and 6- and 12-month follow-up. Significant symptom changes revealed on CAPS and ASI scores at discharge and follow-up are analyzed. Discussion focuses on hypotheses regarding treatment effectiveness, study limitations, and suggestions for further research.

Psychoeducational and Cognitive Behavioral Treatment Programs: Implementation and Evaluation From 1995 to 2015 in Kraepelin's Former Hospital.

PubMed

Schaub, Annette; Hippius, Hanns; Möller, Hans-Jürgen; Falkai, Peter

2016-07-01

Programs that view individuals as capable of taking an active role in managing their illness have gained importance in Europe and the United States. This article describes the implementation and evaluation of group psychoeducational and cognitive behavioral treatment programs at the Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany, over the past 20 years. Implementing psychoeducational programs was the first step to establish cognitive behavioral psychotherapy and dispel the myth of schizophrenia for patients. Programs are also provided for patients with mood disorders, substance use disorders, or both. These groups include topics such as psychoeducation about the illness, establishing rewarding activities, stress management, cognitive therapy, and relapse prevention. More than 1000 patients with schizophrenia or mood disorders (380 schizophrenia, 563 major depression, and 110 bipolar) have participated in illness management groups to learn about their illness and its treatment, and to learn skills to manage their illness. Patients have expressed satisfaction with the programs, and research has supported their effectiveness. Individuals with severe disorders can benefit from psychoeducational and cognitive treatment programs if the programs are adapted to the level of neuropsychological functioning and compensate for cognitive deficits and emotional overload. These findings suggest that providing information about the illness and coping skills for patients and relatives are important for treatment outcome. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Availability of HIV-related health services in adolescent substance abuse treatment programs.

PubMed

Knudsen, H K; Oser, C B

2009-10-01

Given that alcohol and drug abuse heightens the risk of adolescents acquiring HIV, substance abuse treatment programs for youths may represent an important site of HIV prevention. In this research, we explored the adoption of three HIV-related health services: risk assessment during intake, HIV prevention programing, and HIV testing. Data were collection through telephone interviews with 149 managers of adolescent-only substance abuse treatment programs in the USA. About half of these programs had adopted HIV risk assessment and HIV prevention. On-site HIV testing was less widely adopted, with only one in four programs offering this service. At the bivariate level, the availability of on-site primary medical care and the availability of an overnight level of care were positively associated with these three types of services. The association for the measure of an overnight level of care was no longer significant once medical services were controlled. However, in a separate analysis, it was found that programs offering an overnight level of care were much more likely to offer on-site medical care than outpatient-only facilities. There was also evidence that publicly funded treatment programs were more likely to offer HIV prevention and on-site HIV testing, after controlling for other organizational characteristics. Much more research about the adoption of HIV-related services in adolescent substance abuse treatment is needed, particularly to offer greater insight into why certain types of organizations are more likely to adopt these health services.

A theory-based newsletter nutrition education program reduces nutritional risk and improves dietary intake for congregate meal participants.

PubMed

Francis, Sarah L; MacNab, Lindsay; Shelley, Mack

2014-01-01

At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, "food secure" White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P < .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control).

Substance Abuse-Specific Knowledge Transfer or Loss? Treatment Program Turnover versus Professional Turnover among Substance Abuse Clinicians

PubMed Central

Eby, Lillian T.; Curtis, Sara L.

2014-01-01

This longitudinal study investigated the extent to which substance abuse (SA) clinician turnover is associated with SA-specific knowledge loss due to change in professions (professional turnover) versus SA-specific knowledge transfer due to movement from one SA clinical setting to another (treatment program turnover). For this study, clinicians had to voluntarily leave their current treatment program. Eligible clinicians completed a quantitative survey while employed and a qualitative post-employment exit interview 1 year later. Compared to those that exited the SA profession (N = 99), clinicians who changed treatment programs (N = 120) had greater SA-specific formal knowledge and were more likely to be personally in recovery. No differences were found between the two groups in terms of SA-specific practical knowledge. PMID:25115318

Eye Color as a Predictor of Outcomes in Behavior Therapy.

ERIC Educational Resources Information Center

Markle, Allan; And Others

1984-01-01

Examined the relationship between outcomes of behaviorally oriented treatment for children (N=366) and eye color. Findings were consistent with theoretical expectations: Dark-eyed children and teenagers responded better to reactive treatment programs than their light-eyed counterparts, while the reverse was true for self-paced treatment programs.…

Attrition from an Adolescent Addiction Treatment Program: A Cross Validation.

ERIC Educational Resources Information Center

Mathisen, Kenneth S.; Meyers, Kathleen

Treatment attrition is a major problem for programs treating adolescent substance abusers. To isolate and cross validate factors which are predictive of addiction treatment attrition among adolescent substance abusers, screening interview and diagnostic variables from 119 adolescent in-patients were submitted to a discriminant equation analysis.…

Client Narratives about Experiences with a Multicouple Treatment Program for Intimate Partner Violence

ERIC Educational Resources Information Center

Todahl, Jeff; Linville, Deanna; Tuttle Shamblin, Abby F.; Ball, David

2012-01-01

A handful of clinical trials have concluded that conjoint couples treatment for intimate partner violence is safe and at least as effective as conventional batterer intervention programs, yet very few researchers have explored couples' perspectives on conjoint treatment. Using qualitative narrative analysis methodology, the researchers conducted…

75 FR 10485 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... programs (programs that pay for substance abuse treatment and prevention services, not for certain... the services. The provisions apply to the Substance Abuse Prevention and Treatment Block Grant (SAPT... (OMB) as part of the Substance Abuse Prevention and Treatment Block Grant FY 2008-2010 annual...

Water Treatment Plant Operation. Volume II. A Field Study Training Program.

ERIC Educational Resources Information Center

California State Univ., Sacramento. School of Engineering.

The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

Water Treatment Plant Operation. Volume I. A Field Study Training Program.

ERIC Educational Resources Information Center

California State Univ., Sacramento. School of Engineering.

The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

Treatment Service Patterns and Organizational Structures: An Analysis of Programs in DATOS-A.

ERIC Educational Resources Information Center

Delany, Peter J.; Broome, Kirk M.; Flynn, Patrick M.; Fletcher, Bennett W.

2001-01-01

Examined availability of various treatment services within a national sample of programs treating adolescent drug abuse patients. Created treatment service delivery profiles and examined them in context of organizational variables. Found that distinct profiles of services existed within residential and outpatient modalities and that these service…

The "REST" Program: A New Treatment System for the Oppositional Defiant Adolescent.

ERIC Educational Resources Information Center

Stein, David B.; Smith, Edward D.

1990-01-01

Compared REST (Real Economy System for Teens) program, which combines behavioral treatment and cognitive restructuring, with traditional talk therapy, which uses primarily cognitive restructuring, in treatment of oppositional defiant adolescents. Results showed significantly greater improvement on all target behaviors (room care, personal hygiene,…

A Copay Foundation Assistance Support Program for Patients Receiving Intravenous Cancer Therapy

PubMed Central

Rajurkar, Swapnil P.; Presant, Cary A.; Bosserman, Linda D.; McNatt, Wendy J.

2011-01-01

Purpose: With the advent of newer cancer therapies (eg, biologic and cytotoxic), treatment is becoming increasingly expensive for patients with cancer. Patients enrolled in Medicare and commercial insurance plans often have large copay requirements with each treatment cycle. Often, these patients undergo significant financial hardship, and some patients decline treatment. We have developed a support program that works closely with all copay assistance foundations to secure financial assistance to facilitate appropriate treatment. Methods: In September, 2008 we initiated a coordinated program with various copay assistance foundations, including Healthwell, Cancer Care, Patient Access, Chronic Disease Fund, Beckstrand Cancer, Lilly Cares and the Leukemia and Lymphoma Society. Patients requesting assistance with chemotherapy copay were enrolled in this program. Information about income level, chemotherapy regimens, and associated copay was given to these foundations, who then determined the amount of monetary assistance. Results: Since the initiation of this program, of 201 patients who began receiving chemotherapy, 25 (12.4%) requested assistance with this program for either intravenous or oral treatments. The current results of time delays for foundation decision, success rates and administrative costs to secure funding will be presented at the time of the poster presentation. Conclusion: Copay for chemotherapy drugs is a financial hardship for a significant number of patients. Coordinated resources must be provided and reimbursed to facilitate appropriate and sustainable cancer care. This program is a successful model for other centers to adopt. PMID:21731517

Development and Pilot Randomized Control Trial of a Drama Program to Enhance Well-being Among Older Adults

PubMed Central

Moore, Raeanne C.; Straus, Elizabeth; Dev, Sheena I.; Parish, Steven M.; Sueko, Seema; Eyler, Lisa T.

2016-01-01

Objective Develop a novel theatre-based program and test its feasibility, tolerability, and preliminary efficacy for improving empathy/compassion and well-being among older adults. Method Thirteen older adults were randomized to a 6-week Drama Workshop (DW) program or time-equivalent Backstage Pass (BP) control condition. Pre- and post-treatment measures included empathy, compassion, and mood scales. Additional post-treatment measures included self-rated change in empathy/compassion, confidence, and affect. Participants also rated their mood/affect after each session. Results The program was successfully completed and well-liked. No pre-to-post-treatment changes in empathy/compassion or mood symptoms were found in either group. Compared to BP, DW weekly ratings indicated higher levels of anxiety and lower happiness; however, the DW program had higher self-ratings of positive change in self-esteem, confidence, and happiness post-treatment. Discussion While the DW may not promote empathy/compassion and was personally challenging during the program, engagement in dramatic exercises and rehearsing and performing a dramatic piece was seen by participants as a positive growth experience, as indicated by the post-treatment ratings of enhanced self-esteem, confidence and happiness. Thus, such a program might be useful for counteracting some of the potential negative aspects of aging, including reduced self-efficacy due to physical limitations and negative affect due to losses. PMID:28503015

Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation

PubMed Central

Renton, Tian; Tang, Herman; Ennis, Naomi; Cusimano, Michael D; Bhalerao, Shree; Schweizer, Tom A

2014-01-01

Background Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. Objective The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? Methods Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. Results The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. Conclusions There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool. PMID:25249003

Web-based intervention programs for depression: a scoping review and evaluation.

PubMed

Renton, Tian; Tang, Herman; Ennis, Naomi; Cusimano, Michael D; Bhalerao, Shree; Schweizer, Tom A; Topolovec-Vranic, Jane

2014-09-23

Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool.

Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: implications for program evaluation.

PubMed

Lawn, Stephen D; Myer, Landon; Harling, Guy; Orrell, Catherine; Bekker, Linda-Gail; Wood, Robin

2006-09-15

The scale-up of antiretroviral treatment (ART) services in resource-limited settings requires a programmatic model to deliver care to large numbers of people. Understanding the determinants of key outcome measures--including death and nondeath losses--would assist in program evaluation and development. Between September 2002 and August 2005, all in-program (pretreatment and on-treatment) deaths and nondeath losses were prospectively ascertained among treatment-naive adults (n=1235) who were enrolled in a community-based ART program in South Africa. At study censorship, 927 patients had initiated ART after a median of 34 days after enrollment in the program. One hundred twenty-one (9.8%) patients died. Mortality rates were 33.3 (95% CI, 25.5-43.0), 19.1 (95% CI, 14.4-25.2), and 2.9 (95% CI, 1.8-4.8) deaths/100 person-years in the pretreatment interval, during the first 4 months of ART (early deaths), and after 4 months of ART (late deaths), respectively. Pretreatment and early treatment deaths together accounted for 87% of deaths, and were independently associated with advanced immunodeficiency at enrollment. Late deaths were comparatively few and were only associated with the response to ART at 4 months. Nondeath program losses (loss to follow-up, 2.3%; transfer-out, 1.9%; relocation, 0.7%) were not associated with immune status and were evenly distributed during the study period. Loss to follow-up and late mortality rates were low, reflecting good cohort retention and treatment response. However, the extremely high pretreatment and early mortality rates indicate that patients are enrolling in ART programs with far too advanced immunodeficiency. Causes of late access to the ART program, such as delays in health care access, health system delays, or inappropriate treatment criteria, need to be addressed.

Generating AN Optimum Treatment Plan for External Beam Radiation Therapy.

NASA Astrophysics Data System (ADS)

Kabus, Irwin

1990-01-01

The application of linear programming to the generation of an optimum external beam radiation treatment plan is investigated. MPSX, an IBM linear programming software package was used. All data originated from the CAT scan of an actual patient who was treated for a pancreatic malignant tumor before this study began. An examination of several alternatives for representing the cross section of the patient showed that it was sufficient to use a set of strategically placed points in the vital organs and tumor and a grid of points spaced about one half inch apart for the healthy tissue. Optimum treatment plans were generated from objective functions representing various treatment philosophies. The optimum plans were based on allowing for 216 external radiation beams which accounted for wedges of any size. A beam reduction scheme then reduced the number of beams in the optimum plan to a number of beams small enough for implementation. Regardless of the objective function, the linear programming treatment plan preserved about 95% of the patient's right kidney vs. 59% for the plan the hospital actually administered to the patient. The clinician, on the case, found most of the linear programming treatment plans to be superior to the hospital plan. An investigation was made, using parametric linear programming, concerning any possible benefits derived from generating treatment plans based on objective functions made up of convex combinations of two objective functions, however, this proved to have only limited value. This study also found, through dual variable analysis, that there was no benefit gained from relaxing some of the constraints on the healthy regions of the anatomy. This conclusion was supported by the clinician. Finally several schemes were found that, under certain conditions, can further reduce the number of beams in the final linear programming treatment plan.

Mental health programs seek religious following.

PubMed

Kim, H

1990-08-06

A handful of mental health treatment programs are building therapy around prayer sessions and Bible study in an attempt to attract mainstream Christians who otherwise would be wary about seeking treatment.

Quitting smoking during substance use disorders treatment: Patient and treatment-related variables.

PubMed

Campbell, Barbara K; Le, Thao; Tajima, Barbara; Guydish, Joseph

2017-02-01

Although individuals in substance use disorders (SUD) treatment continue to smoke at high rates, regulatory, policy and programming changes promoting tobacco cessation are being implemented and some patients quit successfully. We examined associations of smoking patterns, tobacco advertising receptivity, anti-tobacco message awareness, health risk perception, attitudes towards addressing smoking and availability of smoking cessation services with quitting smoking during SUD treatment. Surveys were completed by 1127 patients in 24 programs chosen randomly, stratified by program type (residential, methadone maintenance, outpatient), from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Among respondents who had been in SUD treatment for at least one month, there were 631 current smokers and 52 former smokers who reported quitting smoking during treatment for at least one month prior to survey completion; these respondents comprised our sample (N=683). Results showed that participants who reported health concerns as a reason for quitting were 1.27 times more likely to have quit during treatment (p=0.015) than those reporting health concerns affected quitting a little or not at all. Additionally, participants who reported that smoking cessation was part of their personal treatment plan during SUD treatment were 1.08 times more likely to have quit during treatment (p<0.001). Participants in methadone treatment were 49% less likely to report successfully quitting during treatment than those in outpatient treatment (95%CI: 0. 35-0.75, p<0.001). Leveraging health concerns about smoking and including smoking cessation in an individualized treatment plan may help increase smoking cessation during SUD treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Cohesion to the Group and Its Association with Attendance and Early Treatment Response in an Adult Day-Hospital Program for Eating Disorders: A Preliminary Clinical Investigation

ERIC Educational Resources Information Center

Crino, Natalie; Djokvucic, Ivana

2010-01-01

Treatment outcome studies demonstrate that day-hospital programs are effective in the treatment of eating disorders. Few descriptions are available on the specifics of treatment, particularly the process of therapy. The group therapy modality is thought to provide important therapeutic benefits. The present study aimed to examine the association…

Residential Substance Abuse Treatment for Urban American Indians and Alaska Natives, Part II: Costs.

PubMed

McFarland, Bentson H; Walker, Dale; Silk-Walker, Patricia

2017-01-01

The present study examined costs of two residential substance abuse treatment programs designed for urban American Indians and Alaska Natives (AI/ANs). Costs for one agency were well within national norms, while costs at the other program were less than expected from nationwide data. Economies of scale accounted for much of the difference between observed and expected costs. Culturally specific residential substance abuse treatment services can be provided to urban AI/ANs within budgets typically found at mainstream programs.

Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

ERIC Educational Resources Information Center

van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

2012-01-01

In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing…

A Census of Prison-Based Drug Treatment Programs: Implications for Programming, Policy, and Evaluation

ERIC Educational Resources Information Center

Welsh, Wayne N.; Zajac, Gary

2004-01-01

Despite a growing realization that unmeasured programmatic differences influence prison-based drug treatment effectiveness, few attempts to systematically measure such differences have been made. To improve program planning and evaluation in this area, we developed a census instrument to collect descriptive information about 118 prison-based drug…

Survey of CACREP-Accredited Programs: Training Counselors To Provide Treatment for Sexual Abuse.

ERIC Educational Resources Information Center

Kitzrow, Martha Anne

2002-01-01

Discusses the importance of training counselors to provide adequate treatment for survivors of sexual abuse. Presents the results of a survey of programs approved by the Council for Accreditation of Counseling and Related Educational Programs regarding current training practices, and offers recommendations and a model for developing a training…

The Effectiveness of Two Programs To Develop Visual Perception in Spanish Schoolchildren with Low Vision.

ERIC Educational Resources Information Center

Lopez-Justicia, Maria D.; Martos, Francisco J.

1999-01-01

This study compared improvements in visual function of 20 Spanish children with low vision, ages 4 to 6 years. Children received either the Barraga and Morris program or the Frostig program, or placebo control or no treatment. No significant differences between treatment groups were found. (DB)

Marijuana Use by Heroin Abusers as a Factor in Program Retention

ERIC Educational Resources Information Center

Ellner, Melvyn

1977-01-01

Primary heroin abusers who remained in a voluntary drug-free treatment program for an average of nine months were carefully matched with not-retained control subjects. Marijuana was used by the retained subjects as a heroin substitute and those who used marijuana were more apt to remain in the treatment program. (Author)

Outcomes of Parent Education Programs Based on Reevaluation Counseling

ERIC Educational Resources Information Center

Wolfe, Randi B.; Hirsch, Barton J.

2003-01-01

We report two studies in which a parent education program based on Reevaluation Counseling was field-tested on mothers randomly assigned to treatment groups or equivalent, no-treatment comparison groups. The goal was to evaluate the program's viability, whether there were measurable effects, whether those effects were sustained over time, and…

76 FR 47518 - Energy Conservation Program: Treatment of “Smart” Appliances in Energy Conservation Standards and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

... Conservation Program: Treatment of ``Smart'' Appliances in Energy Conservation Standards and Test Procedures... well as in test procedures used to demonstrate compliance with DOE's standards and qualification as an... development of energy conservation standards and test procedures for DOE's Appliance Standards Program and the...

Multidimensional Implementation Evaluation of a Residential Treatment Program for Adolescent Substance Abuse

ERIC Educational Resources Information Center

Faw, Leyla; Hogue, Aaron; Liddle, Howard A.

2005-01-01

The authors applied contemporary methods from the evaluation literature to measure implementation in a residential treatment program for adolescent substance abuse. A logic model containing two main components was measured. Program structure (adherence to the intended framework of service delivery) was measured using data from daily activity logs…

Analyzing for Individual Differences in Evaluating Compensatory Education Programs. Occasional Paper No. 27.

ERIC Educational Resources Information Center

Krus, Patricia H.

Trait-Treatment Interaction (TTI), a research method for observing experimental effects of treatments on subjects of different aptitudes and learning characteristics, is suggested as an effective evaluation tool to provide evaluators and educators in compensatory education programs with information about which program is best for different kinds…

The Treatment of Eating Disorder Clients in a Community-Based Partial Hospitalization Program.

ERIC Educational Resources Information Center

Levitt, John L.; Sansone, Randy A.

2003-01-01

Outlines a multi-faceted treatment approach to eating disorders within a partial hospital program that is affiliated with a community mental health hospital. Although empirical confirmation is not currently available, initial clinical impressions indicate that the program is facilitating the recovery of these difficult-to-treat individuals.…

Mood and Weight Loss in a Behavioral Treatment Program.

ERIC Educational Resources Information Center

Wing, Rena R.; And Others

1983-01-01

Evaluated the relationship between mood and weight loss for 76 patients participating in two consecutive behavioral treatment programs. Weight losses averaged 12.2 pounds (5.55 kg) during the 10-week program. Positive changes in mood were reported during this interval, and these changes appeared to be related to changes in weight. (Author/RC)

Tribal water utility management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-03-01

Contents: primacy program (what is primacy, advantages and disadvantages, treatment as a state, grant applications and funding); safe drinking water act (sampling requirements, coliform standard, public notification, surface water treatment rule impacts, uic and wellhead protection programs, lead/copper rule); water utility management (how is the utility program evaluated, who's responsible, what is the board and tribal council role).

Evaluating Predictors of Program Attrition among Women Mandated into Batterer Intervention Treatment

ERIC Educational Resources Information Center

Buttell, Frederick P.; Powers, Dolores; Wong, Asia

2012-01-01

Objective: The purpose of the present study was to evaluate pretreatment differences between treatment completers and dropouts among a large sample of women ordered into a 26-week batterer intervention program (BIP). Method: The study employed a nonequivalent, control-group design (comparing program completers to dropouts) in a secondary analysis…

School-Based Anxiety Treatments for Children and Adolescents

PubMed Central

Herzig-Anderson, Kathleen; Colognori, Daniela; Fox, Jeremy K.; Stewart, Catherine E.; Warner, Carrie Masia

2012-01-01

SUMMARY School-based empirically supported treatments for anxiety disorders are a promising avenue for providing necessary intervention to distressed youth who would otherwise never receive treatment. Sustaining such programs in school settings should be viewed as a multiple-stage process, from integration of the program into the institution and maintenance of the intervention to responding to institutional change and ownership of the program by the school.51 Given the scarce resources available to schools, additional research on embedding programs into the school culture and maximizing existing resources is essential to enhancing the sustainability of school-based interventions for anxiety disorders and reaching youth in need. PMID:22801000

Service dog training program for treatment of posttraumatic stress in service members.

PubMed

Yount, Rick A; Olmert, Meg D; Lee, Mary R

2012-01-01

In July 2008, social worker and certified service dog trainer Rick Yount created the first Warrior dog-training program designed to be a safe, effective, nonpharmaceutical intervention to treat the symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury in Veterans and service members undergoing treatment at a large Veterans Administration residential treatment facility. In 2009, Yount was asked to establish the program at a prominent Department of Defense medical center. In October 2010, Yount was invited to create a service dog training program to support the research and treatment mission at the new National Intrepid Center of Excellence (NICoE), in Bethesda, Maryland. This program, now being offered through the nonprofit foundation Warrior Canine Connection, continues to produce anecdotal evidence that training service dogs reduces the PTSD symptoms of Warrior-trainers and that the presence of the dogs enhances the sense of wellness in the NICoE staff and the families of our Wounded Warriors. Under the research leadership of the NICoE, the Warrior Canine Connection research team plans to systematically investigate the physiological, psychological, and behavioral benefits of this program.

The Texas Medication Algorithm Project Patient and Family Education Program: a consumer-guided initiative.

PubMed

Toprac, M G; Rush, A J; Conner, T M; Crismon, M L; Dees, M; Hopkins, C; Rowe, V; Shon, S P

2000-07-01

Educating patients with mental illness and their families about the illness and its treatment is essential to successful medication (disease) management. Specifically, education provides patients and families with the background they need to participate in treatment planning and implementation as full "partners" with clinicians. Thus, education increases the probability that appropriate and accurate treatment decisions will be made and that a treatment regimen will be followed. The Texas Medication Algorithm Project (TMAP) has incorporated these concepts into its philosophy of care and accordingly created a Patient and Family Education Program (PFEP) to complement the utilization of medication algorithms for the treatment of schizophrenic, bipolar, and major depressive disorders. This article describes how a team of mental health consumers, advocates, and professionals developed and implemented the PFEP. In keeping with the TMAP philosophy of care, consumers were true partners in the program's development and implementation. They not only created several components of the program and incorporated the consumer perspective, but they also served as program trainers and advocates. Initially, PFEP provides basic and subsequently more in-depth information about the illness and its treatment, including such topics as symptom monitoring and management and self-advocacy with one's treatment team. It includes written, pictorial, videotaped, and other media used in a phased manner by clinicians and consumer educators, in either individual or group formats.

A meta-analysis of predictors of offender treatment attrition and its relationship to recidivism.

PubMed

Olver, Mark E; Stockdale, Keira C; Wormith, J Stephen

2011-02-01

The failure of offenders to complete psychological treatment can pose significant concerns, including increased risk for recidivism. Although a large literature identifying predictors of offender treatment attrition has accumulated, there has yet to be a comprehensive quantitative review. A meta-analysis of the offender treatment literature was conducted to identify predictors of offender treatment attrition and examine its relationship to recidivism. The review covered 114 studies representing 41,438 offenders. Sex offender and domestic violence programs were also examined separately given their large independent literatures. The overall attrition rate was 27.1% across all programs (k = 96), 27.6% from sex offender programs (k = 34), and 37.8% from domestic violence programs (k = 35). Rates increased when preprogram attrition was considered. Significant predictors included demographic characteristics (e.g., age, rw = -.10), criminal history and personality variables (e.g., prior offenses, rw = .14; antisocial personality, rw = .14), psychological concerns (e.g., intelligence, rw = -.14), risk assessment measures (e.g., Statistical Information on Recidivism scale, rw =.18), and treatment-related attitudes and behaviors (e.g., motivation, rw = -.13). Results indicated that treatment noncompleters were higher risk offenders and attrition from all programs significantly predicted several recidivism outcomes ranging from rw = .08 to .23. The clients who stand to benefit the most from treatment (i.e., high-risk, high-needs) are the least likely to complete it. Offender treatment attrition can be managed and clients can be retained through an awareness of, and attention to, key predictors of attrition and adherence to responsivity considerations.

Efficacy of a multidisciplinary treatment program in patients with severe fibromyalgia.

PubMed

Casanueva-Fernández, Benigno; Llorca, Javier; Rubió, Josep Blanch I; Rodero-Fernández, Baltasar; González-Gay, Miguel A

2012-08-01

The purpose of this study was to evaluate the efficacy of a multidisciplinary treatment program in patients severely affected by fibromyalgia. Thirty-four fibromyalgia patients were randomly divided into two groups. The control group: 17 women who continued their medical treatment and participated in four educational sessions and the experimental group that included 17 patients who besides the former medical treatment also underwent a weekly 1-h session program for 8 weeks including massage therapy, ischemic pressure on the 18 tender points, aerobic exercise and thermal therapy. At the beginning of the program, there were no significant differences between the two groups in any of the parameters. At the end of treatment, there was a significant improvement in the experimental group in the following items: vitality, social functioning, grip strength and the 6-min walk test. At 1 month after the end of treatment, the experimental group showed significant differences in overall health perception, social functioning, grip strength and the 6-min walk test. At that time, considering the threshold for clinical efficacy set at an improvement of 30% or above for the analyzed variables, 25% of the patients met the requirement for improvement of the following: number of symptoms: Visual Analogic Scale for fatigue, Fibromyalgia Impact Questionnaire and Beck Anxiety Inventory. In conclusion, patients with severe manifestations of fibromyalgia can obtain improvement with a short-term, low-cost and simple-delivery multidisciplinary program. However, additional studies including higher numbers of patients are needed to confirm the beneficial effect of this treatment program.

Feasibility of a computer-assisted alcohol screening, brief intervention and referral to treatment program for DWI offenders.

PubMed

Mullen, Jillian; Ryan, Stacy R; Mathias, Charles W; Dougherty, Donald M

2015-11-09

Alcohol use patterns that are hazardous for one's health is prevalent among DWI (driving while intoxicated) offenders and is a key predictor of recidivism. The aim of this program evaluation was to determine the feasibility and usability of implementing a computer-assisted screening, brief intervention and referral to treatment (SBIRT) program for DWI offenders to enable the identification of those in need of treatment services soon after arrest. Our treatment program consisted of a web-based, self-guided screening tool for assessing alcohol use patterns and generating a personalized feedback report that is then used to deliver a brief motivational intervention and if needed, a referral to treatment. Between August and November 2014, all DWI offenders attending orientation for pre-trial supervision were assessed for eligibility. Of the 129 eligible offenders, 53.5 percent enrolled and the first 50 were asked to complete a usability and satisfaction questionnaire. The results demonstrated that the majority of those screened reported at-risk alcohol use patterns requiring referral to treatment. Clients reported high ratings of usability and satisfaction with the screening tool and personalized feedback report, which did not significantly differ depending on alcohol use patterns. There were relatively few technical difficulties, and the majority of clients reported high levels of satisfaction with the overall SBIRT program. Results of this program evaluation suggest that computer-assisted SBIRT may be successfully implemented within the criminal justice system to DWI offenders soon after arrest; however, further research is required to examine its effects on treatment utilization and recidivism.

Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia.

PubMed

Letebo, Mekitew; Shiferaw, Fassil

2016-06-02

Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organized and comprehensive response to NCDs. Lack of NCD national policy, strategies, treatment guidelines and surveillance and monitoring systems are features of health systems in many developing countries. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardization of patient and program monitoring tools. In this cross-sectional qualitative study we assessed existing monitoring and evaluation (M&E) tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, we explored the M&E tools being used in the program and analyzed how these tools might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. Our findings indicate the apparent lack of information systems for NCD services, including the absence of standardized patient and program monitoring tools to support the services. We identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardized tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardizing patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.

Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

PubMed

Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz

2015-11-01

There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley Periodicals, Inc. on behalf of Research Society on Alcoholism.

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

PubMed

Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

2017-10-01

School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

Schemes for Oestrus Synchronization Protocols and Controlled Breeding Programs in Cattle

NASA Astrophysics Data System (ADS)

Sabo, Y. G.; Sandabe, U. K.; Maina, V. A.; Balla, H. G.

Today prostaglandin and progesterone has been found widely used in several schemes of oestrus synchronization and controlled breeding program. Several controlled breeding program, have been developed for synchronizing groups of all open or lactating cows within a breeding group with or without ovarian palpation. Such programs are reviewed in this article which involves extending the luteal phase by treatment with exogenous progesterone such as: progesterone treatment regimes using syncro-mate-B, progesterone releasing intravaginal device, melengesterol acetate-select and melegestrol acetate plus prostaglandin. Also reviewed in the program is the termination of the luteal phase by treatment with prostaglandin or its analogues. These includes, controlled breeding without ovarian palpation such as, the 7-days program; 11-days program, target breeding, ovsynch program, Heat synch, Cosynch and pre synch-ovsynch program. In our opinion full potential of progesterone and prostaglandin for the detection of oestrus and timed artificial insemination should be utilized. This reduces the much labour input employed in previous years. The practitioner of the livestock herd health must-develop strategies for the delivery of this technology to livestock farmers, its use and limitations.

The SBIRT program matrix: a conceptual framework for program implementation and evaluation.

PubMed

Del Boca, Frances K; McRee, Bonnie; Vendetti, Janice; Damon, Donna

2017-02-01

Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of services to those at risk for the adverse consequences of alcohol and other drug use, and for those with probable substance use disorders. Research on successful SBIRT implementation has lagged behind studies of efficacy and effectiveness. This paper (1) outlines a conceptual framework, the SBIRT Program Matrix, to guide implementation research and program evaluation and (2) specifies potential implementation outcomes. Overview and narrative description of the SBIRT Program Matrix. The SBIRT Program Matrix has five components, each of which includes multiple elements: SBIRT services; performance sites; provider attributes; patient/client populations; and management structure and activities. Implementation outcomes include program adoption, acceptability, appropriateness, feasibility, fidelity, costs, penetration, sustainability, service provision and grant compliance. The Screening, Brief Intervention and Referral to Treatment Program Matrix provides a template for identifying, classifying and organizing the naturally occurring commonalities and variations within and across SBIRT programs, and for investigating which variables are associated with implementation success and, ultimately, with treatment outcomes and other impacts. © 2017 Society for the Study of Addiction.

The Canadian effort to prevent and control hypertension: can other countries adopt Canadian strategies?

PubMed

Campbell, Norm R C; Sheldon, Tobe

2010-07-01

To indicate the key elements of current Canadian programs to treat and control hypertension. In the early 1990s Canada had a hypertension treatment and control rate of 13%. A Canadian strategy to prevent and control hypertension was developed and a coalition of national organizations and volunteers formed to develop increasingly extensive programs. The Canadian effort was largely based on annually updated hypertension management recommendations, an integrated and extensive hypertension knowledge translation program and an increasingly comprehensive outcomes assessment program. After the start of the annual process in 1999, there were very large increases in diagnosis and hypertension treatment coupled with dropping rates of cardiovascular disease. More recent initiatives include an extensive education program for the public and people with hypertension, a program to reduce dietary salt and a funded leadership position. The treatment and control rate increased to 66% when last assessed (2007-2009). The study describes important aspects of the Canadian hypertension management programs to aid those wishing to develop similar programs. Many of the programs could be fully or partially implemented by other countries.

Cost-Utility and Cost-Effectiveness Analyses of Face-to-Face Versus Telephone-Based Nonpharmacologic Multidisciplinary Treatments for Patients With Generalized Osteoarthritis.

PubMed

Cuperus, Nienke; van den Hout, Wilbert B; Hoogeboom, Thomas J; van den Hoogen, Frank H J; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M

2016-04-01

To evaluate, from a societal perspective, the cost utility and cost effectiveness of a nonpharmacologic face-to-face treatment program compared with a telephone-based treatment program for patients with generalized osteoarthritis (GOA). An economic evaluation was carried out alongside a randomized clinical trial involving 147 patients with GOA. Program costs were estimated from time registrations. One-year medical and nonmedical costs were estimated using cost questionnaires. Quality-adjusted life years (QALYs) were estimated using the EuroQol (EQ) classification system, EQ rating scale, and the Short Form 6D (SF-6D). Daily function was measured using the Health Assessment Questionnaire (HAQ) disability index (DI). Cost and QALY/effect differences were analyzed using multilevel regression analysis and cost-effectiveness acceptability curves. Medical costs of the face-to-face treatment and telephone-based treatment were estimated at €387 and €252, respectively. The difference in total societal costs was nonsignificantly in favor of the face-to-face program (difference €708; 95% confidence interval [95% CI] -€5,058, €3,642). QALYs were similar for both groups according to the EQ, but were significantly in favor of the face-to-face group, according to the SF-6D (difference 0.022 [95% CI 0.000, 0.045]). Daily function was similar according to the HAQ DI. Since both societal costs and QALYs/effects were in favor of the face-to-face program, the economic assessment favored this program, regardless of society's willingness to pay. There was a 65-90% chance that the face-to-face program had better cost utility and a 60-70% chance of being cost effective. This economic evaluation from a societal perspective showed that a nonpharmacologic, face-to-face treatment program for patients with GOA was likely to be cost effective, relative to a telephone-based program. © 2016, American College of Rheumatology.

Patient’s self-evaluation of two education programs for age-related skin changes in the face: a prospective, randomized, controlled study

PubMed Central

Williams, Linda M; Alderman, Jane E; Cussell, Garry; Goldston, John; Hamilton, Neal; Lim, Adrian C; Goodman, Greg J; Halstead, Michael B; Rogers, John D

2011-01-01

Background: An interactive software program (HOYS) has been developed utilizing a database of digital images depicting various aspects and degrees of aging of exposed skin across seven geographic regions, representing a total of 35 facial and extrafacial subregions. A five-point photonumeric rating scale, which portrays age-related skin changes across five decades for each of these subregions, underpins this patient-based interactive self-assessment program. Based on the resulting outputs from this program, an individualized treatment prioritization list is generated for each region where significant differences between the patient’s chronological and esthetic ages exist. This provides guidance for the patient and the treating physician on treatment options. Methods: To evaluate the utility of HOYS in the clinic, relative to education programs currently used in Australian private esthetic clinics, a total of 95 esthetically-orientated patients were enrolled in a prospective, randomized, controlled, multicenter study. Results: Compared with a prospective cohort of patients completing a standard education program commonly utilized in Australian esthetic clinics, patients receiving the HOYS education program reported greater empowerment through improved knowledge of specific age-related skin changes. This was associated with a clearer understanding of treatment options available to them, and a perceived ability to participate in the selection of the treatments potentially administered to improve their appearance. These differences between the two education groups were highly significant. Conclusion: Patients completing the HOYS patient education program have an improved understanding of age-related changes to exposed skin of their face, neck, décolletage, and hands. Due to the patient-specific nature of the program, these patients perceive a greater role in the deciding which esthetic treatments should be subsequently administered to enhance their appearance, through an improved understanding of the rationale for these treatments and indeed how they should be prioritized to achieve the best outcome for them. PMID:22087069

Translational research: are community-based child obesity treatment programs scalable?

PubMed

Hardy, Louise L; Mihrshahi, Seema; Gale, Joanne; Nguyen, Binh; Baur, Louise A; O'Hara, Blythe J

2015-07-14

Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions. Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables. Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program. This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

Summer treatment programs for youth with ADHD.

PubMed

Fabiano, Gregory A; Schatz, Nicole K; Pelham, William E

2014-10-01

Children with attention-deficit/hyperactivity disorder (ADHD) require intensive treatments to remediate functional impairments and promote the development of adaptive skills. The summer treatment program (STP) is an exemplar of intensive treatment of ADHD. STP intervention components include a reward and response-cost point system, time-out, use of antecedent control (clear commands, establishment of rules and routines), and liberal praise and rewards for appropriate behavior. Parents also participate in parent management training programming to learn how to implement similar procedures within the home setting. There is strong evidence supporting the efficacy of the STP as an intervention for ADHD. Copyright © 2014 Elsevier Inc. All rights reserved.

Learning to pass: sex offenders' strategies for establishing a viable identity in the prison general population.

PubMed

Schwaebe, Charles

2005-12-01

This article endeavors to illustrate the realities of prison life for sex offenders and the means by which they attempt to establish viable identities and acquire a survivable niche in the prison general population, particularly when established identities and protective niches are put at risk by entry into a sex offender treatment program. Qualitative data was collected by repeatedly interviewing a cohort of sex offenders for 6 months as they completed a basic sex offender treatment program. The findings indicate a need to include consideration of treatment context in understanding the limits of treatment gain in prison-based programs.

Women's perceived benefits of exercise during and after breast cancer treatment.

PubMed

Bulmer, Sandra Minor; Howell, Jeremy; Ackerman, Louise; Fedric, Regan

2012-01-01

Empirical data support the benefits of physical activity for women who have been diagnosed with breast cancer. However, the experience of exercising during or after breast cancer treatment has not been fully documented. The purpose of the researchers in this study was to provide an in-depth description of women's experiences with exercising during or after their breast cancer treatments, specifically, their perceptions of the benefits they experienced as a result of participation in an individualized exercise program that included cardiovascular and resistance activities. Forty-five women who had been diagnosed with breast cancer within the previous two years were recruited from two oncology practices after electing to enroll in an exercise program. Data were collected between September 2006 and August 2007 through in-depth interviews at various stages in the exercise program and analyzed simultaneously using thematic analysis methods. Whether in treatment or post-treatment, women attributed psychological, physical, and social benefits to their participation in the exercise program. Participants credited the program with helping them to feel better, regain control over their bodies and their lives, manage their emotions, and prepare them to live healthfully going forward. These results provide insight into the specific ways women experience exercise during and after their breast cancer treatments.

The Chinese free antiretroviral treatment program: challenges and responses.

PubMed

Zhang, Fujie; Haberer, Jessica E; Wang, Yu; Zhao, Yan; Ma, Ye; Zhao, Decai; Yu, Lan; Goosby, Eric P

2007-12-01

To respond to the HIV/AIDS epidemic in China, the National Center for AIDS/STD Control and Prevention established the Division of Treatment and Care in late 2001. The pilot for the National Free ART Program began in Henan Province in 2002, and the program fully began in 2003. Treatment efforts initially focused on patients infected through illicit blood and plasma donation in the mid-1990s and subsequently expanded to include HIV-infected injection drug users, commercial sex workers, pregnant women, and children. The National Free ART Database was established in late 2004, and includes data on current patients and those treated before 2004. Over 31 000 adult and pediatric patients have been treated thus far. Challenges for the program include integration of drug treatment services with ART, an under-resourced health care system, co-infections, stigma, discrimination, drug resistance, and procurement of second-line ART. The merging of national treatment and care, epidemiologic, and drug resistance databases will be critical for a better understanding of the epidemic, for earlier identification of patients requiring ART, and for improved patient follow-up. The Free ART Program has made considerable progress in providing the necessary care and treatment for HIV-infected people in China and has strong government support for continued improvement and expansion.

The Coping Cat Program for Anxious Youth: The FEAR Plan Comes to Life

ERIC Educational Resources Information Center

Podell, Jennifer L.; Mychailyszyn, Matthew; Edmunds, Julie; Puleo, Connor M.; Kendall, Philip C.

2010-01-01

Manual-based treatments (therapist manuals, child workbooks) exist for the treatment of anxiety disorders in youth. The current article describes a cognitive-behavioral treatment program, "Coping Cat", for childhood anxiety, with an emphasis on its flexible application and implementation as well as video components to demonstrate aspects of the…

Treating Tobacco Dependence: Development of a Smoking Cessation Treatment Program for Outpatient Mental Health Clinics

ERIC Educational Resources Information Center

Gulliver, Suzy Bird; Wolfsdorf, Barbara A.; Morissette, Sandra Baker

2004-01-01

Response to smoking cessation treatment programs sharply decreases when applied to smokers with psychiatric comorbidities. Consequently, the development of smoking cessation treatments that address the needs of psychiatric patients is greatly needed. The primary purpose of this article is to detail the process of development of an empirically…

78 FR 62506 - TRICARE; Coverage of Care Related to Non-Covered Initial Surgery or Treatment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... Supplemental Health Care Program waiver. This proposed rule is necessary to protect TRICARE beneficiaries from...-covered surgery or treatment was necessary to assure adequate availability of health care to the Active... Regulatory Actions Under the TRICARE private sector health care program, certain conditions and treatments...

Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity

ERIC Educational Resources Information Center

Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna

2008-01-01

Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…

The Relationship between Pre-Treatment Clinical Profile and Treatment Outcome in an Integrated Stuttering Program

ERIC Educational Resources Information Center

Huinck, Wendy J.; Langevin, Marilyn; Kully, Deborah; Graamans, Kees; Peters, Herman F. M.; Hulstijn, Wouter

2006-01-01

A procedure for subtyping individuals who stutter and its relationship to treatment outcome is explored. Twenty-five adult participants of the Comprehensive Stuttering Program (CSP) were classified according to: (1) stuttering severity and (2) severity of negative emotions and cognitions associated with their speech problem. Speech characteristics…

Operation of Wastewater Treatment Plants. Volume 1. A Field Study Training Program. Third Edition. Revised.

ERIC Educational Resources Information Center

California State Univ., Sacramento. Dept. of Civil Engineering.

The purpose of this wastewater treatment field study training program is to: (1) develop new qualified wastewater treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

Issues in the Analysis of Selectivity Bias. Discussion Papers. Revised.

ERIC Educational Resources Information Center

Barnow, Burt S.; And Others

Selectivity bias arises in program evaluation when the treatment or control status of the subjects is related to unmeasured characteristics that themselves are related to the program outcome under study. This situation has the potential to lead to an incorrect estimation of the treatment effect when assignment to treatment and control groups is…

Water Treatment Plant Operation Volume 2. A Field Study Training Program. Revised.

ERIC Educational Resources Information Center

California State Univ., Sacramento. School of Engineering.

The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals that incur indirect costs for graduate medical education programs. 412.105 Section 412.105 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective...

An Evaluation of Programmed Treatment-integrity Errors during Discrete-trial Instruction

ERIC Educational Resources Information Center

Carroll, Regina A.; Kodak, Tiffany; Fisher, Wayne W.

2013-01-01

This study evaluated the effects of programmed treatment-integrity errors on skill acquisition for children with an autism spectrum disorder (ASD) during discrete-trial instruction (DTI). In Study 1, we identified common treatment-integrity errors that occur during academic instruction in schools. In Study 2, we simultaneously manipulated 3…

Multidisciplinary Treatment of Eating Disorders - Part 2: Primary Goals and Content of Treatment

ERIC Educational Resources Information Center

Stewart, Tiffany M.; Williamson, Donald A.

2004-01-01

This article describes the program content of a multidisciplinary, hospital-based program for severe eating disorders. Common goals for treatment of patients with eating disorders are discussed. Details about the specific therapeutic strategies used in individual and group therapy are provided. Also, information about dietary counseling and…

A Model for the Inclusion of a Physical Fitness and Health Promotion Component in a Chemical Abuse Treatment Program.

ERIC Educational Resources Information Center

Fridinger, Fred; Dehart, Beverly

1993-01-01

Describes treatment program at Charter Hospital in Fort Worth, Texas, which incorporates comprehensive medical examination, fitness and nutritional screenings, and appropriate exercise activities into alcohol and other substance abuse treatment. Notes that educational sessions are offered on health fitness, risk reduction, stress management,…

42 CFR 485.641 - Condition of participation: Periodic evaluation and quality assurance review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... program to evaluate the quality and appropriateness of the diagnosis and treatment furnished in the CAH and of the treatment outcomes. The program requires that— (1) All patient care services and other... therapy are evaluated; (3) The quality and appropriateness of the diagnosis and treatment furnished by...

The Role of Transport Use in Adolescent Wilderness Treatment: Its Relationship to Readiness to Change and Outcomes

ERIC Educational Resources Information Center

Tucker, Anita R.; Bettmann, Joanna E.; Norton, Christine L.; Comart, Casey

2015-01-01

Background: Considering the sensitive ethical issues related to involuntary treatment of adolescents, research investigating youth transport practices and treatment outcomes is clearly needed. Youth transport is common practice in many private pay programs, including wilderness therapy programs. Objective: This study of 350 adolescents in…

Design Seminar for Land Treatment of Municipal Wastewater Effluents.

ERIC Educational Resources Information Center

Demirjian, Y. A.

This document reports the development and operation of a country-wide wastewater treatment program. The program was designed to treat liquid wastewater by biological treatment in aerated lagoons, store it, and then spray irrigate on crop farmland during the growing season. The text discusses the physical design of the system, agricultural aspects,…

21 CFR 1301.72 - Physical security controls for non-practitioners; narcotic treatment programs and compounders for...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Physical security controls for non-practitioners... security controls for non-practitioners; narcotic treatment programs and compounders for narcotic treatment... shall have the following specifications or the equivalent: 30 man-minutes against surreptitious entry...

21 CFR 1301.72 - Physical security controls for non-practitioners; narcotic treatment programs and compounders for...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Physical security controls for non-practitioners... security controls for non-practitioners; narcotic treatment programs and compounders for narcotic treatment... shall have the following specifications or the equivalent: 30 man-minutes against surreptitious entry...

21 CFR 1301.72 - Physical security controls for non-practitioners; narcotic treatment programs and compounders for...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Physical security controls for non-practitioners... security controls for non-practitioners; narcotic treatment programs and compounders for narcotic treatment... shall have the following specifications or the equivalent: 30 man-minutes against surreptitious entry...

21 CFR 1301.72 - Physical security controls for non-practitioners; narcotic treatment programs and compounders for...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Physical security controls for non-practitioners... security controls for non-practitioners; narcotic treatment programs and compounders for narcotic treatment... shall have the following specifications or the equivalent: 30 man-minutes against surreptitious entry...

Substance Use, Education, Employment, and Criminal Activity Outcomes of Adolescents in Outpatient Chemical Dependency Programs

PubMed Central

Balsa, Ana I.; Homer, Jenny F.; French, Michael T.; Weisner, Constance M.

2010-01-01

Although the primary outcome of interest in clinical evaluations of addiction treatment programs is usually abstinence, participation in these programs can have a wide range of consequences. This study evaluated the effects of treatment initiation on substance use, school attendance, employment, and involvement in criminal activity at 12 months post-admission for 419 adolescents (aged 12 to 18) enrolled in chemical dependency recovery programs in a large managed care health plan. Instrumental variables estimation methods were used to account for unobserved selection into treatment by jointly modeling the likelihood of participation in treatment and the odds of attaining a certain outcome or level of an outcome. Treatment initiation significantly increased the likelihood of attending school, promoted abstinence, and decreased the probability of adolescent employment, but it did not significantly affect participation in criminal activity at the 12-month follow-up. These findings highlight the need to address selection in a non-experimental study and demonstrate the importance of considering multiple outcomes when assessing the effectiveness of adolescent treatment. PMID:18064572

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial.

PubMed

Oei, T P S; Raylu, N; Lai, W W

2018-06-01

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η 2 ) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.

Evaluation of a therapeutic community treatment program: a long-term follow-up study in Spain.

PubMed

Fernández-Montalvo, Javier; López-Goñi, José J; Illescas, Cristina; Landa, Natalia; Lorea, Iñaki

2008-01-01

The aims of this study is to carry out a long-term follow-up evaluation of a well-established therapeutic community treatment for addictions in Navarre (Spain) and to make a comparison between the program completers and the dropouts, as well as between relapsing and nonrelapsing patients, on a broad set of variables. A long-term follow-up design (mean of 6 years after leaving treatment) was used to analyze the outcomes of the therapeutic program. The sample consisted of 155 subjects (113 completers and 42 dropouts). A personal interview was carried out with each one of the located subjects. The interviews took place between September 2000 and September 2004. Treatment "dropouts" manifested a higher and earlier rate both of relapses, and of new treatments for their drug addiction than the completion group. The program was also effective in reducing criminal behavior and improving the state of health. Significant differences were found across outcome variables when comparison was made between treatment completers and "dropouts." All subjects improved on outcome variables after receiving the treatment. When relapsing and nonrelapsing patients were compared, significant outcome differences were also found between groups. The study's limitations are noted and future needed research is suggested.

Alcohol Screening among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program.

PubMed

Klimas, Jan; Muench, John; Wiest, Katharina; Croff, Raina; Rieckman, Traci; McCarty, Dennis

2015-01-01

Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention, and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n = 208) and in an opioid treatment program (n = 204) over a two-year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. In the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counselors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested that organizational, structural, provider, patient, and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow.

Acceptance and relationship context: a model of substance use disorder treatment outcome.

PubMed

Gifford, Elizabeth V; Ritsher, Jennifer B; McKellar, John D; Moos, Rudolf H

2006-08-01

This study presented and tested a model of behavior change in long-term substance use disorder recovery, the acceptance and relationship context (ARC) model. The model specifies that acceptance-based behavior and constructive social relationships lead to recovery, and that treatment programs with supportive, involved relationships facilitate the development of these factors. This study used a prospective longitudinal naturalistic design and controlled for baseline levels of study variables. The model was tested on a sample of 2549 patients in 15 residential substance use disorder treatment programs. Acceptance-based responding (ABR), social relationship quality (SRQ), treatment program alliance (TPA) and substance use-related impairment were assessed using interviews and self-report questionnaires. TPA predicted ABR and SRQ and, in turn, ABR predicted better 2-year and 5-year treatment outcomes. The baseline-controlled model accounted for 41% of the variance in outcome at 2-year follow-up and 28% of the variance in outcome at 5-year follow-up. CONCLUSIONS Patients from treatment programs with an affiliative relationship network are more likely to respond adaptively to internal states associated previously with substance use, develop constructive social relationships and achieve long-term treatment benefits.

Retention predictors related to intensive outpatient programs for substance use disorders.

PubMed

Veach, L J; Remley, T P; Kippers, S M; Sorg, J D

2000-08-01

The purpose of this research was to expand knowledge in the current literature regarding treatment retention in intensive outpatient substance abuse treatment programs. The sample in this study participated in a hospital-based program accredited by the Joint Commission on Accreditation for Health Organizations (JCAHO) that utilized the Minnesota model. Specifically, this inquiry investigated whether treatment retention would be predicted by gender, age, employment status, number of problems on the treatment plan, whether the referral was related to driving while intoxicated (DWI), marital status, race, and whether each of the following substance problems was listed as the client's primary DSM-IV diagnosis: alcohol dependence, cocaine dependence, polysubstance dependence, opioid dependence, sedative/hypnotic dependence, cannabis dependence, other (or unknown) dependence, alcohol abuse, cannabis abuse, amphetamine abuse, and caffeine intoxication. Findings indicated that those retained in treatment, when compared to those who dropped out, had significantly more problems on their treatment plans, were more likely to be alcoholics, were less often cocaine addicts, and were more likely to be employed. The results of this study suggest that clients with this profile have increased likelihood of being retained in intensive outpatient substance abuse treatment programs.

Thermodynamic analysis of the efficiency of high-temperature steam electrolysis system for hydrogen production

NASA Astrophysics Data System (ADS)

Mingyi, Liu; Bo, Yu; Jingming, Xu; Jing, Chen

High-temperature steam electrolysis (HTSE), a reversible process of solid oxide fuel cell (SOFC) in principle, is a promising method for highly efficient large-scale hydrogen production. In our study, the overall efficiency of the HTSE system was calculated through electrochemical and thermodynamic analysis. A thermodynamic model in regards to the efficiency of the HTSE system was established and the quantitative effects of three key parameters, electrical efficiency (η el), electrolysis efficiency (η es), and thermal efficiency (η th) on the overall efficiency (η overall) of the HTSE system were investigated. Results showed that the contribution of η el, η es, η th to the overall efficiency were about 70%, 22%, and 8%, respectively. As temperatures increased from 500 °C to 1000 °C, the effect of η el on η overall decreased gradually and the η es effect remained almost constant, while the η th effect increased gradually. The overall efficiency of the high-temperature gas-cooled reactor (HTGR) coupled with the HTSE system under different conditions was also calculated. With the increase of electrical, electrolysis, and thermal efficiency, the overall efficiencies were anticipated to increase from 33% to a maximum of 59% at 1000 °C, which is over two times higher than that of the conventional alkaline water electrolysis.

Organizational Readiness for Change and Opinions toward Treatment Innovations

PubMed Central

Fuller, Bret E.; Rieckmann, Traci; Nunes, Edward V.; Miller, Michael; Arfken, Cynthia; Edmundson, Eldon; McCarty, Dennis

2007-01-01

Program administrators and staff in treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) completed surveys to characterize participating programs and practitioners. A two-level random effects regression model assessed the influence of Organizational Readiness for Change (ORC) and organizational attributes on opinions toward the use of four evidence-based practices (manualized treatments, medication, integrated mental health services, and motivational incentives) and practices with less empirical support (confrontation and noncompliance discharge). The ORC Scales suggested greater support for evidence-based practices in programs where staff perceived more program need for improvement, better Internet access, higher levels of peer influence, more opportunities for professional growth, a stronger sense of organizational mission and more organizational stress. Support for confrontation and noncompliance discharge, in contrast, was strong when staff saw less opportunity for professional growth, weaker peer influence, less Internet access, and perceived less organizational stress. The analysis provides evidence of the ORC’s utility in assessing agency strengths and needs during the implementation of evidence-based practices. PMID:17434708

A national hypertension treatment program in Germany and its estimated impact on costs, life expectancy, and cost-effectiveness.

PubMed

Gandjour, Afschin; Stock, Stephanie

2007-10-01

Almost 15 million Germans may suffer from untreated hypertension. The purpose of this paper is to estimate the cost-effectiveness of a national hypertension treatment program compared to no program. A Markov decision model from the perspective of the statutory health insurance (SHI) was built. All data were taken from secondary sources. The target population consists of hypertensive male and female patients at high or low risk for cardiovascular events at different age groups (40-49, 50-59, and 60-69 years). The analysis shows fairly moderate cost-effectiveness ratios even for low-risk groups (less than 12,000 euros per life year gained). In women at high risk antihypertensive treatment even leads to savings. This suggests that a national hypertension treatment program provides good value for money. Given the considerable costs of the program itself, any savings from avoiding long-term consequences of hypertension are likely to be offset, however.

Hazelden's model of treatment and its outcome.

PubMed

Stinchfield, R; Owen, P

1998-01-01

Although the Minnesota Model of treatment for alcohol and drug addiction is a common treatment approach, there are few published reports of its effectiveness. This study describes the Minnesota Model treatment approach as practiced at Hazelden, a private residential alcohol and drug abuse treatment center located in Center City, Minnesota (a founding program of the Minnesota Model) and presents recent outcome results from this program. This study includes 1,083 male and female clients admitted to Hazelden for treatment of a psychoactive substance-use disorder between 1989 and 1991. The outcome study is a one group pretest/posttest design. Data collection occurred at admission to treatment and at 1-month, 6-month, and 12-month posttreatment. At 1-year follow-up, 53% reported that they remained abstinent during the year following treatment and an additional 35% had reduced their alcohol and drug use. These results are similar to those reported by other private treatment programs. The Minnesota Model has consistently yielded satisfactory outcome results, and future research needs to focus on the therapeutic process of this common treatment approach.

In Support of a National Treatment Evaluation Study.

PubMed

Brown, Barry S; Flynn, Patrick M

2015-01-01

Argument is made for the importance of conducting a national treatment evaluation to permit understanding of the nature and effectiveness of typical treatment programming. Only through such study can we hope to learn areas of success and failure of normative programming relative to population characteristics and treatment strategies, and the extent to which research-based initiatives have been adopted by the field. That information is central to efforts to draw up a research agenda appropriate to the needs of clients and the staffs responsible for their treatment, and to clarify and respond to gaps in the application of potentially useful treatment components. In spite of such need, our understanding of typical treatment programming and of its effectiveness is based on data collected from a treatment cohort of 20 years ago, although patterns of drug use, characteristics of clients, and the treatment components available have all undergone substantial change. The responsibility taken to provide such information to the field, once seen as a central task of research, needs to be reasserted to strengthen and support our treatment efforts.

Patterns of drug treatment entry by Latino male injection drug users from different national/geographical backgrounds.

PubMed

Reynoso-Vallejo, Humberto; Chassler, Deborah; Witas, Julie; Lundgren, Lena M

2008-02-01

This study examined patterns of treatment entry by Puerto Rican, Central American, Dominican, and other Latino male injection drug users (IDUs) in the state of Massachusetts over the time period 1996-2002. Specifically, it explored whether these populations had different patterns relative to three paths: entry into detoxification only, entry into residential treatment, or entry into methadone maintenance. Using a state-level MIS dataset on all substance abuse treatment entries to all licensed treatment programs, bi-variate and logistic regression methods were employed to examine patterns of drug treatment utilization among Latino men residing in Massachusetts. Three logistic regression models, which controlled for age, education, homelessness, employment, history of mental health treatment, health insurance, criminal justice involvement, having injected drugs in the past month, and number of treatment entries, indicated that Puerto Rican men were significantly less likely to only use detoxification services and residential treatment services, and significantly more likely to enter methadone maintenance compared to Latino men from Central American, Dominican, or other Latino backgrounds. For example, Central American men were 2.4 times more likely to enter only detoxification programs and 54% less likely to enter methadone maintenance programs than Puerto Rican male IDUs. For program planning, include the need to (a) develop varied drug treatment services to meet the needs of non-homogenous Latino groups within the population, (b) tailor outreach efforts to effectively reach all Latino groups, and (c) increase awareness among practitioners of differential patterns of treatment utilization.

Physiological work performance in chronic low back disability: effects of a progressive activity program.

PubMed

Thomas, L K; Hislop, H J; Waters, R L

1980-04-01

Fifteen patients were tested before and after treatment in a multifaceted inpatient program for chronic low back pain to determine if a gradually progressive activity program affected gait performance and physiological capacity. Before treatment, all patients demonstrated decreased physiological conditioning by higher-than-expected values for oxygen consumption and heart rate and by lower-than-normal gait velocity, stride length, and cadence. After treatment, an increase in mean walking velocity of 19 meters/minute reflected parallel gains in cadence and stride length. Improved mechanical performance resulted in improved "energetics." Energy spent per unit of distance walked decreased by 18 percent after treatment, providing a useful measure of increased physiological efficiency. Results indicated that patients with chronic low back disability can derive significant conditioning effects from an exercise program based on general function.

Treatment Cost Analysis Tool (TCAT) for Estimating Costs of Outpatient Treatment Services

PubMed Central

Flynn, Patrick M.; Broome, Kirk M.; Beaston-Blaakman, Aaron; Knight, Danica K.; Horgan, Constance M.; Shepard, Donald S.

2009-01-01

A Microsoft® Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment types were $882, $1,310, and $1,381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment. PMID:19004576

Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

PubMed

Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

2009-02-01

A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

Spillover effects of HIV testing policies: changes in HIV testing guidelines and HCV testing practices in drug treatment programs in the United States.

PubMed

Frimpong, Jemima A; D'Aunno, Thomas; Helleringer, Stéphane; Metsch, Lisa R

2016-07-29

To examine the extent to which state adoption of the Centers for Disease Control and Prevention (CDC) 2006 revisions to adult and adolescent HIV testing guidelines is associated with availability of other important prevention and medical services. We hypothesized that in states where the pretest counseling requirement for HIV testing was dropped from state legislation, substance use disorder treatment programs would have higher availability of HCV testing services than in states that had maintained this requirement. We analyzed a nationally representative sample of 383 opioid treatment programs from the 2005 and 2011 National Drug Abuse Treatment System Survey (NDATSS). Data were collected from program directors and clinical supervisors through telephone surveys. Multivariate logistic regression models were used to measure associations between state adoption of CDC recommended guidelines for HIV pretest counseling and availability of HCV testing services. The effects of HIV testing legislative changes on HCV testing practices varied by type of opioid treatment program. In states that had removed the requirement for HIV pretest counseling, buprenorphine-only programs were more likely to offer HCV testing to their patients. The positive spillover effect of HIV pretest counseling policies, however, did not extend to methadone programs and did not translate into increased availability of on-site HCV testing in either program type. Our findings highlight potential positive spillover effects of HIV testing policies on HCV testing practices. They also suggest that maximizing the benefits of HIV policies may require other initiatives, including resources and programmatic efforts that support systematic integration with other services and effective implementation.

Tobacco Dependence Treatment Training Programs: An International Survey

PubMed Central

Rigotti, Nancy A.; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2016-01-01

Abstract Introduction: In line with Article 14 guidelines for the WHO Framework Convention on Tobacco Control, we aimed to assess the progress in training individuals to deliver tobacco cessation treatment. Methods: Cross-sectional web-based survey in May–September 2013 among 122 experts in tobacco control and training from 84 countries (73% response rate among 115 countries surveyed). We measured training program prevalence, participants, and challenges faced. Results: Overall, 21% ( n = 18/84) of countries, mostly low and middle-income countries (LMICs; P = .002), reported no training program. Among 66 countries reporting at least one training program, most (84%) trained healthcare professionals but 54% also trained other individuals including community health workers, teachers, and religious leaders. Most programs (54%) cited funding challenges, although stability of funding varied by income level. Government funding was more commonly reported in higher income countries (high 56%, upper middle 50%, lower middle 27%, low 25%; P = .03) while programs in LMICs relied more on nongovernmental organizations (high 11%, upper middle 37%, lower middle 27%, low 38%; P = .02). Conclusions: One in five countries reported having no tobacco treatment training program representing little progress in terms of training individuals to deliver tobacco treatment in LMICs. Without more trained tobacco treatment providers, one of the tenets of Article 14 is not yet being met and health inequalities are likely to widen. More effort and resources are needed to ensure that healthcare worker educational programs include training to assess tobacco use and deliver brief advice and that training is available for individuals outside the healthcare system in areas with limited healthcare access. PMID:26117835

Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

PubMed

Mohamed, Somaia

2013-03-01

There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

Water treatment and handwashing behaviors among non-pregnant friends and relatives of participants in an antenatal hygiene promotion program in Malawi.

PubMed

Russo, Elizabeth T; Sheth, Anandi; Menon, Manoj; Wannemuehler, Kathleen; Weinger, Merri; Kudzala, Amose C; Tauzie, Blessius; Masuku, Humphreys D; Msowoya, Tapona E; Quick, Robert

2012-05-01

Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases. To integrate hygiene improvement with antenatal care, free hygiene kits (water storage containers, water treatment solution, soap) and educational messages were distributed to pregnant women at antenatal clinics in Malawi. We assessed water treatment and hygiene practices of 275 non-pregnant friends and relatives of the hygiene kit recipients at baseline and follow-up nine months later to measure program impact on non-participants in the same communities. At follow-up, friends and relatives who did not receive kits or education were more likely than at baseline to purchase and use water treatment solution (25% versus 1%; P < 0.0001) and demonstrate correct handwashing practices (60% versus 18%; P < 0.0001). This antenatal clinic-based program resulted in improved water treatment and hygiene behaviors among non-pregnant friends and relatives living in the same communities as hygiene kit recipients, suggesting that program benefits extended beyond direct beneficiaries.

A model for dual disorder treatment in acute psychiatry in a VA population.

PubMed

Ahrens, M P

1998-01-01

One model for addressing the dual disorders of substance abuse and a concomitant mental disorder in an acute-psychiatry inpatient ward of a VA Medical Center utilized psychoeducation and ward policies to empower patients to make decisions affecting their recoveries. Existing staff shared responsibilities for implementing activities and creating ward milieu that supported psychiatric patients toward a life free of alcohol and drugs as they gained in acceptance of responsibility for the management of their mental disorders. Integrated programming assisted patients in constructing a meaningful path of recovery out of multiple treatment approaches and philosophies. Treatment principles, ward policies, and goals for an integrated acute-psychiatry model evolved over 4 years. Designed from a consumer-oriented "strengths perspective," patients responded to the new programming with satisfaction and gratitude. Recent adaptation of these policies, principles, and goals to a newly instituted continuous-care treatment program indicates the appropriateness of their application for outpatient dual disorder treatment and programming as well.

Program factors related to women's substance abuse treatment retention and other outcomes: a review and critique.

PubMed

Sun, An-Pyng

2006-01-01

This study examined program factors related to women's substance abuse treatment outcomes. Although substance abuse research is traditionally focused on men, some more recent studies target women. A systematic review of 35 empirical studies that included solely women subjects or that analyzed female subjects separately from male subjects revealed five elements related to women's substance abuse treatment effectiveness; these are (1) single- versus mixed-sex programs, (2) treatment intensity, (3) provision for child care, (4) case management and the "one-stop shopping" model, and (5) supportive staff plus the offering of individual counseling. Although all 35 studies contribute to the knowledge base, critiques of six areas of design weakness in the studies were included to provide directions for future studies; these are (1) lack of a randomized controlled design, (2) nondisentanglement of multiple conditions, (3) lack of a consistent definition for treatment factors and outcomes, (4) small sample size, (5) lack of thorough program description, and (6) lack of thorough statistical analyses.

The Impulsive Lifestyle Counseling Program for Antisocial Behavior in Outpatient Substance Abuse Treatment.

PubMed

Thylstrup, Birgitte; Hesse, Morten

2016-06-01

Antisocial behavior is associated with low quality of life for the patient and with adverse effects on society and those close to the antisocial patient. However, most patients with antisocial behavior are not seen in treatment settings that focus on their personality but rather in criminal justice settings, substance-abuse treatment, and social welfare settings. This article describes the adaptation and implementation of a highly structured manualized treatment, Impulsive Lifestyle Counseling (ILC), based on the Lifestyle Issues program, a 10-week psychoeducation program studied in prison settings. ILC consists of four sessions over 4 weeks and a booster session 8 weeks later. The goal of treatment is described to patients as "to help people identify their impulsive thoughts and lifestyle leading to problems with drug use, other people, and the police." Two clinical examples and reflections on our experiences with the training and implementation of the ILC program are presented. © The Author(s) 2011.

Do drug treatment services predict reunification outcomes of mothers and their children in child welfare?

PubMed Central

Grella, Christine E.; Needell, Barbara; Shi, Yifei; Hser, Yih-Ing

2009-01-01

The effect of mothers’ participation in substance abuse treatment on reunification with their children who are in out-of-home care is an important policy issue. This article examines the predictors of child reunification among mothers who participated in a statewide treatment outcome study. Data were integrated from multiple sources to determine the contributions of characteristics of mothers (n = 1,115), their children (n = 2,299), and treatment programs (n = 43) on reunification outcomes. Hierarchical linear modeling was used to determine the fixed and random effects of mother, child, and program characteristics. Mothers with more employment and psychiatric problems were less likely to be reunified with their children; completion of 90 or more days in treatment approximately doubled their likelihood of reunification. Mothers who were treated in programs providing a “high” level of family-related or education/employment services were approximately twice as likely to reunify with their children as those who were treated in programs with “low” levels of these services. PMID:18775623

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Refills of Maintenance Medications Through Military Treatment Facility Pharmacies or National Mail Order Pharmacy Program. Final rule.

PubMed

2016-11-02

This final rule implements section 702 (c) of the Carl Levin and Howard P. "Buck" McKeon National Defense Authorization Act for Fiscal Year 2015 which states that beginning October 1, 2015, the pharmacy benefits program shall require eligible covered beneficiaries generally to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. An interim final rule is in effect. Section 702(c) of the National Defense Authorization Act for Fiscal Year 2015 also terminates the TRICARE For Life Pilot Program on September 30, 2015. The TRICARE For Life Pilot Program described in section 716(f) of the National Defense Authorization Act for Fiscal Year 2013, was a pilot program which began in March 2014 requiring TRICARE For Life beneficiaries to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. TRICARE for Life beneficiaries are those enrolled in the Medicare wraparound coverage option of the TRICARE program. This rule includes procedures to assist beneficiaries in transferring covered prescriptions to the mail order pharmacy program.

A Strategy for Making Decisions and Evaluating Alternative Juvenile Offender Treatment Programs: Compensating for Missing Information.

ERIC Educational Resources Information Center

Roberts, Albert R.; Schervish, Phillip

1988-01-01

National survey data on the cost-effectiveness and cost-benefits of 11 different juvenile offender treatment program types are reviewed. Best-worst-midpoint, threshold, and convergency analyses are applied to these studies. Meaningful ways of dealing with missing information when evaluating alternative juvenile justice policies and programs are…

A Guide to Screening for the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) Under Medicaid.

ERIC Educational Resources Information Center

Frankenburg, William K.; North, A. Frederick, Jr.

The manual was designed to help public officials, physicians, nurses, and others to plan and implement an Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid. Procedures for carrying out components of an EPSDT program are recommended. Part 1 discusses organization and administration of screening, diagnosis, and…

Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

ERIC Educational Resources Information Center

Theurer, Gregory; Lovell, David

2008-01-01

An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…

Exploring the Outcomes of a Novel Computer-Assisted Treatment Program Targeting Expressive-Grammar Deficits in Preschoolers with SLI

ERIC Educational Resources Information Center

Washington, Karla N.; Warr-Leeper, Genese; Thomas-Stonell, Nancy

2011-01-01

Purpose: The impact of a newly designed computer-assisted treatment ("C-AT") program, "My Sentence Builder", for the remediation of expressive-grammar deficits in children with specific language impairment (SLI) was explored. This program was specifically designed with features to directly address expressive-grammar difficulties, thought to be…

Enhancing Therapeutic Gains: Examination of Fidelity to the Model for the Intensive Mental Health Program

ERIC Educational Resources Information Center

Randall, Camille J.; Biggs, Bridget K.

2008-01-01

Given that the development of treatment fidelity assessment protocol is an integral but too frequently ignored aspect of clinical trials for psychological treatments, the Intensive Mental Health Program (IMHP) sought to build fidelity activities into training, program evaluation, and clinical recordkeeping from the outset of a 3 year study period.…

The High/Scope Perry Preschool Program: Cost-Benefit Analysis Using Data from the Age-40 Followup

ERIC Educational Resources Information Center

Belfield, Clive R.; Nores, Milagros; Barnett, Steve; Schweinhart, Lawrence

2006-01-01

This paper presents an updated cost-benefit analysis of the High/Scope Perry preschool Program, using data on individuals aged 40. Children were randomly assigned to a treatment or control group. Program costs are compared against treatment impacts on educational resources, earnings, criminal activity, and welfare receipt. Net present values are…

Evaluation of a Weight Loss Treatment Program for Individuals with Mild Mental Retardation

ERIC Educational Resources Information Center

Sailer, Angela B.; Miltenberger, Raymond G.; Johnson, Brigitte; Zetocha, Kim; Egemo, Kristin; Hegstad, Holly

2006-01-01

Obesity is a major problem for people in the United States. Individuals with mental retardation also are prone to obesity. The most successful programs for treating obesity typically are treatment packages consisting of multiple behavioral components. Research in the area of weight loss and mental retardation has not evaluated programs for…

Experiential Education, Outdoor Adventure As a Modality in Residential Treatment. A Survey of Programs, Principles, Research and Practice.

ERIC Educational Resources Information Center

Duindam, Ton

Orthopedagogisch Centrum (OC) Michiel is a multifunctional regional institution in the Netherlands that serves troubled families and youth at risk. Outdoor programs are used as a treatment modality for adolescents with behavior disorders, drug addictions, or criminal records. Outward Bound was the first experiential outdoor program in the…

Effect of the Programmed Nutrition Beef Program on moisture retention of cooked ground beef patties and enhanced strip loins.

PubMed

2015-02-01

This study evaluated the influence of the Programmed Nutrition Beef Program and exogenous growth promotants (ExGP) on water holding capacity characteristics of enhanced beef strip loins. Sixty, frozen strip loins, arranged in a 2 × 2 factorial treatment arrangement with dietary program serving as the first factor and use of ExGP as the second factor, were thawed, injected with an enhancement solution, and stored for 7 days. Loins from ExGP cattle possessed the ability to bind more (P < 0.05) water before pumping and bind less (P < 0.05) water after pumping and storage. Loin pH across treatments was similar (P > 0.10) before injection, but increased post-injection and after storage (P < 0.01). Treatments did not affect loin purge loss, steak cook loss, and expressible moisture (P > 0.10). The Programmed Nutrition Beef Program and use of ExGPs minimally impacted water holding capacity of enhanced frozen/thawed beef strip loins.