Four worksite weight loss programs with high-stress occupations using a meal replacement product.

The objective was to evaluate the efficacy of worksite weight reduction programs at high-stress worksites. We employed a longitudinal study based on two meal replacements daily with subjects choosing a third 'sensible' meal. The subjects were 492 healthy, overweight men and women working in high-stress occupations (police, hospital health professionals, flight crew members, firefighters). The mean group ages ranged from 32.17 +/- 5.70 to 44.50 +/- 16.40 years; the mean group body mass indexes (BMIs) ranged from 27.40 +/- 2.54 to 32.90 +/- 3.39 kg/m(2). The completion rate for the 12 weeks was 79.8%. Reductions in mean weight and mean BMI were greater than in medically supervised clinical trials with non-worksite adults. Firefighters lost the most weight and medical personnel the least. Follow-up found considerable retention of weight loss. Men lost significantly more weight than women (p < 0.006). We conclude that employees in some high-stress settings may participate productively in worksite weight reduction and maintenance programs that use meal replacements.

A mandatory short-term methadone-to-abstinence program in New York City.

In July 1998, Mayor Rudolph Giuliani of New York City introduced a program requiring the 2100 patients in methadone maintenance programs in selected clinics to terminate their use of methadone within 90 days. Previous short-term methadone-to-abstinence programs in California had generally been unsuccessful. Seven months of debate and controversy ensued. And several new ideas received widespread attention because of the public spotlight on this issue. In January 1999, the Mayor announced that his program had been inadequately conceptualized, was not realistic, and was being withdrawn. The wide attention given the Mayor's new program and its criticism by various authorities had led to a thoughtful examination of the whole methadone maintenance situation, with a reasonable likelihood that the situation would improve.

The relationship between nonenforcement of state pornography laws and rates of sex crime arrest.

The nonoperation of antipornography statutes in four states (Maine, North Carolina, Pennsylvania, and Washington) for varying periods between 1973 and 1986 provided an opportunity to examine the impact of such statutes and pornography availability on sex crimes because nonenforcement is associated with an increase in the availability of sexually explicit materials. Arrests for property offenses and for rape, prostitution, and other sex offenses during the period before the suspension of the laws, when compared with the period during suspension, reflected no significant changes. Findings are consistent with other foreign and American studies that have failed to find a link between exposure to sexually explicit media materials and rates of reports of rape and other sex offenses.

Is there a national standard with respect to attitudes toward sexually explicit media material?

Surveys in 10 states conducted with probability samples of adults (N = 4621) between 1976 and 1985 found that a statistically significant majority of the respondents in each state indicated acceptance of sexually explicit content in mass media. In each state, respondents felt that (i) standards have changed so that such material has become more acceptable; (ii) adults have the right to obtain such materials; and (iii) it is all right for adults to obtain and see materials containing exposure of the genitalia and every kind of sexual activity. Some factors contributing to what appears to be an emerging national consensus of acceptance are discussed.

An incest survivors' therapy group.

A weekly therapy group for women who have been incest victims and are residents of Odyssey House, a therapeutic community for drug abusers, is described. Women participating in the group have a significantly greater retention and graduation rate than other women in the program. The group reduces isolation; helps in dealing with denial; clarifies relations with children, other family members, and significant others; and facilitates dealing with incest-related guilt and shame. The impressive therapeutic progress of the incest survivors, which is attributable to the group, suggests the possible utility of such a group for other therapeutic communities and treatment programs.

Marathon therapy: treating rape survivors in a therapeutic community.

Odyssey House is a therapeutic community (TC) in New York City that treats a wide range of drug abusers. For over 20 years. Odyssey House has conducted an annual marathon therapy group for women who are rape survivors. This article summarizes the program's experience with the marathon and reports on its therapeutic accomplishments.

Are pictures more valid than words in conveying the content of sex in the media? Studies in North Carolina and New York State.

Two studies were conducted to determine if telephone survey questions and seeing sexually explicit media materials would lead, in matched groups, to the same or different attitudes towards tolerating the materials. In North Carolina, adults (n = 40) who saw explicit films and an explicit magazine and 503 adults who answered telephone survey questions about sex materials were equally tolerant. In New York State, a group (n = 78) which saw an explicit film had similar attitudes of toleration toward it as a matched group (n = 80) which answered general questions about sexually explicit materials and a sample (n = 81) of adults who were individually interviewed by telephone about sexually explicit materials. In view of the logistic difficulties of assembling representative samples of a large geographic area, like a state, it was concluded that telephone surveys provide valid measures of attitudes toward sexually explicit materials.

Social behavior, public policy, and nonharmful drug use.

A body of research conducted over several decades has established that a considerable proportion of regular users of heroin, cocaine, and other psychoactive drugs continue to function effectively at work and in other areas of social life. Yet American policy has been predicated on assumptions of a universal course of drug use leading to dependency and dysfunctional behavior. A rational drug policy would be shaped in light of a more nuanced understanding of the relationship between drug use and socially adaptive and maladaptive behavior.

Retention and outcome at ACI, a unique therapeutic community.

A study was conducted of retention and outcome of the first 100 clients at ACI, a therapeutic community in New York City that is unique in its combination of a relatively short treatment cycle, fee for service funding, early reentry, use of guided scream therapy and bonding, and implementation of the Casriel theory of the New Identity Process. Retention rates at 3, 6, 9, and 12 months were 95%, 90%, 86%, and 80%, respectively. Excellent or good outcomes were achieved by 80 clients. Some reasons for these very favorable results are discussed, in terms of previous studies of therapeutic community procedures and results.

The counselor in drug user treatment.

The counselor--the key staff member at therapeutic communities, outpatient drug-free treatment, and methadone maintenance--provides a wide range of services to clients. Crucial issues with respect to parity and other relationships between professional and ex-user counselors, counselor mobility, credentialing, role modeling, division of labor among counselors with different backgrounds, training, relations with alcoholism counselors, and changes linked to multiple drug use and funding shifts are discussed.

A comparison of the relative safety of phenylpropanolamine, acetaminophen, ibuprofen and aspirin as measured by three compendia.

A comparison was made among phenylpropanolamine, aspirin, acetaminophen and ibuprofen in terms of their relative safety, as measured by adverse reaction reports published since 1980, the five semiannual reports published by the Drug Abuse Warning Network during 1984-1986 and annual reports from Poison Control Centers from 1983-1986. On each of the three measures, phenylpropanolamine had the fewest reported adverse reactions.

Three controlled trials of weight loss with phenylpropanolamine.

A multisite double-blind study was designed to determine the effectiveness of a phenylpropanolamine-caffeine combination in achieving weight loss. Two-hundred and one obese adult patients were divided into three separate groups in which phenylpropanolamine/caffeine was compared with either placebo (6 weeks), mazindol (6 weeks), or diethylpropion (8 weeks). In these clinical trials, phenylpropanolamine/caffeine proved to be as effective as mazindol and diethylpropion and significantly more effective than placebo in achieving weight loss. Overall, phenylpropanolamine/caffeine had fewer side effects than mazindol and diethylpropion. Its use as an effective anorectic agent in the treatment of obesity is reviewed.