Urine test for the assessment of smoking status.

A simple, quick and inexpensive test for smoking status would be useful in a variety of settings. The non-polar barbituric acid derivative 1,3-dibutyl-2-thiobarbituric acid (DBTB) is described as a novel derivatisation reagent for nicotine and its metabolites in the König reaction to assess smoking status. The relative performance of qualitative methods for assessing smoking status using DBTB and the previously employed derivatisation reagent 1,3-diethyl-2-thiobarbituric acid (DETB), as well as quantitatively-based methods for determining 'total nicotine metabolites' (TNMs) using these two reagents, were evaluated against a cotinine-based radioimmunoassay (RIA) as the 'gold standard'. Clinical sensitivity and specificity for all the approaches studied were in excess of 94%. Simple qualitative assessment by eye was superior to quantitatively-based measures of smoking status. Correlation between estimation of nicotine metabolites using DBTB, DETB and RIA were good. The most efficient and convenient method to distinguish between smokers and non-smokers was the simple qualitative method using the more lipophilic reagent DBTB.

Intended and unintended effects of explicit warnings on eyewitness suggestibility: evidence from source identification tests.

Previous studies have shown that source identification (ID) tests reduce, and in some cases eliminate, eyewitness suggestibility errors. The present study showed that the suggestibility errors participants committed on a source ID test were further reduced when they were given the explicit postwarning that the experimenter was trying to trick them. These postwarnings reduced suggestibility to the same extent as prewarnings, and they did so for both once and repeatedly suggested items. In addition, the benefits of the pre- and postwarnings persisted when participants were retested 1 week later, but only if the suggestions had been repeated. For once-suggested items, the warning had the unintended effect of improving old/new recognition of the suggested information at retest, an effect that offset the improvements in source discrimination accuracy conferred by the warning. The advantages of using source ID tests for investigating group differences in eyewitness suggestibility are discussed.

State health care reforms: how they affect children and adolescents with emotional disorders and their families.

This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged, most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional disorders and their families but also to the systems of care that have been developing over the past decade to serve them. Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children, and the need for greater family involvement in the planning and implementation of these reforms.