The drug court. A new strategy for drug use prevention.

The concept of Drug Treatment Court is relatively new and is an innovative response by local communities to deal with the escalation of criminal activity associated with substance abuse. The frequency of repeated offenses by drug users, the overcrowding of jail space, and a diminished sense of community well-being contributed to the motivation to look for a new approach by the criminal justice system--the creation of Drug Treatment Courts. This article reviews the strategy behind this creation.

Critical care unit transfer: reducing patient stress through nursing interventions.

Thirty patients hospitalized with acute myocardial infarction were studied by means of comparison of randomized groups to determine the effectiveness of two different nursing interventions on reducing the stress associated with CCU transfer. In order to promote continuity of patient care, one intervention implemented a family centered nursing approach while the other established a staff nurse-patient relationship prior to transfer to the general medical unit. Inferences as to the relationship between each of the nursing interventions and reduction of patient stress during the CCU transfer period were based on a comparison of the mean scores of psychosocial and physiological measures for the experimental and control groups. Six variables were measured. Overall, experimental patients in each group scored lower than control patients for (1-3) patient stress as reported by patient, family, and nurse, (4) cardiovascular complications within 24 hours of transfer, and (5) cardiovascular complications 24 to 72 hours after transfer; no difference was found in (6) physical complaints reported by the patient the evening of transfer.

The Ottawa County project: a report of a tuberculosis screening project in a small mining community.

Following a retrospective review of tuberculosis cases reported from Ottawa County, Oklahoma, from 1969 through 1973, a selective tuberculosis screening project was implemented. Screening of a "target group" of the population, 519 former miners, greater than or equal to 50 years of age, resulted in the discovery of abnormal chest X-rays in 182; (103 with silicosis, 36 with silicotuberculosis, 12 with inactive tuberculosis, and 31 with other abnormalities). Eighty-five of these persons had positive tuberculin skin tests. Preventive therapy was recommended for 50, and 36 completed the prescribed course of treatment. Eight new bacteriologically confirmed cases of tuberculosis were found and treated. A large number of persons (1,904) residing in the same area who were not part of the target group were also screened for tuberculosis. This group contained a large number of positive tuberculin reactors but very few were candidates for isoniazid preventive therapy. Thirteen persons in this group had abnormal chest X-rays consistent with inactive tuberculosis but 12 had been identified and given preventive therapy before the project began. These data suggest that selective approaches to screening for tuberculosis in a community which are based on an in-depth retrospective review of the tuberculosis case register can be highly successful.