Neutral and selective processes shape MHC gene diversity and expression in stocked brook charr populations (Salvelinus fontinalis).

The capacity of an individual to battle infection is an important fitness determinant in wild vertebrate populations. The major histocompatibility complex (MHC) genes are crucial for a host's adaptive immune system to detect pathogens. However, anthropogenic activities may disrupt natural cycles of co-evolution between hosts and pathogens.

Using community surveys to inform the planning and implementation of environmental change strategies: participatory research in 12 Washington communities.

A number of studies have demonstrated the efficacy of environmental change strategies (ECS) in effecting community-level change on attitudes and behaviors related to underage drinking (Treno and Lee in Alcohol Res Health 26:35-40, 2002; Birckmayer et al. in J Drug Educ 34(2):121-153, 2004). Primary data collection to inform the design of these strategies, however, can be resource intensive and exceed the capacity of community stakeholders.

A mixed-method exploration of functioning in Safe Schools/Healthy Students partnerships.

This paper presents a mixed-method approach to measuring the functioning of Safe Schools/Healthy Students (SS/HS) Initiative partnerships. The SS/HS national evaluation team developed a survey to collect partners' perceptions of functioning within SS/HS partnerships. Average partnership functioning scores were used to rank each site from lowest to highest.

Genotype, serotype, and antibiotic resistance of sorbitol-negative Escherichia coli isolates from feedlot cattle.

Rectal fecal samples from 80 steers receiving Rumensin, Revalor-S, and Liquamycin alone or in combination for growth promotion and disease prevention were examined for the presence of non-O157:H7 Shiga toxin-producing Escherichia coli. All isolates were identified with the API 20E test, virulence genes were detected with a PCR assay, and antibiotic susceptibilities were determined with the Sensititre system. Of the 153 E.

A population-based study on substance abuse treatment for adults with disabilities: access, utilization, and treatment outcomes.

Aims: To examine potential disparities in access to substance abuse treatment services for Medicaid-eligible adults with disabilities, and compare utilization rates and outcomes in outpatient programs.

Design: Population-based multi-year cross-sectional study.

Setting: State-wide examination of substance-abuse treatment, particularly outpatient.

Challenges substance abuse treatment agencies faced in adoption of computer-based technology to improve assessment.

The Oregon Practice Improvement Collaborative provided resources and technical assistance to help five Oregon drug treatment agencies adopt computer-based technology of their choice to support client progress in treatment. This manuscript describes agency processes related to that adoption of technology. Agencies chose computer programs to improve clinical outcomes, reduce staff burden, and respond to external pressures.

Relating substance abuse counselor background to the provision of clinical tasks.

This study examines the diverse academic and professional background characteristics of substance abuse treatment counselors, relating these characteristics to the work counselors are doing. Results indicate that while academic and professional background characteristics differentiate whether counselors perform certain clinical tasks or not, they do not differentiate the amount of time they spend doing them. In fact, regression analyses indicate that academic and professional background characteristics currently account for less than 10% of the total variability associated with how counselors spend their time.

Access barriers to substance abuse treatment for persons with disabilities: an exploratory study.

Research in substance abuse (SA) treatment has demonstrated that persons with disabilities (PWDs) are at substantially higher risk for SA than persons without disabilities. Despite their higher risk, PWDs access SA treatment at a much lower rate than persons without disabilities. Using the Behavioral Model for Vulnerable Populations as a research framework, we identified reasons for differences in access to SA treatment for Medicaid-eligible adults with disabilities in Oregon through a multiphase study.

Organization and financing of alcohol and substance abuse programs for American Indians and Alaska Natives.

Objectives: Although American Indians and Alaska Natives have high rates of substance abuse, few data about treatment services for this population are available. We used national data from 1997-2002 to describe recent trends in organizational and financial arrangements.

Methods: Using data from the Indian Health Service (IHS), the Substance Abuse and Mental Health Services Administration, the National Institute on Alcohol Abuse and Alcoholism, the Henry J.

Prospective validation of substance abuse severity measures from administrative data.

Background: Severity measures for clients in substance abuse treatment programs are becoming increasingly important as funders adopt payment systems linked to agency performance. Recently, two severity measures based on administrative data have been developed. This study validated these measures using prospective data.

Growth performance and shedding of some pathogenic bacteria in feedlot cattle treated with different growth-promoting agents.

Eighty steers with a mean body weight of 319 kg were used in a study to evaluate the effect of a growth-promoting implant (trenbolone acetate plus estradiol benzoate), monensin, and oxytetracycline on the steer performance and shedding of some foodborne pathogens. The steers were allotted to one of eight treatment combinations according to a randomized complete block design with 16 pens of five animals. Rectal fecal samples were collected before treatment commenced and over a period of more than 24 weeks to study the influence of treatments on the intestinal microbiology of the animals.

Antibiotic resistance and hypermutability of Escherichia coli O157 from feedlot cattle treated with growth-promoting agents.

In a longitudinal study (165 days), we investigated the effect of growth-promoting agents (monensin and trenbolone acetate-estradiol) and an antibiotic (oxytetracycline) on the incidence in feedlot steers of Escherichia coli O157, including antibiotic-resistant and hypermutable isolates. Eighty steers in 16 pens were treated with eight combinations of promoters, and each treatment was duplicated. Fecal samples were collected at nine different sampling times for detection of E.

Outcomes for medicaid clients with substance abuse problems before and after managed care.

Medicaid conversion from fee for service to managed care raised numerous questions about outcomes for substance abuse treatment clients. For example, managed care criticisms include concerns that clients will be undertreated (with too short and/or insufficiently intense services). Also of interest are potential variations in outcome for clients served by organizations with assorted financial arrangements such as for-profit status versus not-for-profit status.

Impact of patient placement criteria on substance abuse treatment under the Oregon Health Plan.

When Oregon shifted to managed care for Medicaid-funded substance abuse treatment, standardized patient placement and discharge criteria were rapidly implemented statewide. This prospective, naturalistic study examines the validity and impact of placement criteria with a sample of 240 adults presenting for treatment compared to a sample of 287 in Washington state, where implementation was phased in slowly. Baseline profile analysis suggested better differentiation between Level II and Level III clients for the Oregon sample and better implementation than with the Washington sample, presumably because Oregon clinicians received more training and had more experience with the criteria.

The impact of managed care on publicly funded outpatient adolescent substance abuse treatment: service use and six-month outcomes in Oregon and Washington.

This study assessed the impact of managed care on publicly funded adolescent substance abuse treatment by comparing differences in service utilization and outcomes across prospective samples from two states: Oregon, which uses managed care practices in service financing and delivery, and Washington, which does not. One hundred and six adolescents from Washington and 94 from Oregon, who entered outpatient substance abuse treatment in 1998 and 1999, completed self-report surveys about their substance use before and after receiving treatment (follow-up rate = 75 percent). In addition, clinical chart reviews conducted at the 6-month follow-up assessed the type and amount of treatment these adolescents received during the study period.

Effect of managed care on access to mental health services among Medicaid enrollees receiving substance treatment.

Objective: Mental health services are important to treatment retention and positive outcomes for many clients of substance abuse treatment programs. For these clients the implementation of managed care should provide for continued or increased access to mental health treatment, rather than decreased access because of short-term, cost-reduction objectives. This study assessed whether converting Medicaid from a fee-for-service program to a capitated, prepaid managed care program affected access to mental health services among clients who were treated for substance abuse.

The toughest job you'll ever love: a Pacific Northwest Treatment Workforce Survey.

The training, recruitment, and retention of the most qualified professionals for the substance abuse treatment workforce is a crucial underlying strategy in the improvement of client care. Conducted in the year 2000, this survey of substance abuse treatment agency directors and clinical staff in the Pacific Northwest of the United States provides the first empirical estimates of issues surrounding these goals and points to the need for more aggressive strategies if a quality workforce is to be maintained and improved. Results of the survey indicate that there is an average of 25% turnover per year among treatment agency staff, and that the vast majority of this turnover is voluntary and stays within the treatment profession.

Oregon's transition to a managed care model for Medicaid-funded substance abuse treatment: steamrolling the glass menagerie.

The approval of a Health Care Financing Administration (now called Centers for Medicare and Medicaid Services) 1115 Medicaid waiver in Oregon allowed the state to design and implement an expanded publicly funded health care system, the Oregon Health Plan (OHP). Integral to OHP is the administration of physical and behavioral health services, including outpatient substance abuse treatment, through contracted managed care organizations. The two overarching changes to the outpatient substance abuse treatment system were expanded Medicaid eligibility and new operating procedures for the outpatient substance abuse treatment system.

Integration and its discontents: substance abuse treatment in the Oregon Health Plan.

With the creation of the Oregon Health Plan (OHP) in 1994, Oregon placed its Medicaid program under a managed care system. This paper examines the managed care practices of seven health plans serving OHP enrollees between 1996 and 1998. Results indicated that the original vision of integrating substance abuse treatment services with physical care for OHP enrollees evolved into a multilayered, carved-out approach.

Reducing psychiatric hospital use of the rural poor through intensive transitional acute care.

A controlled study of the impact of brief, transitional acute care in reducing psychiatric treatment costs for people in rural areas is presented. Treatment emphasized home-based counseling and support, 24-hour rapid response, rural outreach, and intensive support management. The objective was to avert hospitalizations when possible, expedite discharge, and reduce likelihood of readmission, while maintaining comparable or superior clinical outcome.