Little Rock. The Seller shall have transferred to Little Rock, LLC the real property assets for the plant located in Little Rock, Arkansas. Such distributed real property assets include solely the land and buildings, together with the air distribution system, electrical system, telephone system and HVAC system contained in such buildings, and the Seller shall retain title to all other machinery, other equipment (including cranes) and other personal property located at such plant (provided that, any cranes not used by the Company in its business at another location shall revert to Little Rock, LLC).
Little Rock. Xx. Xxxxx is affili- ated with the latter institution. Xx. XxXxxxxxx is with the College of Nursing, Universi- ty of Arkansas for Medical Sciences,
Little Rock. Xx. Xxxx is with the Child and Adoles- cent Service, Xxxxxx Xxxx Army Medical Center, Washington, D.C. Xx. Xxxxxx is with the Department of Psychiatry, Naval Medical Center San Diego. Send correspondence to Xx. Xxxx, Central Arkansas Veterans Healthcare System, 0000 Xxxx Xxxxx Xxxxx (000/XXX), Xxxxx Xxxxxx Xxxx, XX 00000 (e-mail: xxxxxx@xxxx.xxx). This study was presented in part at the annual meeting of the Veterans Affairs Health Services Research and Devel- opment, March 9–11, 2004, Washington, D.C. chizophrenia occurs in 1 percent of the population, but patients with schizophrenia occupy more S than 40 percent of psychiatric hospital beds (1). The annual U.S. cost of schizophrenia is estimated at $33–$65 billion, making it one of the most ex- pensive psychiatric disorders in terms of direct treatment costs and indirect costs of lost productivity and expendi- tures for public assistance (2,3). Al- though antipsychotic medications are an essential component for treating patients with schizophrenia, adher- ence continues to be a major problem (4,5). Nonadherence to antipsychotic medication treatment leads to several important clinical and economic prob- lems, including psychotic relapse, in- creased clinic and emergency depart- ment visits, and rehospitalization (2,6–9). In a comprehensive literature review of neuroleptic withdrawal, the mean cumulative relapse rate was 53 percent for patients withdrawn from antipsychotic medication and 16 per- cent for those whose illness was man- aged with antipsychotic medication (10). In addition to these costly clini- cal problems, there is growing evi- dence that nonadherence to antipsy- chotic medications substantially im- pairs health-related quality of life and functioning (11–13). Efficacious antipsychotic regimens frequently do not achieve their po- tential because of nonadherence. In a review of the antipsychotic medica- 1170 PSYCHIATRIC SERVICES ♦ xx.xxxxxxxxxxxxxxxx.xxx ♦ August 2006 Vol. 57 No. 8 tion adherence literature, Xxxxxx and Xxxxxxxxx (4) reported a median nonadherence rate of 42 percent. In a literature review using stricter inclu- sion criteria, Xxxxx and colleagues (5) reported a median nonadherence rate of 47 percent. They found that the most consistently reported and potentially modifiable risk factors for nonadherence were patient-related factors (poor insight into having a mental illness, negative attitude or subjective response toward antipsy- chotic medication, and substance abuse) and env...
