Internet-based group contingency management to promote abstinence from cigarette smoking: a feasibility study

Background

In contingency management (CM) interventions, monetary consequences are contingent on evidence of drug abstinence. Typically, these consequences are contingent on individual performance. Consequences contingent on group performance may promote social support (e.g., praise).

Methods

Thus, to combine social support with the monetary incentives of CM, we integrated independent and interdependent group contingencies of reinforcement into an Internet-based intervention to promote smoking abstinence. Breath carbon monoxide (CO) measures were compared between treatment conditions and a baseline control condition. Thirteen participants were divided into 5 groups or “teams” (n = 2-3 per team). Each participant submitted video recordings of CO measurement twice daily via the Internet. Teammates could monitor each other's progress and communicate with one another through an online peer support forum. During a 4-day tapering condition, vouchers exchangeable for goods were contingent on gradual reductions in breath CO. During a 10-day abstinence induction condition, vouchers were contingent on abstinence (CO ≤ 4 ppm). In both treatment conditions, concurrent independent and interdependent group contingencies were arranged (i.e., a mixed contingency arrangement).

Results

Less than 1% of CO samples submitted during baseline were ≤ 4 ppm, compared to 57% submitted during abstinence induction. Sixty-five percent of participants’ comments on the online peer support forum were rated as positive by independent observers. Participants rated the intervention favorably on a treatment acceptability questionnaire.

Conclusion

The results suggest that the intervention is feasible and acceptable for promoting abstinence from cigarette smoking.     

氨甲环酸片用于人工流产术止血的临床观察

目的探讨氨甲环酸片用于早孕孕妇行人工流产术的止血效果。方法将120例孕妇随机分为氨甲环酸组和对照组各60例,并按妇科检查及B型超声测定判断孕周大小进行配对。氨甲环酸组于人工流产术前2h予以氨甲环酸片500mg口服,对照组不服用任何药物。测量并比较2组术中及术后出血量,同时观察药物不良反应。结果氨甲环酸组术中、术后出血量及总出血量少于对照组,差异均有统计学意义(P<0.05)。氨甲环酸组出现轻度恶心18例(30.0%),轻度头晕8例(13.3%);对照组仅出现轻度恶心1例(1.7%),均未做任何处理自行好转。结论氨甲环酸片用于早孕孕妇人工流产术有较好的止血效果,术中及术后出血量均明显减少,无严重不良反应,有利于患者恢复。     

医院信息系统与膳食系统的集成设计方案及实现

针对医院信息系统常用的三种系统集成设计方案,做了简单介绍和比较.根据实际情况,选择最佳方案.结合HIS与膳食系统的集成,阐述基于ORACLE数据库的触发器应用,正确认识使用触发器可能带来的问题,充分利用其优势完成系统集成任务.     

飞扬肠胃炎片治疗肠易激综合征的疗效观察

目的：探讨飞扬肠胃炎片治疗肠易激综合征的疗效,为临床提供参考。方法：将本院收治的90例肠易激综合征患者随机分为治疗组与对照组,各45例,对照组给予中药汤剂进行治疗,治疗组在对照组的基础上给予飞扬肠胃炎片进行治疗,观察两组的临床疗效和不良反应,并进行统计学比较。结果：对照组临床总有效为38例,总有效率为84.4%,治疗组临床总有效为43例,总有效率为95.6%,两组间比较差异有统计学意义,P〈0.05。两组患者治疗过程中和治疗后心率、血压、肝功能等均未出现明显变化,亦无其他不良反应现象出现,两组间比较,差异无统计学意义,P〉0.05。结论：飞扬肠胃炎片辅助中药汤剂治疗肠易激综合征有明显的疗效,其疗效优于单纯应用中药汤剂组,且未见不良反应现象发生,值得临床推广应用。     

丙戊酸镁缓释片辅助治疗精神分裂症兴奋激越的效果观察

目的：评价丙戊酸镁缓释片辅助治疗伴有兴奋、激越等症状的精神分裂症患者合理性及安全性。方法：将120例伴有兴奋激越精神分裂症患者随机分为单用非典型抗精神病药物组（57例））和联用丙戊酸镁缓释片组（63例）,以阳性与阴性症状量表（PANSS）、临床疗效大体评定量表（CGI）评定疗效,副反应量表（TESS）为主评估不良反应。结果：1周后两组间PANSS（G分、S分、T分）比较有统计学意义（P〈0.05）,治疗前后均有统计学意义。6周后联用组总有效率为94．74％,单用组为87．3％（P〈0．05）。两组不良反应比较差异无统计学意义（P〉0．05）。结论：丙戊酸镁缓释片能辅助治疗精神分裂症患者的兴奋、激越等症状,起效迅速、安全。     

Changes in the relative reinforcing effects of cigarette smoking as a function of initial abstinence

Rationale  Experimental research is needed in investigating how early smoking abstinence affects relapse risk. Objective  The present study assessed the feasibility of promoting smoking abstinence using once- rather than thrice-daily abstinence monitoring and the relationship between different durations of initial abstinence and changes in smoking preference. Methods  Participants were 34 adult smokers randomized into one of two conditions: 14-day (14C) and 1-day (1C) contingent payment for smoking abstinence. Smoking status and participant ratings were assessed daily; a delay discounting task involving hypothetical money and an inter-temporal choice task involving hypothetical money and cigarettes were administered at baseline and days 7 and 14; a direct test of preference for smoking versus money was assessed on day 14. Results  Once-daily monitoring gained robust experimental control over smoking abstinence. No differences in delay discounting for hypothetical money were observed between the two conditions. Compared to the 1C condition, participants in the 14C condition (1) showed significant increases in the mean percent of delayed hypothetical money over cigarettes choices in the inter-temporal choice task, (2) were significantly less likely to ever choose the smoking option in the direct test of preference for smoking versus money, and (3) reported greater ease of abstaining from smoking and lower nicotine withdrawal and craving. Conclusions  These results offer a more efficient procedure for experimentally promoting smoking abstinence, while providing further evidence that an initial period of sustained abstinence produces a profile of changes consistent with an overall lowering of relapse risk.     

Whole-body 3D water/fat resolved continuously moving table imaging

PURPOSE: To study the feasibility of three-dimensional (3D) whole-body, head-to-toe, water/fat resolved MRI, using continuously moving table imaging technology. MATERIALS AND METHODS: Experiments were performed on nine healthy volunteers, acquiring 3D whole-body head-to-toe data under continuous motion of the patient table. Two different approaches for water/fat separation have been studied. Results of a three-point chemical shift encoding and a spectral presaturation technique were compared with respect to image quality and performance. Furthermore, fast, low-resolution, whole-body water/fat imaging was performed in two minutes total scan time to derive patient-specific parameters such as the total water/fat ratio, the intraperitoneal/extraperitoneal fat ratio, and the body mass index (BMI). RESULTS: Good water/fat separation with decent image quality was obtained in all cases. The three-point chemical shift encoding approach was found to be more efficient with respect to signal-to-noise ratio (SNR) and acquisition time. CONCLUSION: Whole-body water/fat sensitive MRI using continuous table motion is feasible and could be of interest for clinical practice. Some improvements of the method are desirable.     

A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder

There is currently controversy regarding the need for and the effectiveness of behavior modification for children with attention-deficit hyperactivity disorder (ADHD) despite years of study and multiple investigations reporting beneficial effects of the intervention. A meta-analysis was conducted by identifying relevant behavioral treatment studies in the literature. One-hundred seventy-four studies of behavioral treatment were identified from 114 individual papers that were appropriate for the meta-analysis. Effect sizes varied by study design but not generally by other study characteristics, such as the demographic variables of the participants in the studies. Overall unweighted effect sizes in between group studies (.83), pre-post studies (.70), within group studies (2.64), and single subject studies (3.78) indicated that behavioral treatments are highly effective. Based on these results, there is strong and consistent evidence that behavioral treatments are effective for treating ADHD.     

地震后医护人员心理卫生状况的调查分析

目的调查地震灾害一年后在都江堰市工作的医护人员心理卫生状况和相关因素,为以后开展心理咨询和治疗提供科学依据。方法采用症状自评量表（SCL-90）,对灾区都江堰市8家医院的220名医护人员（调查组）和非受灾区崇州市7家医院的213名医护人员（对照组）进行心理健康评定比较并同时与全国常模比较,对结果进行分析。结果SCL-90显示,都江堰市8家医院的220名医护人员除人际关系敏感外,其他相关因子分数均高于全国常模,P〈0．05。结论地震一年后,都江堰市基层工作的医护人员依然存在心理健康问题,心理健康情况总体低于全国常模水平。在帮助受灾病人的同时,他们也受到地震冲击,应给予他们心理支持,使他们尽早走出心理阴影。     

基于分布式哈希表的电子病历共享和存储网络

提出一种基于分布式哈希表的电子病历及其位置信息的存取模型,以此为基础建立了分层的病历共享网络架构,以及医疗机构间和区域间病历共享和数据同步的机制,讨论了网络拓扑参数的分析计算方法。该方案具有结构简单、伸缩性好、对服务器带宽和响应性能要求低、管理成本低、易于分析和优化的特点。