Spillovers of prosocial motivation: Evidence from an intervention study on blood donors

Blood donations are increasingly important for medical procedures, while meeting demand is challenging. This paper studies the role of spillovers arising from social interactions in the context of voluntary blood donations. We analyze a large-scale intervention among pairs of blood donors who live at the same street address. A quasi-random phone call provides the instrument for identifying the extent to which the propensity to donate spills over within these pairs. Spillovers transmit 41% to 46% of the behavioral impulse from one donor to the peer. This creates a significant social multiplier, ranging between 1.7 and 1.85. There is no evidence that these spillovers lead to intertemporal substitution. Taken together, our findings indicate that policy interventions have a substantially larger effect when targeted towards pairs instead of isolated individuals.     

Estimated effectiveness of school closure and voluntary event cancellation as COVID-19 countermeasures in Japan

BackgroundAs countermeasures against the COVID-19 outbreak, sports and entertainment events were canceled (VEC) in Japan for two weeks from 26 February through 13 March. Moreover, most schools were closed (SC).ObjectiveFor this study, we estimated the basic reproduction number (R₀) and SC and VEC effects.MethodAfter constructing a susceptible–infected–recovered model with three age classes, we used data of symptomatic patients in Japan for 14 January through 24 March. The SC and VEC effects were incorporated into the model through changes in contact patterns and contact frequencies among age classes.ResultsResults suggest R₀ as 2.56, with 95% CI of [2.51, 2.96] before SC and VEC. The respective effects of SC and VEC were estimated as 0.4 (95% CI [0.3, 0.5]) and 0.5 (95% CI [0.3, 0.7]).ConclusionThe estimated R₀ is similar to those found from other studies of China and Japan. Significant reduction of contact frequency has been achieved by SC and VEC. Nevertheless, its magnitude was insufficient to contain the outbreak.     

Decreased movement-related beta desynchronization and impaired post-movement beta rebound in amyotrophic lateral sclerosis

ObjectiveThis study explored event-related desynchronization (ERD) and synchronization (ERS) in amyotrophic lateral sclerosis (ALS) to quantify cortical sensorimotor processes during volitional movements. We furthermore compared ERD/ERS measures with clinical scores and movement-related cortical potential (MRCP) amplitudes.MethodsElectroencephalograms were recorded while 21 ALS patients and 19 controls performed two self-paced motor tasks: sniffing and right index finger flexion. Based on Wavelet analysis the alpha and beta frequency bands were selected for subsequent evaluation.ResultsPatients generated significantly smaller resting alpha spectral power density (SPD) and smaller beta ERD compared to controls. Additionally patients exhibited merely unilateral post-movement ERS (beta rebound) whereas this phenomenon was bilateral in controls. ERD/ERS amplitudes did not correlate with corresponding MRCPs for either patients or controls.ConclusionsThe smaller resting alpha SPD and beta ERD and asymmetrical appearance of beta ERS in patients compared to controls could be the result of pyramidal cell degeneration and/or corpus callosum involvement in ALS.SignificanceThese results support the notion of reduced movement preparation in ALS involving also areas outside the motor cortex. Furthermore post-movement cortical inhibition seems to be impaired in ALS. ERD/ERS and MRCP are found to be independent measures of cortical motor functions in ALS.     

Medical errors: overcoming the challenges

The issue of medical errors has received substantial attention in recent years. The Institute of Medicine (IOM) report released in 1999 has several implications for health care systems in all disciplines of medicine. Notwithstanding the plethora of available information on the subject, little, by way of substantive action, is done toward medical error reduction. A principal reason for this may be the stigma associated with medical errors. An educational program with a practical, informed, and longitudinal approach offers realistic solutions toward this end. Effective reporting systems need to be developed as a medium of learning from the errors and modifying behaviors appropriately. The presence of a strong leadership supported by organizational commitment is essential in driving these changes. A national, provincial or territorial quality care council dedicated solely for the purpose of enhancing patient safety and medical error reduction may be formed to oversee these efforts. The bioethical and emotional components associated with medical errors also deserve attention and focus.     

男性自愿戒毒人群特点的分析研究

目的:男性自愿戒毒人群的特点分析。方法:应用自行研发的气血津液状态辨识系统,开展自愿戒毒者的中医证素研究。吸毒者诊断标准均符合《中国精神障碍分类与诊断标准》第三版(CCMD-3),中医证素采用证素辨证方法采集。结果:自愿戒毒组与公安强制戒毒组男性戒毒者在证素分布趋势大致相同,与司法强制戒毒组具有较大的差异。自愿组与公安组在证素热、血瘀、精亏、大肠的差异有统计学意义,与司法组在证素精亏与大肠的差异无统计学意义,其他证素的差异比较均具有统计学意义。结论:自愿戒毒组与公安强制戒毒组男性戒毒者在证素分布存在一定相似性,且因为自愿戒毒者、强制戒毒者处于不同时期,中医病理因素热和血瘀差异具有统计学意义,以及其心理压力差异变化,都可能会影响毒瘾复发。     

Medicine and Morals,Craving and Compulsion

Thinking about addictions has been dominated by two models: the medical model, which treats addiction as a disease and related behaviors as signs and symptoms, and the moral model, which views addiction and related behaviors as indications of moral failure. This article describes both models and their implications, with special emphasis on the moral model. The meaning of compulsion or coercion caused by internal psychological states, such as craving, is explored to determine if addicts may fairly be held morally and legally responsible for their behavior, such as seeking and using substances. It is argued that diminished rationality better explains than compulsion why addicts might be excused for their behavior, but it is concluded that most addicts can be held responsible for most addiction-related behavior. Nonetheless, both models have desirable characteristics, and sound public policy should not be based solely on either. The implications for criminal justice of employing both models to guide policy are explored.     

Religious Issues Presented by Cancer Patients Seen in Psychiatric Consultation

Despite increased interest in the religious needs of patients with serious illness, the form that religious issues take in patients coping with an illness such as cancer has received little systematic attention. In this evaluation of 50 consecutive hospitalized cancer patients seen in psychiatric consultation, 32 patients were concerned with religious issues. Thirteen patients mentioned religion spontaneously, and 18 were actively struggling with several forms of religious problems: only 9 appeared to have discussed these conccrns with other members of the hospital staff. These findings have implications for the provision of more comprehensive care to patients with cancer and for future research.     

以智慧化献血服务改善献血者体验

献血服务全过程从数据化向智慧化发展是大势所趋。献血服务始终围绕献血者展开，以献血者为中心的特点，决定了科学技术手段应用的终极目标为人的体验和感受。借助智慧管理精准识别献血者需求，是提升献血服务水平的首要任务。以武汉血液中心智慧化献血服务为例，阐述了智慧化为献血者带来的全新体验。     

Effects of sensory cueing on voluntary arm use for patients with chronic stroke: a preliminary study

Fong KN, Lo PC, Yu YS, Cheuk CK, Tsang TH, Po AS, Chan CC. Effects of sensory cueing on voluntary arm use for patients with chronic stroke: a preliminary study.

Objective

To investigate the effect of a 2-week program of sensory cueing in which vibration induces the use of the paretic upper extremity in participants with chronic stroke in the community.

Design

A single-group longitudinal study.

Setting

Self-help organizations.

Participants

A convenience sample of 16 community residents (N=16) with chronic unilateral stroke and mild to moderate upper-extremity impairment stratified by the severity of their paretic arm function, measured by using the Functional Test for the Hemiplegic Upper Extremity (FTHUE).

Interventions

Participants engaged in repetitive upper-extremity task practice for 2 weeks while wearing an ambulatory sensory cueing device on their affected hand for 3 hours a day.

Main Outcome Measures

Evaluations were conducted on the 3 occasions of pretest (1 day before training), posttest (immediately after training), and follow-up test (2 weeks after training) by using the following behavioral measures of paretic upper-extremity performance: the Action Research Arm Test (ARAT), the Box and Block Test, the Fugl-Meyer Assessment (FMA), the FTHUE, power and pinch grips, the Motor Activity Log assessment of arm use, and kinematic data obtained from the device.

Results

Significant differences were found in ARAT and FMA scores among the pretest, posttest, and follow-up evaluations. The lower functioning group achieved a more significant increase in overall upper-extremity score than in the hand score for the FMA.

Conclusion

A combination of sensory cueing and movement-based strategies is useful and feasible in improving paretic upper-extremity performance in participants with chronic stroke; however, additional studies with a larger sample size and longer treatment period in a randomized controlled trial would be beneficial.