Ethanol regulated preference in rats

A series of experiments evaluated the determinants of preference for mixtures of ethanol plus sucrose relative to sucrose in rats. One dipper served 10% ethanol mixed with 10% sucrose, and the second dipper served 10% sucrose. Lever presses operated each dipper according to a variable-interval 5-s schedule. In three experiments the subjects were given pre-session meals of sucrose (2.5–20 ml) or sucrose (20 ml) plus chow (5 or 10 g). Pre-session meals decreased responding maintained by sucrose but not responding maintained by ethanol mixture. In two experiments body weight was varied from 85% to 125% of the initial free-feeding values. Increases in body weight, like pre-session meals, decreased responding reinforced by sucrose, but typically did not decrease responding reinforced by ethanol mixture. Throughout most of the study, ethanol consumption remained at about 1.25 ml per half hour session (3–4 g/kg per 30 min). For example, pre-session access to ethanol mixture decreased within-session ethanol consumption, but total consumption, counting both sources, remained about 1.25 ml/session. The within-session patterns of responding also differed. Responding reinforced by ethanol mix decreased as a function of ethanol consumption, whereas responding reinforced by sucrose was relatively constant throughout the session. The simplest explanation of the results is that ethanol's pharmacological consequences regulated preference.     

The Effect of Health Plan Characteristics on Medicare+Choice Enrollment

Objective. To provide national estimates of the effect of out-of-pocket premiums and benefits on Medicare beneficiaries' choice among managed care health plans.
Data Sources/Study Setting. The data represent the population of all Medicare+Choice (M+C) plans offered to Medicare beneficiaries in the United States in 1999.
Study Design. The dependent variable is the log of the ratio of the market share of the j th health plan to the lowest cost plan in the beneficiary's county of residence. The explanatory variables are measures of premiums and benefits in the j th health plan relative to the premiums and benefits in the lowest cost plan.
Data Collection Methods. The data are from the 1999 Medicare Compare database, and M+C enrollment data from the Centers for Medicare and Medicaid Services (CMS).
Principal Findings. A $10 increase in an M+C plan's out-of-pocket premium, relative to its competitors, is associated with a decrease of four percentage points in the j th plan's market share (i.e., from 25 to 21 percent), holding the premiums of competing plans constant.
Conclusions. Although our price elasticity estimates are low, the market share losses associated with small changes in a health plan's premium, relative to its competitors, may be sufficient to discipline premiums in a competitive market. Bidding behavior by plans in the Medicare Competitive Pricing Demonstration supports this conclusion.     

Cocaine decreases self-control in rats: a preliminary report

Cocaine abuse is often associated with behavior that takes into account short-term, but not long-term consequences. However, there has been no empirical research concerning the effects of cocaine on self-control (choice of a larger, more delayed reinforcer over a smaller, less delayed reinforcer). In the present research, when food-deprived rats repeatedly chose between a larger, more delayed food reinforcer and a smaller, less delayed food reinforcer, chronic intraperitoneal injections of 15 mg/kg cocaine (but not 10 mg/kg fluoxetine) decreased the rats' choices of the larger, more delayed reinforcer. Cocaine can decrease rats' self-control.     

Oral self-administration of etonitazene in rhesus monkeys: Use of a fading procedure to establish etonitazene as a reinforcer

The establishment of orally delivered etonitazene (a potent opioid) as a reinforcer, was studied in eight rhesus monkeys. Initially, when given concurrent access to 2.5 μg/ml etonitazene and the water vehicle, five of the monkeys rejected the drug, whereas the other three monkeys consumed more drug solution than water. The five monkeys that rejected the drug solution underwent an acquisition phase to establish the drug as a reinforcer. A fading procedure was used to transfer control of responding from a 2% (wt/vol) ethanol solution to a 2.5 μg/ml etonitazene solution. Initially, responding was maintained by contingent deliveries of 2% ethanol. Next, across blocks of six or more sessions, increasing amounts of etonitazene were added in steps to the 2% ethanol solution. Subsequently, the 2% ethanol solution was decreased in steps to zero, leaving only the 2.5 μg/ml etonitazene present. When the fading procedure was completed, dose of etonitazene was varied by increasing the volume delivered, first under fixed ratio (FR 4) and then under an FR 8 reinforcement schedule. The same dose manipulations were made with the three monkeys who did not undergo the fading procedure because they preferred etonitazene over water when first tested. Etonitazene was established as a reinforcer for six of the eight monkeys because drug deliveries exceeded vehicle deliveries across a range of drug doses.     

Facilitation of stimulus detection performance of rats with d-amphetamine: a function of dose and level of training

 Conditions under which amphetamine may facilitate stimulus detection task choice performance in rats were investigated. Rats (n=15) were trained in a two-choice, light-detection task to three successively more stringent criterion levels of task training (minimal, intermediate, and extended) and then tested after administration of saline, 0.25, 0.50, and 0.75 mg/kg d-amphetamine (AMP). For each training level, baseline levels of choice accuracy were maintained at approximately 82% by manipulating the animals’ cue duration. No aspect of performance was enhanced by any dose of AMP after minimal criteria training, and there was a dose-dependent decrease in the number of trials completed. After the intermediate level of training, the 0.25 mg/kg dose of AMP reliably increased choice accuracy, there was no reliable change in choice reaction time, and there was a dose-dependent decrease in the number of trials completed. After the extended training, the 0.25 mg/kg dose of AMP reliably increased choice response accuracy, the 0.25 and 0.50 mg/kg doses of AMP reliably decreased choice reaction time, and there was no reliable change in the number of trials completed at any dose of AMP. These results support the contention that psychostimulants can facilitate the choice performance of rats in stimulus detection tasks if an appropriately low dose is used and the animal’s behavior is strongly controlled by the stimulus-reinforcement contingencies of the task. Received: 24 September 1997 / Final version: 9 May 1998     

分级诊疗背景下多病共存患者就医机构选择行为及其影响因素研究

背景 近年来,国内针对多病共存患者在分级诊疗背景下就医机构选择行为的研究较少,研究多病共存患者的就医机构选择行为有重要的现实意义。目的 以分级诊疗为视角,分析多病共存患者就医机构选择行为及其影响因素,为进一步落实分级诊疗制度和合理配置医疗资源提供研究参考。方法 采用随机抽样法,选取2019-06-01至2020-01-01在上海市杨浦区中心医院医疗联合体（上海市杨浦区中心医院和上海市杨浦区定海、延吉、长白社区卫生服务中心）就诊的多病共存患者为研究对象。采用自设问卷对其进行调查,收集多病共存患者的一般资料,了解其对分级诊疗政策的认知情况及实际遵守情况、在不同疾病控制状况下至社区卫生服务中心首诊的意愿,以及其选择就诊医疗机构时考虑的因素等。采用二分类Logistic回归分析多病共存患者此次因病就医是否选择至社区卫生服务中心首诊的影响因素。结果 共发放1 100份问卷,回收有效问卷1 072份,有效问卷回收率为97.45%。1 072例多病共存患者中,老年（≥60岁）多病共存患者占85.07%(912/1 072)。624例（58.21%）患者表示知晓分级诊疗制度;940例（87.69%）患...     

胰腺假性囊肿治疗方法的选择

该文报告２３例胰腺假性囊肿,根据病期、囊肿大小、部位选择治疗方法,其中非手术治疗５例,外引流１例,内引流１４例,囊肿切除术３例。结果：无手术死亡,非手术治愈５例,外引流术后胰瘘１例,囊肿切除术后复发１例,内引流术后无严重并发症出现。我们认为急性囊肿应观察６周,有些病例有自行消散的可能,慢性囊肿一经确诊即可行内引流治疗,内引流是目前较理想的有效手术方式     

Factors that influence infertile couples’ selection of reproductive medicine centers---A cross-sectional questionnaire study

ObjectiveThe number of infertile women undergoing in vitro fertilization (IVF) cycles has increased annually. Due to this competitive environment, we designed a questionnaire and aimed to investigate factors affecting the choice of reproductive medicine center among infertile couples.Materials and methodsThis was a retrospective cross-sectional study that analyzed questionnaires provided by the reproductive medicine center of the Kaohsiung Veterans General Hospital from January 2018 to June 2018. In the questionnaire, there are six categories (environment and equipment, service quality, patient safety, medical quality, information acquisition channel and other) and 36 items. The identified factors were scored and then weighted using principal component analysis.ResultsMost of the 100 identified infertile women were aged 31–35 years, were married 1–3 years, and had a university education level. In the weight analysis, “Clean outpatient clinic and medical equipment” had the greatest weight in the dimension of environment and equipment. The item with the greatest weight in the dimension of service quality was “Waiting time for registration, charging, and receiving medicine”. In the dimension of patient safety, “Privacy is highly respected by medical personnel” had the highest weight. The item with the greatest weight in the dimension of medical quality was “Success rate of reproductive medicine center”. The three items with the highest weights in the dimension of information acquisition channel were “Newspapers and magazines”, “TV media”, and “Facebook page and website of our hospital”. In the other dimensions, the two with the greatest weights were “Reputation of the hospital” and “Reputation of physicians”.ConclusionIn the infertile couples' view, optimal reproductive medicine centers should have a high success rate and great reputation on the internet and in mass media. Additionally, a short waiting time and high levels of privacy and confidentiality are also imperative.     

Improving secure messaging: A framework for support,partnership & information-giving communicating electronically (SPICE)

BackgroundPatient-centered communication benefits patients and is widely endorsed. However, it is primarily associated with face-to-face contexts, although patients are increasingly using electronic platforms, such as secure messaging in patient portals, to communicate with providers.PurposeGiven the popularity of secure messaging and its ability to impact the patient-provider relationship, this study aimed to determine which attributes of patient-centered communication are most desired by cancer patients using secure messaging.MethodsA 2⁶ balanced incomplete block design discrete choice experiment was conducted using the best-worst scaling technique. Respondents were asked to select their most and least preferred attributes of two simulated patient-provider exchanges within each of eight choice sets.Results210 respondents indicated that either level of partnership (high and low) and either level of information-giving (high and low) were most preferred, while response times greater than 24 hours and low levels of support were least favored.ConclusionsSimilar to face-to-face communication, patients value aspects of patient-centered communication in the secure messaging setting and desire them to be included in provider replies.Practice ImplicationsPatient-centered communication is important to patients using secure messaging. Providers should incorporate SPICE (Support, Partnership, and Information-giving while Communicating Electronically).     

肌内效贴配合振动疗法对老年膝骨性关节炎患者疗效观察

目的 探讨肌内效贴配合振动疗法改善老年膝骨性关节炎患者下肢反应时及关节屈伸肌群峰力矩的临床疗效.方法 入选患者随机分为肌内效贴配合振动疗法＋常规局部理疗组（治疗组）及常规局部理疗组（对照组）各20例.在入选时及4w治疗结束时对两组患者的下肢反应时（choice stepping reaction time,CSRT）及下肢关节膝屈伸肌群等速向心峰力矩（peak torque,PT）,同时了解治疗的过敏性与安全性情况.结果 （1）患者的一般基线情况具有可比性,治疗前各项评分两组组间没有明显差异;（2）治疗前后组间比较患者向前、向后的CRST比较均有显著性差异（P＜0.01）;（3）治疗前后组间比较患者的屈、伸肌群PT有显著性差异（P＜0.05）;（4）治疗组组内前后CSRT及PT比较具有显著性差异（P＜0.01）,而对照组无明显差异（P＞0.05）.结论 肌内效贴配合振动疗法可改善老年膝骨性关节炎患者下肢反应时与下肢力量.