Contingency management is effective across cocaine-dependent outpatients with different socioeconomic status

Contingency management (CM) has demonstrated its efficacy for treating cocaine dependence, but there is still some controversy with regard to its dissemination. Understanding how individual differences affect CM outcomes is important for detecting barriers to its dissemination. The aim of this study is to examine the impact of socioeconomic variables in cocaine-dependent outpatients on the effectiveness of CM in a community setting. Cocaine-dependent outpatients (N = 118) were randomized to community reinforcement approach (CRA) treatment or a CRA plus vouchers program. The impact of baseline economic variables, alone and in combination with treatment conditions, on abstinence and retention outcomes after 6 months of treatment was assessed. Results showed that income had no effect on retention or abstinence outcomes after 6 months of treatment in either treatment condition. The addition of a CM component was beneficial for individuals with any socioeconomic status. These results support the generalizability of CM strategies with patients of different socioeconomic status in community settings.     

SAPHO Syndrome: Current Developments and Approaches to Clinical Treatment

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare autoimmune disease which, due to its clinical presentation and symptoms, is often misdiagnosed and unrecognized. Its main features are prominent inflammatory cutaneous and articular manifestations. Treatments with immunosuppressive drugs have been used for the management of SAPHO with variable results. To date, the use of anti-TNF-α agents has proved to be an effective alternative to conventional treatment for unresponsive or refractory SAPHO cases. TNF-α is a pro-inflammatory cytokine and pivotal regulator of other cytokines, including IL-1 β, IL-6, and IL-8, involved in inflammation, acute-phase response induction, and chemotaxis. IL-1 inhibition strategies with anakinra have shown efficacy as first and second lines of treatment. In this review, we will describe the main characteristics of biological drugs currently used for SAPHO syndrome. We also describe some of the promising therapeutic effects of ustekinumab, an antibody against the p40 subunit of IL-12 and IL-23, after failure of multiple drugs including anti-TNF-α and anakinra. We discuss the use and impact of the new anti-IL-1 antagonists involved in the IL-17 blockade, in particular for the most difficult-to-treat SAPHO cases.     

Using Data-Driven,Video-Based Early Childhood Consultation with Teachers to Reduce Children’s Challenging Behaviors and Improve Engagement in Preschool Classrooms

Consultation to teachers can be an effective intervention for reducing young children’s challenging behaviors within the classroom, yet there is a need for more efficient approaches that provide data-driven, video-based support to enhance and expand teacher and child impacts. This paper focuses on a newly developed early childhood consultation model, called Learning to Objectively Observe Kids (LOOK), which involves the use of data from validated measures about children, and video-based feedback, to guide teachers’ selection and implementation of behavioral strategies. Results from a small randomized controlled trial demonstrate LOOK impacts on teachers’ use of social–emotional teaching strategies and self-efficacy, as well as children’s positive and negative engagement with teachers, peers, and learning activities in preschool classrooms.