Rethinking safety behaviors in insomnia: examining the perceived utility of sleep-related safety behaviors

Harvey's cognitive model of insomnia (2002a) proposes that sleep-related safety behaviors play a central role in the maintenance of insomnia because such maladaptive coping strategies are thought to reinforce threat-based appraisals of the likelihood and consequences of poor sleep. Research to date has assessed the frequency of safety behavior use in those with insomnia only; however, in addition to the frequency of occurrence, the function of safety behaviors (i.e., a belief that they will prevent a feared outcome from occurring), may be an important consideration. The purpose of this study was to examine sleep-related safety behaviors based on an expanded theoretical understanding of such behaviors across psychological disorders; that is, by examining both their frequency and perceived utility. Undergraduate students (N = 376) completed an online survey about their sleep, mood, and use of sleep-related safety behaviors. Insomnia severity was associated with a greater perceived need to use safety behaviors (i.e., utility) but not with frequency of safety behavior use. Higher perceived utility of safety behaviors was also associated with unhelpful beliefs about sleep, fear and avoidance of fatigue, and both general and sleep-specific helplessness. These results suggest that these behaviors and the associated underlying maladaptive beliefs may be important targets in cognitive behavioral therapy for insomnia. The current study extends the existing literature and refines the concept of safety behaviors in insomnia to include both the function and frequency of these behaviors.     

Functional analysis and treatment of human-directed undesirable behavior exhibited by a captive chimpanzee

A functional analysis identified the reinforcer maintaining feces throwing and spitting exhibited by a captive adult chimpanzee (Pan troglodytes). The implementation of a function-based treatment combining extinction with differential reinforcement of an alternate behavior decreased levels of inappropriate behavior. These findings further demonstrate the utility of function-based approaches to assess and treat behavior problems exhibited by captive animals.     

The effects of prompting and reinforcement on safe behavior of bicycle and motorcycle riders

A reversal design was used to evaluate the effects of vocal and written prompts as well as reinforcement on safe behavior (dismounting and walking bicycles or motorcycles on a sidewalk) on a university campus. Results indicated that an intervention that consisted of vocal and written prompts and reinforcement delivered by security guards was effective at increasing safe behavior exhibited by bicycle and motorcycle riders. No differences were observed between vehicle type or gender with regard to engagement in safe behavior.     

The effects of a rectangular rapid-flashing beacon on vehicle speed

In 2008, nearly 31% of vehicle fatalities were related to failure to adhere to safe vehicle speeds (National Highway Traffic Safety Administration [NHTSA], 2009). The current study evaluated the effect of a rectangular rapid-flashing beacon (RRFB) triggered by excessive speed on vehicle speed using a combined alternating treatments and reversal design. The percentage of vehicles traveling above 41 mph (66 km per hour) decreased by 20%, and speed distributions showed a shift toward lower speeds during the RRFB condition.     

Right‐wing authoritarianism,Big Five and perceived threat to safety

Using structural equations modelling, we performed a secondary analysis of the data collected by the Italian Observatory of the North West (Italian national sample, N = 976) to investigate the direct, mediated and moderated relations connecting the Big Five personality factors and perceived personal and societal threat to safety with right‐wing authoritarianism (RWA). Openness, Conscientiousness and perceived societal threat to safety exerted additive effects on RWA; the relation between Openness and RWA was partially mediated by societal threat to safety and that between societal threat to safety and RWA was moderated by Openness. Limitations and possible developments of this research are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

甲状腺癌的诊治原则

甲状腺癌是内分泌系统最常见的恶性肿瘤,它的发病率正逐年增加,其诊断方法包括体格检查、超声检查、细针穿刺、影像学检查及实验室检查等,甲状腺癌的治疗以外科手术为主,对较晚期或远处转移的患者可行综合治疗(I131,放疗,化疗)。总之,甲状腺癌经合理治疗,可获得较好的预后。     

抗血管生成靶向药物相关性高血压

高血压是抗血管生成靶向药物最常见的副作用之一,其机制和管理受到重视。本文就靶向药物导致高血压的机制进行了探讨,考虑可能与抗血管生成药物的作用靶点有关,即影响了血管内皮生长因子的功能所致;介绍临床如何进行高血压管理并建议在抗血管生成靶向药物使用过程中规范地监测、控制血压,开展相关研究。     

放射科工作流程重组期间医务人员工作负荷的实验研究

通过对放射科实施工作流程重组期间医务人员工作负荷的研究分析,发现工作流程重组在提高工作效率的同时,也不可避免地增加医务人员工作负荷。只有运用针对性的措施,有效减轻工作负荷压力,才能保障工作流程重组顺利进行。     

甲型H1N1流感普通型与重症型的处理

本文回顾性总结历史上几次世界性甲型流感流行和2009年H1N1流感流行情况。概述了2009年H1N1流感普通型病例的临床处理。重点阐述2009年H1N1流感重症型病例的高危人群、发生的危险因素以及临床表现。特别强调重症型流感抗病毒治疗的重要性及适应证。同时提醒关注神经氨酸酶抑制剂应用的耐药问题。     

心脑血管疾病患者高血糖的管理

糖尿病是心脑血管疾病的主要危险因素,血糖控制不佳会加重此类患者的病情,影响其预后,因此,急慢性心脑血管疾病患者的高血糖要积极处理。在血糖控制过程中,要综合考虑患者的病情,选择安全、有效的降糖方案,避免低血糖和药物的副作用。本文就心脑血管疾病患者高血糖的管理进行了总结。