Development of a Behavioral Activation–Based Intervention for Cigarette-Smoking Young Adults

Quitting smoking during young adulthood can substantially reduce tobacco-related morbidity and mortality later in life. Depressive symptomatology is prevalent among smokers and increases risk for poor smoking cessation outcomes. However, few integrated behavioral interventions simultaneously target smoking and depressive symptoms and rarely have young smokers been included in the development of these interventions. In this paper we describe an 8-session behavioral activation–based treatment for smoking (BATS; MacPherson et al., 2010) adapted for youth. We conducted a series of focus groups with young adult smokers with depressive symptoms in order to modify treatment manuals to be developmentally appropriate. Subsequently, we completed a small pilot group (n = 5) of the intervention to provide preliminary data on feasibility, acceptability, and outcomes. We provide a case series of the participants in order to provide clinical illustrations of how the modified BATS treatment was implemented among young adults. Most pilot study participants exhibited smoking abstinence and smoking reductions at the end of treatment, as well as improvement in depressive symptoms and maintenance of levels of activation and environmental reward. Participants provided positive qualitative constructive feedback regarding the intervention.     

Adverse childhood experiences and autonomic regulation in response to acute stress: the role of the sympathetic and parasympathetic nervous systems

Background and objectives: After a previous report demonstrated blunted heart rate (HR) reactivity in association with adverse childhood experiences (ACEs) [Voellmin, A., Winzeler, K., Hug, E., Wilhelm, F. H., Schaefer, V., Gaab, J.,?…?Bader, K. (2015). Blunted endocrine and cardiovascular reactivity in young healthy women reporting a history of childhood adversity. Psychoneuroendocrinology, 51, 58–67. doi:10.1016/j.psyneuen.2014.09.008], the present analysis aimed at clarifying the role of the sympathetic and parasympathetic branches of the autonomic nervous system in this relationship.

Design and Methods: One hundred eighteen healthy young women provided data on ACEs and underwent psychosocial stress testing. Systolic blood pressure (SBP) and respiratory sinus arrhythmia (RSA, quantified by high-frequency HR variability) were assessed as measures of sympathetic and parasympathetic cardiovascular activity, respectively. A mediation model was calculated to test the indirect effects of ACEs on HR via SBP and RSA.

Results: The effect of ACEs on HR reactivity was mediated by SBP reactivity but not by RSA reactivity. ACEs were associated with reduced SBP at rest.

Conclusions: ACEs were associated with down-regulation in a measure of sympathetic but no alteration in a measure of parasympathetic cardiovascular stress reactivity in adulthood. Future research will need to clarify whether this indicates risk or resilience.     

胰头癌外科治疗体会

总结提高胰头癌手术切除率、手术技巧和治疗效果的经验。回顾性分析自2003年9月起收治的39例胰头癌病人的临床资料,术中采用解剖性探查、蚊式钳勾划技术,对36例病人全部一次性行胰十二指肠切除术(PD)。手术切除率92.31%,剥离出的癌灶侵犯血管壁的断缘组织中镜下见到癌细胞25.93%,淋巴结转移率47.22%;胰周神经节、丛侵犯率55.56%,并发症发生率25.00%。解剖性探查、蚊式钳勾划技术的应用显著提高胰十二指肠切除率。     

Multiple and concurrent schedule performance: independence from concurrent and successive schedule contexts

Six pigeons were trained on multiple variable-interval schedules and performance was measured in the presence or absence of another variable-interval schedule (the common schedule) arranged concurrently with both components. Manipulations included varying the rate of reinforcement on the common schedule, leaving the common schedule unchanged while the components of the multiple schedule were varied, varying the multiple schedule components in the absence of the common schedule, and varying one component of the multiple schedule while the other component and the common schedule were unchanged. The normal rate-increasing and rate-decreasing effects of reinforcement rate increase were found, except that changing one multiple schedule component did not affect the response rate in the successively available common schedule component. Both concurrent and multiple schedule performance undermatched obtained reinforcement-rate ratios, but the degree of undermatching in multiple schedules was reliably greater. Allocation of responses between multiple schedule components was unaffected by the concurrent availability of reinforcement, and allocation of responses between concurrent schedules was unaffected by the successive availability of different reinforcement rates.     

Effects of an audio cueing system on the rate of teacher praise

The effects of automated cueing on teacher praise rate was investigated in one special, one fourth-, and one seventh-grade classroom. After establishing baseline praise rates in each of the three classrooms, two methods for increasing teacher praise rate were introduced according to a multiple-baseline design. During the first phase, two teachers were instructed to count and graph their praise rate during each session. All teachers received auditory cues to prompt praising during another phase. In all cases, introduction of cues markedly increased teacher praise rates, but self-recording was relatively ineffective. An analysis of teacher-praise distributions showed that cues closely controlled teacher praise for two of the three teachers.     

Facilitation of human tobacco self-administration by ethanol: a behavioral analysis.

The effect of ethanol on the cigarette smoking of alcoholic subjects was studied in a residential laboratory. During daily 6-hr sessions, cigarettes were obtained either by request to the ward staff or by operation of a lever (fixed-ratio 5 or 10). In a mixed sequence across days, sessions involved ingestion of either vehicle (orange juice or vehicle plus ethanol (133.7 g). During ethanol sessions, the rate of cigarette smoking increased from 26% to 117% of vehicle levels. A series of control studies eliminated a number of potential behavorial mechanisms for the observed effect and indicated that the ethanol-induced increase in cigarette smoking occurred under a variety of experimental conditions: (1) when smoking could not occur concurrently with ethanol or vehicle consumption; (2) when subjects were not allowed to socialize; (3) when ingestion of ethanol or vehicle was scheduled for a number of consecutive days; (4) when various doses of ethanol were administered under blind conditions. In control experiments, weighing unsmoked tobacco and counting the number of puffs per cigarette indicated the effect was not due to smoking less of each cigarette. The effect was not limited to the experimental sessions alone, since total daily smoking was higher on ethanol days than vehicle days.     

吉林省医务人员吸烟现况及知识态度分析

为了更好地了解吉林省医务人员的吸烟状况,为进一步开展控烟工作提供科学依据,对吉林省50家医疗机构的3787名医务人员进行问卷调查,调查结果显示,男性医务人员吸烟率较高;医务人员对烟草危害认识不全面,控烟意识较为薄弱.应加强对医务人员烟害知识等方面的培训,以改变其吸烟行为、提高控烟责任意识.     

Repressive coping style and autonomic reactions to two experimental stressors in healthy men and women

Autonomic and affective responses to two different stress tasks were measured in 45 males and 74 females, categorized as repressive, true low-anxious, true high-anxious, and defensive high-anxious. Electrodermal activity (EDA) was used as a measure of sympathetic activity and the high frequency (HF) spectral component of heart rate variability as a measure of parasympathetic activity. Contrary to our predictions, reactivity of repressors did not differ from the reactivity of true low-anxious participants. The results draw attention to previous inconsistent findings within the literature on repressive coping style and autonomic nervous system dysregulation. It is suggested that future research could benefit from the use of more consistent operationalizations of the repressive coping construct and from comparing alternative measures of repressive coping within the same study.     

Frequency and pattern of voluntary pedalling is influenced after one week of heavy strength training

Changes in voluntary rhythmic leg movement characteristics of freely chosen cadence (reflecting movement frequency) and tangential pedal force profile (reflecting movement pattern) were investigated during 4 weeks of (i) heavy hip extension strength training (HET, n = 9), (ii) heavy hip flexion strength training (HFT, n = 9), and (iii) no intervention (CON, n = 9). Training consisted of three 5RM–10RM sets per session, with two sessions/week. Submaximal ergometer cycling was performed before the training period (pretest) and after every week of training (test A1, A2, A3, and posttest). Strength increased by on average 25% in HET and 33% in HFT. Freely chosen cadence was only changed in HET, occurring already after 1 week of training. Thus, percentage reductions of cadence in HET at test A1, A2, A3, and posttest, with respect to the pretest value, amounted for maximally on average 17%, or 14 rpm, and were larger than the corresponding changes in CON (p = .037). Percentage increases in minimum tangential pedal force in HET at test A1, A2, A3, and posttest, with respect to the pretest value, were larger than the corresponding changes in CON (p = .024). Heavy hip flexion strength training did not cause such alterations.     

Tensile properties of precracked tempered martensitic steel specimens tested at ultralow strain rates in high-pressure hydrogen atmosphere

Tensile tests were performed on precracked Cr–Mo martensitic steel (C: 0.38, Si: 0.22, Mn: 0.84, P: 0.024, S: 0.021, Ni: 0.08, Cr: 1.11, Mo: 0.15, Cu: 0.12, Fe: bal. (wt%)) specimens at various strain rates (ranging from 6.5 × 10^?8 s^?1 to 1.0 × 10^?4 s^?1) in high-pressure (95 MPa) hydrogen and helium atmospheres. Irrespective of the strain rate, the tensile strength in the helium atmosphere was 1400 MPa. In the hydrogen atmosphere, the tensile strength decreased to less than 600 MPa at a strain rate of 2.0 × 10^?5 s^?1. However, the tensile strength increased to 900 MPa when the strain rate was decreased to 6.5 × 10^?8 s^?1. This recovery of the tensile strength was because of the decrease in the local stress in the vicinity of the precrack because of hydrogen.